Study examines link between mental health and oral health

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A study examining the mental health-oral health association cross-sectionally and longitudinally was presented at the 52nd Annual Meeting and Expo of the AADOCR, held in conjunction with the 47th Annual Meeting of the CADR. The AADOCR/CADR Annual Meeting and Expo was held at the Oregon Convention Center in Portland from March 15-18, 2023.

The study, led by Alex Kalaigian of the University of California, San Francisco School of Dentistry, acquired self-reported data from the Population Assessment of Tobacco and Health (PATH) study. The Global Appraisal Individual Needs-Short Screener (GAIN-SS) measured mental health symptoms across three disorder categorizations: internalizing, externalizing, and substance use.

Six oral health conditions were assessed: self-rated oral health, bleeding gums, loose teeth, tooth loss, gum disease, and bone loss. A cross-sectional analysis in PATH Wave 4 (2016-2018, N=30,753) compared the survey-weighted prevalence of six oral health outcomes according to the severity of mental health conditions. Prospectively, PATH Wave 5 (2018-2019) oral health outcomes were assessed based on Wave 4 mental health conditions (N=26,177). Survey-weighted logistic regression models controlled for confounders (age, sex, smoking, etc.) with imputation for missing values.

Cross-sectionally, all six oral health adverse events demonstrated a statistically significant higher prevalence with increasing severity of mental health conditions. For example, the adjusted risk of bone loss around the teeth was 1.79 times higher [95%CI 1.30-2.46] in the high versus no/low categories of internalizing problems.

Longitudinally, associations with externalizing problems and substance use largely dissipated, but multiple associations with internalizing problems persisted. For example, the adjusted risk of bleeding gums was 1.40 times higher [95%CI 1.22-1.62] in the high versus no/low categories of internalizing problems.

The study concluded that providers should expect higher levels of oral disease in patients with adverse mental disorders. Apart from externalizing problems and substance use, symptoms of internalizing problems are a plausible risk factor for future oral health problems. These results can inform the medical and dental communities in the diagnosis and treatment of people with mental illness.

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Provided by the International Association for Dental Research

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