AN INQUIRY INTO THE IMPACT OF ORAL HEALTH ON THE QUALITY OF LIFE OF ELDERLY INDIVIDUALS IN LAGOS, NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The mouth cavity functions as the main gateway to the body, and any elements that affect dental health can also have consequences for general health (Nyong, 2022). Oral health encompasses the state of the mouth, teeth, and facial structures, enabling humans to perform essential activities such as eating, breathing, and speaking. It encompasses psychological factors like as confidence, general well-being, and the capacity to engage in social interactions and employment without encountering pain, discomfort, or shame. Oral health experiences alterations throughout an individual's lifespan, commencing from birth and persisting into old age. It is intricately linked to one's total well-being and plays a pivotal role in empowering individuals to actively participate in society and achieve their maximum capabilities (WHO, 2023).

Nigeria now has a population of over 5 million senior individuals, making it the biggest concentration of elderly people in West Africa. According to Amadi (2020), the senior population is estimated to reach 16 million by 2030 and 47 million by 2060. The senior population has a significantly high occurrence of periodontal disorders, with a prevalence rate of around 90.8% for gingivitis and 75.4% for periodontitis (Bayo et al., 2020).  The oral cavity, akin to all other bodily regions, serves as a mirror of the aged population's overall health and well-being, given that dental ailments exert influence on numerous facets of general health. Up to 50.0% of deaths caused by the top 10 major causes of death in senior individuals in Nigeria and other Sub-Saharan African countries can be attributed to lifestyle factors such as lack of physical activity and inadequate dental hygiene (Shoibowalw et al., 2022). Consequently, it is crucial to examine the interaction between oral disorders and ageing, as well as the effect of these diseases on the elderly's quality of life.

The World Health Organisation (2022) defines quality of life as an individual's subjective assessment of their overall well-being, taking into account their social, cultural, and personal circumstances, as well as their aspirations, expectations, and worries. According to Ademiluyi (2023), commonly used measures to assess the quality of life encompass factors such as economic prosperity, employment, environmental conditions, physical and mental well-being, education, opportunities for leisure and recreation, social integration, religious convictions, and the presence of safety, security, and personal freedom. The concept of quality of life encompasses various domains, such as international development, healthcare, politics, and employment (Olusanya, 2022). Health-related quality of life refers to the assessment of an individual's overall well-being and how it is influenced by their health status (Meshach, 2019). Oral health-related quality of life is a complex concept that encompasses multiple dimensions. The state of one's oral health significantly affects an individual's daily activities, state of being, and overall life satisfaction. The senior population is susceptible to several dental issues, including dental caries and periodontal disease, which are the primary oral health concerns globally. These two diseases exhibit a high prevalence rate, extensive geographical distribution, varying degrees of severity, and pose significant public health issues for the aged population in Nigeria and worldwide (Amadi, 2020).

According to Wole (2021), oral health is an essential component of overall health and quality of life, especially for older adults. As individuals grow older, they become more vulnerable to oral health issues, which can have a substantial influence on their everyday functioning, including their capacity to eat, communicate, and engage in social activities. Son et al. (2021) have demonstrated that inadequate oral health can cause substantial declines in quality of life, especially among older individuals. Tooth loss, gum disease, and oral infections are common problems that can result in pain, discomfort, and challenges with eating and speaking (Ming et al., 2018). Research indicates that older individuals frequently face restricted availability of dental services as a result of financial limitations, difficulties with transportation, and a scarcity of specialised healthcare options (Adebiyi et al., 2020). This study examines the influence of dental health on the quality of life of older adults in Lagos, Nigeria. Lagos, being a vibrant urban region, poses distinctive difficulties and prospects in the realm of healthcare provision. The geriatric population in Lagos is seeing an increase, leading to a corresponding demand for specialised healthcare services, such as dental treatment (Egbadon et al., 2021). This study aims to emphasise the unique difficulties encountered by the population in Lagos and the wider consequences for public health. Therefore, the necessity for doing this investigation arises.

1.2 Statement of the problem

The well-being of older persons is greatly impacted by their general health, which included oral health as well (Okuku, 2022). Lagos, Nigeria is experiencing an increasing number of older individuals, who encounter significant difficulties in maintaining optimal dental hygiene. Although oral health is crucial for general well-being, there is a lack of study on the impact of dental disorders on the daily lives and quality of life of senior adults in this area.

The geriatric population frequently has a range of oral health problems, including tooth loss, gum disease, and oral infections. These conditions can result in pain, discomfort, and challenges in activities such as eating, speaking, and social interaction (Charles et al., 2021). These issues can have a negative impact on their physical well-being, mental state, and social relationships. In addition, Olamide et al. (2020) assert that the elderly typically face insufficient access to dental care services as a result of budgetary limitations, mobility challenges, and a scarcity of specialised treatments that cater to their specific requirements.

