The journal of nutrition, health & aging

, Volume 23, Issue 10, pp 1021–1025 | Cite as

Burden of Oral Symptoms and Health-Related Quality of Life in Long-Term Care Settings in Helsinki, Finland

  • Riitta K. T. SaarelaEmail author
  • N. M. Savikko
  • H. Soini
  • S. Muurinen
  • M. H. Suominen
  • H. Kautiainen
  • K. H. Pitkala



Poor oral health may complicate eating and deteriorate nutritional status. However, little is known about how the burden of oral symptoms (OS) is associated with the health-related quality of life (HRQoL) of vulnerable older people in institutional settings. This study explores how the burden of certain OS (chewing problems, swallowing difficulties, dry mouth) is associated with functioning, morbidity, nutritional status and eating habits. It also examines the association between the OS burden and HRQoL.


A cross-sectional study in 2017.


All long-term care wards in Helsinki, Finland.


2401 older residents (74% females, mean age 83.9).


Nurses assessed the residents and completed questionnaires on the participants’ demographics, functional status, diagnoses, OS and eating habits. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and HRQoL with a 15-dimensional instrument (15D).


Of the residents, 25.4% had one OS and 16.6% two or three OS. OS burden was associated linearly with poorer cognitive and physical functioning and a higher number of comorbidities, edentulousness without dentures, and less frequent teeth brushing/denture cleaning. OS burden was also associated with malnutrition, lower BMI and eating less during main meals. In the multivariate analyses adjusted for various confounding factors, a higher number of OS was associated with lower HRQoL. OS burden correlated with nearly all dimensions of HRQoL.


Oral symptoms are associated with generic HRQoL. Therefore, OS should be regularly assessed and managed in daily care.

Key words

dry mouth chewing problems swallowing difficulty health-related quality of life nursing home 


Conflict of interest: None.

Ethical standards: The local ethics committee of Helsinki University Hospital and the City of Helsinki approved the study.


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Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • Riitta K. T. Saarela
    • 1
    Email author
  • N. M. Savikko
    • 2
    • 3
  • H. Soini
    • 4
  • S. Muurinen
    • 3
  • M. H. Suominen
    • 3
  • H. Kautiainen
    • 3
  • K. H. Pitkala
    • 3
    • 5
  1. 1.City of Helsinki, Department of Social Services and Health CareOral Health CareCity of HelsinkiFinland
  2. 2.City of Espoo, Elderly CareEspooFinland
  3. 3.Department of General Practice and Primary Health CareUniversity of HelsinkiHelsinkiFinland
  4. 4.City of Helsinki, Department of Social Services and Health Care, Developmental and Operational SupportHelsinkiFinland
  5. 5.Helsinki University Hospital, Unit of Primary Health CareHelsinkiFinland

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