Objectives: To identify different clusters of health-related behaviours and examine whether these clusters are associated with maintaining 20 or more teeth.
Background: Engaging in risky behaviours impacts tooth loss, particularly among older adults. Maintaining 20 teeth is a challenge for this age group. The co-occurrence of health-risk behaviours is common and has been linked to an increased risk of multiple chronic diseases, including tooth loss.
Material and methods: A cross-sectional analysis of wave 7 of the English Longitudinal Study of Ageing (ELSA) was conducted. Functional dentition was self-reported as having 20 or more teeth. Four health-related behaviours (smoking, alcohol intake, fruit and vegetable consumption, and physical activity) were analysed to investigate their association with functional dentition. Demographic characteristics (sex, age, ethnicity) and socioeconomic factors (education, wealth) were included as covariates. Latent Class Analysis (LCA) was conducted using four dichotomised behaviour variables to identify clusters of behaviours. Logistic regression modelling was used to examine the association between clusters of health-related behaviours and functional dentition. The model was adjusted for demographic and socioeconomic factors.
Results: A total of 7783 participants were included. The LCA model identified three clusters: (1) risky, (2) moderate and (3) healthy. In the fully adjusted logistic regression model, the odds of having a functional dentition were 1.42 higher among those in the moderate cluster (95% CI: 1.23, 1.65), and 1.70 higher among those in the healthy cluster (95% CI: 1.39, 2.09) than for participants in the risky cluster.
Conclusion: Risky behaviours tend to cluster among older adults. Engaging in multiple risky behaviours is associated with having fewer than 20 teeth. Initiatives and public health campaigns that focus on these clustering patterns, as well as the underlying factors, could benefit both oral and general health.
Keywords: adult; dentition; health behaviour; social factors; tooth loss.
© 2025 The Author(s). Gerodontology published by Gerodontology Association and John Wiley & Sons Ltd.