INTRODUCTION:
Older adults living in quilombola communities in Brazil experience health inequities. Oral health problems can substantially affect quality of life. This study aimed to investigate the relationship between oral health self-perception, clinically assessed oral conditions and self-reported quality of life among older quilombola adults.

METHODS:
A cross-sectional study was conducted using a census of older adults in a quilombola community in the municipality of Bom Conselho, Pernambuco, Brazil. Data collection included structured interviews to assess sociodemographic characteristics, self-perceived oral health, perceived need for dental treatment and quality of life, as well as standardized clinical oral examinations. Descriptive and inferential statistical analyses were conducted to evaluate associations and the concordance between subjective perceptions and normative clinical findings.

RESULTS:
Participants presented a marked burden of oral health problems. Sixty-five quilombola older adults were included (mean age 68.3±7.0 years; 60–92; 55.4% men). Although 90.8% reported at least one lifetime dental visit, 55.4% had not attended in over three years and 35.4% reported access barriers, mainly cost and distance (10.8% each). Tooth loss was almost universal (95.4%), with 66.2% losing more than six teeth and 26.2% presenting complete edentulism. Mean Decayed, Missing and Filled Teeth index was 17.6; caries experience reached 95.4% and pulpal complications 24.6%. Prosthesis use was low (32.3%), despite clinical need in 96.9%. Oral conditions impacted chewing (55.4%), sleep (58.5%) and smiling (46.2%). Self-rated oral health was regular or poor in 66.2% and was significantly associated with clinical treatment need (p=0.040).

CONCLUSIONS:
The findings demonstrate substantial oral health needs and significant impacts on quality of life among older quilombola adults, alongside discrepancies between clinical conditions and self-perceived oral health. These results highlight the need for culturally sensitive and equitable oral health policies focused on improving access to care, rehabilitation services and health promotion, contributing to healthier aging in quilombola communities.