SOCIOBEHAVIORAL DETERMINANTS OF TOOTH LOSS IN ELDERLY TRIBAL WOMEN: A MIXED METHODS STUDY

Background: Tooth loss significantly impacts quality of life, nutrition, and systemic health, disproportionately affecting vulnerable populations like elderly tribal women. While sociobehavioral factors are known determinants of oral health, their specific interplay within unique tribal contexts remains poorly understood.
Methods: A sequential explanatory mixed-methods design was employed. Quantitatively, a cross-sectional survey assessed sociodemographic characteristics, oral health behaviors, knowledge, attitudes, and clinical tooth loss (using WHO criteria) among 300 participants. Qualitatively, in-depth interviews explored lived experiences and contextual factors with a purposively selected subsample (n=20). Descriptive statistics, chi-square tests, t-tests, ANOVA, and logistic regression were used for quantitative analysis. Thematic analysis was applied to qualitative data.
Results: The mean age was 68.5 ± 6.2 years. The prevalence of tooth loss (≥1 tooth missing) was 92.7%, with a mean number of missing teeth of 14.8 ± 8.3. Significant associations were found between higher tooth loss and: lower education level (p<0.001), lower household income (p=0.002), lack of regular dental visits (p<0.001), use of traditional tooth cleaning methods (e.g., neem twig) alone (p=0.008), lower oral health knowledge scores (p<0.001), and negative attitudes towards dental care (p=0.001). Logistic regression identified low education (OR=3.85, 95% CI: 1.92-7.71), irregular dental visits (OR=4.12, 95% CI: 2.05-8.28), and low oral health knowledge (OR=2.67, 95% CI: 1.34-5.32) as independent predictors. Qualitative themes revealed barriers like geographic isolation, cultural beliefs prioritizing symptomatic care, financial constraints, distrust of formal healthcare, and the influence of traditional healers.
Conclusion: Tooth loss is extremely prevalent among elderly tribal women, driven by a complex interplay of socioeconomic disadvantage, limited access to care, low oral health literacy, cultural practices, and healthcare system distrust. Interventions must be culturally tailored, integrating community engagement, improving access, enhancing
health literacy, and respecting traditional practices while promoting evidence-based preventive care.