Preferences for oral health states in a US community-dwelling functionally impaired older adult population: 2000-2001

Objectives: To determine whether and how much time in a state of ill oral health an older person would be willing to trade for optimal oral health. Methods: This is a cross-sectional observational study of 76 subjects (52 female, 24 male) ages 47-93 (mean 75.2) recruited from a Medicare demonstration. Subjects had to need or receive help with 2+ activities of daily living (ADLs) or 3+ instrumental ADLs plus had to have had recent significant healthcare services use. A Time Trade-Off (TTO) approach was used. TTO utility is defined as the amount of symptom-free time (i.e., the optimal oral health state) divided by the amount of time with symptoms (either their current oral health state or the worst imaginable oral health state, depending on the scenario), at the point of indifference (the point past which the person is unwilling to trade additional life expectancy). Results: When starting from their current oral health state, 39% of the subjects were willing to exchange time resulting in a shorter life with optimal oral health. They were willing to trade 14.0 months of life on average and valued each year in their current oral health state as 91% of a year in optimal oral health. When starting in the poorest oral health state, 79% of the subjects were willing to accept a shorter life. They were willing to trade 33.7 months of life on average, and valued the poorest state as worth 79% of a year in optimal oral health. Conclusions: Dentists should take into consideration this group's preference for optimal oral health.