Bamidele (2023) argues that older persons, who are seeing a significant growth in numbers, are more likely to retain their teeth but also face higher risks of oral diseases. However, these individuals are often not adequately represented in epidemiological studies that focus on the whole population. According to Onuoha (2023), it is necessary to prioritise the oral health of older persons and incorporate oral health evaluations and guidance from dental experts into the interdisciplinary discourse. Moreover, it is crucial to create standardised tools for evaluating oral health in older individuals. Additionally, there should be a stronger emphasis on collaboration between different healthcare professionals and the implementation of care plans that prioritise the maintenance of daily oral hygiene and the prevention of oral diseases. These efforts aim to enhance overall health and well-being (Ebenezer, 2023). Considering the crucial importance of oral health in preserving the overall well-being and the unique difficulties encountered by older adults in Lagos, it is imperative to do a thorough investigation into this matter. Gaining a comprehensive understanding of how oral health affects the daily lives of individuals will offer useful insights into the magnitude of the issue. This knowledge will then guide the creation of focused interventions and policies with the goal of enhancing oral health care for the aged population. Therefore, the necessity for doing this investigation arises.

Objectives of the study

The primary objective of this study is to critically investigate the impact of oral health on the quality of life of elderly individuals in Lagos, Nigeria. Specific objectives of this study are to:

To examine the factors associated with oral health-related quality of life among elderly individuals.

To identify the impact of oral health disease on the overall quality of life among elderly individuals.

To identify the barriers to access and utilization of dental services among elderly individuals in Lagos, Nigeria

To offer strategies for improving oral health promotion, access to dental care services, and quality of life for elderly individuals in Lagos, Nigeria.

1.4 Research Questions

The following research questions will be answered in this study:

What are the factors associated with oral health-related quality of life among elderly individuals in Lagos?

What is the impact of oral health disease on the overall quality of life among elderly individuals in Lagos?

What are the barriers to access and utilization of dental services among elderly individuals in Lagos, Nigeria?

What are the strategies for improving oral health promotion, access to dental care services, and quality of life for elderly individuals in Lagos, Nigeria?

1.5 Research Hypotheses

The following research hypotheses are formulated to guide the study:

Ho: There is no significant impact of oral health disease on the overall quality of life among elderly individuals in Lagos.

Ha: There is significant impact of oral health disease on the overall quality of life among elderly individuals in Lagos.

1.6 Significance of the study

This work not only fills a notable void in oral health research pertaining to the elderly, but also carries implications for healthcare policy, interventions, and community education efforts targeted at enhancing the well-being of this susceptible population in Lagos, Nigeria.

Furthermore, oral health is frequently disregarded in geriatric healthcare, despite its significant consequences. This study highlights the significance of giving priority to oral health care as part of the overall healthcare routine for the senior population, which could potentially impact healthcare policies and practices. The study's findings can help increase awareness among senior folks and healthcare practitioners regarding the significance of maintaining dental health to enhance quality of life. Utilising local research findings in education can result in improved oral health practices and outcomes.

Moroever, the study can provide valuable insights to policy makers and healthcare practitioners regarding the necessity of incorporating comprehensive oral health services into geriatric healthcare programmes. It can promote policies that endorse proactive oral health care and facilitate the availability of dental services for senior persons in Lagos and comparable metropolitan environments. 

In addition, future academics will employ it as a comprehensive analysis of the existing scholarly literature. Therefore, individuals who have a deep passion for this area of study can rely on this work as a trustworthy and rigorously assessed source of information.

1.7 Scope of the study

Broadly, this study focus is to critically investigate the impact of oral health on the quality of life of elderly individuals in Lagos, Nigeria. Specifically, this study seeks examine factors associated with oral health-related quality of life among elderly individuals in Nigeria and identify the impact of oral health disease on the overall quality of life among elderly individuals in Nigeria.

Further, this study will focus on identify barriers to access and utilization of dental services among elderly individuals in Nigeria and it also seeks offer strategies for improving oral health promotion, access to dental care services, and quality of life for elderly individuals in Nigeria.

The study is carried out in Lagos, Nigeria.

1.8 Limitations of the study

As with any human undertaking, the researchers faced various minor restrictions during the investigation. The main restriction was the lack of significant literature on the subject, due to the restricted availability of data regarding an inquiry into the impact of oral health on the quality of life of elderly individuals in Lagos, Nigeria. Hence, a large allocation of time and labour was necessary to ascertain the proper materials, books, or information and gather data. 

Furthermore, this study is hampered by its small sample size and narrow geographical reach, focused primarily on Lagos, Nigeria. Therefore, the conclusions of this study cannot be applied to other scenarios, thus necessitating further inquiry. 

Moreover, the researcher's restrictions were primarily due to financial restraints, as they are a student without any source of money to sustain themselves. The excessive transportation costs at the research location, worsened by the prevalent inflation in Nigeria, provided a substantial obstacle in fulfilling the expenses related with transportation.

Furthermore, the researcher encountered a time constraint due to the requirement to complete this research while still completing the obligations of attending lectures and engaging in other educational activities.

1.9 Definition of terms

Oral health: Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment.

Oral disease (Dental Disorder): Oral diseases encompass a range of diseases and conditions that include dental caries, periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, noma and birth defects such as cleft lip and palate.

Quality of life: Quality of life is the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events.