Insights from a Study on the Association between Mental Health and Oral Health

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At the 52nd Annual Meeting & Exhibition of the AADOCR, held concurrently with the 47th Annual Meeting of the CADR at the Oregon Convention Center in Portland from March 15-18, 2023, a study was presented that investigated the association between mental health and oral health both cross-sectionally and longitudinally.

The study, led by Alex Kalaigian from the University of California, San Francisco School of Dentistry, utilized self-reported data from the Population Assessment of Tobacco and Health (PATH) Study. The mental health symptoms were measured using the Global Appraisal Individual Needs-Short Screener (GAIN-SS) and classified into three categories: internalizing, externalizing, and substance use. Six oral health conditions, including self-rated oral health, bleeding gums, loose teeth, tooth loss, gum disease, and bone loss, were evaluated.

The cross-sectional analysis was conducted on PATH Wave 4 (2016-2018, N=30,753) data, which compared the prevalence of six oral health outcomes according to the severity of mental health problems. The prospective analysis was performed on PATH Wave 5 (2018-2019) data, which assessed oral health outcomes according to the mental health problems reported in Wave 4 (N=26,177). Confounders such as age, sex, and tobacco use were controlled for using survey-weighted logistic regression models with imputation for missing values.

The study found that all six adverse oral health outcomes had a statistically significant greater prevalence over increasing severity of mental health problems cross-sectionally. Longitudinally, associations with externalizing and substance use problems largely dissipated, but multiple associations with internalizing problems persisted. The study concluded that individuals with adverse mental health conditions are likely to have higher levels of oral disease, and that internalizing problems may be a plausible risk factor for future adverse oral health, independent of externalizing and substance use problems.

This research was presented in an Interactive Talk presentation titled “Examining Mental Health and Oral Health: A Nationally Representative Cohort.”

Key Takeaways in a Nutshell – Health Newstrack

1. There is a significant association between mental health and oral health. The study found that individuals with adverse mental health conditions had higher levels of oral disease, and that symptoms of internalizing problems may be a risk factor for future adverse oral health.

2. Six oral health conditions were evaluated in the study: self-rated oral health, bleeding gums, loose teeth, tooth loss, gum disease, and bone loss.

3. The study found that the associations between externalizing and substance use problems and adverse oral health outcomes largely dissipated over time, but multiple associations with internalizing problems persisted.

4. Providers should be aware of the higher levels of oral disease among patients with adverse mental health conditions, and these results may inform both medical and dental communities in diagnosing and providing treatment to individuals suffering from mental illness.


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