Contextual and individual determinants of oral health-related quality of life in older Brazilians Joa ˜o Gabriel Silva Souza 1 • Ba ´rbara Emanoele Costa Oliveira 1 • Andrea Maria Eleute ´rio De Barros Lima Martins 2 Accepted: 25 October 2016 Ó Springer International Publishing Switzerland 2016 Abstract Purpose This cross-sectional, population-based study evaluated contextual and individual determinants on the oral health-related quality of life in older Brazilians. Materials and methods Data from the National Survey of Oral Health were used. The sample was selected by multi- stage probability cluster sampling, with probability propor- tional to size. The Oral Impacts on Daily Performance (OIDP) was used to evaluate oral health-related quality of life (OHRQoL). Contextual variables of municipalities and individual variables of older people were included. Descrip- tive, bivariate and multilevel analyses were conducted. Results Of the sample of 7619 older Brazilians, 45.7% was impacted by at least one of the OIDP items. The item impact average was 1.2 (95% CI 1.04–1.37). The impact on OHR- QoL was lower in older Brazilians residents in municipalities with the highest value of the GINI index (contextual vari- able) (p = 0.007), among edentulous people (p = 0.001) and dental prosthesis users (p \ 0.001). This impact was greater among older people of nonwhite skin color (p = 0.024), lower family income (p = 0.024) and dissat- isfied with the oral health (p \ 0.001). Conclusion A high prevalence of oral problems impacting OHRQoL in older Brazilians was identified. Furthermore, the impact prevalence was related to a positive situation in contextual determinants and a negative situation for the individual, showing a social inequalities profile in relation to individual determinants. Keywords Quality of life Á Oral health Á Elderly Á Oral health-related quality of life Introduction The demographic transition has occurred in recent decades due to a decline in the birth rate, an increase in life expectancy, and health care improvement, generating a significant enhance in the population of older people in the world [1]. There is a concomitant increase in the preva- lence of chronic diseases [2], creating a negative impact on people’s quality of life [3]. Once oral health is part of overall health, it therefore is an essential part of quality of life [4, 5]. Evaluation of oral health has been often conducted from a focus on dental and/or oral clinical conditions (conducted by dentists, according to pre-established standards) [6]. Clinical conditions, however, do not indicate how people feel they are affected by their oral health condition [7]. It is noteworthy that prevalence of some oral problems, such as tooth loss [8], may increase with age, which could con- tribute to a negative impact on oral health-related quality of life (OHRQoL). OHRQoL has been described as the impact of oral dis- orders on people’s everyday lives that have sufficient magnitude to affect the experience and perception of life as a whole in terms of frequency, severity, and duration [9]. Systematic reviews of the literature have demonstrated the negative impact of oral problems on people’s quality of life [10, 11]. Clinical trials, such as those carried out in Spain [12] and Japan [13], have shown the effect of changes & Joa ˜o Gabriel Silva Souza jgabriel.ssouza@yahoo.com.br 1 Piracicaba Dental School, University of Campinas, Avenue Limeira 901, Vila Rezende, Piracicaba, SP 13414-903, Brazil 2 Department of Dentistry, University of Montes Claros, Montes Claros, MG, Brazil 123 Qual Life Res DOI 10.1007/s11136-016-1447-7