Oral health outcomes following early-life exposure to war-related hardship: a cross-sectional study

Background: The Holocaust was a uniquely traumatic historical event marked by prolonged periods of starvation, extreme physical and psychological stress, and deprivation of basic human rights. While previous research has explored the general health consequences of Holocaust exposure, the long-term effects on oral health have received limited attention. Oral health is an essential component of overall well-being, with edentulism (complete tooth loss) recognized as a marker of severe oral disease and functional impairment in older adults. This purpose of this study was to assess the long-term impact of Holocaust exposure on oral health outcomes, specifically the prevalence of complete edentulism, among elderly Jewish Israelis more than six decades after World War II. Methods: A cross-sectional analysis was conducted using data from a nationallyrepresentative Israeli survey of adults aged 65 and older, carried outbetween 2005 and 2006. The sample included 1,459 Jewish participants,of whom 396 were identified as Holocaust survivors. Data were collectedvia structured in-home interviews and, for a subset, clinical oralexaminations. Multivariate logistic regression was used to identifypredictors of having two full dentures, serving as a proxy for completetooth loss. Results: Holocaust survivors exhibited significantly higher rates of complete edentulism compared to the control group (56.3% vs. 45.7%, p < 0.01). After adjusting for confounders, factors independently associated with having two full dentures included older age, smoking history, recent dental visits, Holocaust exposure, lower religiosity, and caregiver dependence. The final model explained 22.2% of the variance in denture status. Conclusion: Holocaust survivors exhibited poorer oral health compared to their peers,with several contributing factors identified in the analysis.These findings highlight the need for tailored dental and health servicesfor Holocaust survivors and other trauma-exposed populations, andunderscore the long-term oral health implications of early-life adversity.