Investigating the Oral Health of Individuals with Depression: Finding from the 2015-2016 National Health and Nutrition Examination Survey (NHANES)

Abstract

Background: Recent studies have shown an association between oral disease (e.g. periodontal) and depression. However, most of these studies did not examine depression in association with other critical oral health outcomes such as preventative dental care and dental care access, as well as oral health-related quality of life. Therefore, the study aims to investigate the association between depression with indicators of oral health taking into account sociodemographics and chronic disease indicators (CDI). Methods: The data were obtained from 2015-2016 NHANES. Our independent variable is depression status, which was measured using the Patient Health Questionnaire-9 (PHQ-9). The dependent variables are oral health outcomes (oral health condition, oral ache, periodontal disease, bone loss, dental care, dentist visit, feeling bad and having difficulty because of oral health, and using dental floss). Covariates included sociodemographics and CDI such as current smoking, diabetes, and body mass index. Results: A total of 5,992 respondents 18+ years old were included. The sample mean age was 47.22 (45.97-48.46). Out of 5,992 respondents 49.67% were females. The prevalence of depression was 5.48%, and greater among females (65%) than males (34%); higher among individuals with low income (42%) than others (p value <.0001). After adjusting for sociodemographics and CDI, participants with depression were more likely to report fair/poor oral condition [aOR=2.18 (1.33-3.57)], oral pain [aOR=2.87 (1.86-4.44)], and difficulty accessing needed dental care [aOR=2.78 (2.00-3.86)] than others. Having depression was associated with poor oral health perceptions [aOR=2.26 (1.51-3.38)], and having difficulty at job/school because of their oral health [aOR=2.96 (1.64-5.33)]. Conclusion: The present study provides empirical evidence on the association between depression with oral health outcomes, including access to dental care.