Relationship between adult oral health, depression, pain, and general health

Objectives: Few studies have examined relationships between race/ethnicity, self-reported oral health, depression, bodily pain, and self-reported health in a population of adults ages 45-64.

Methods: Survey and performance-based data was collected from 383 white, 368 black, 206 English-speaking (EL) and 324 Spanish-speaking Latinos (SL) recruited from 2 academic medical centers and 2 community clinics in Cleveland and Chicago. Oral health was assessed as follows: “How would you describe the health of your gums and teeth—excellent, very good, good, fair or poor”? Three “outcomes” (SF-36v2) assess depression, pain, and general health, measured on a 0-100 scale. Analyses included descriptive statistics, OLS regression including adjustments for demographics, SES and physical functioning.

Results: SL's reported worse depression, pain, and general health compared to all other groups. Blacks and SL's reported significantly worse oral health (48.2% and 53.7% fair/poor, respectively) compared to whites and EL's (30.3% and 30.6%, respectively). For subjects in fair and poor categories of oral health, there were strong and positive relationships to worse depression (beta=11.1 and 17.7; p<0.001, respectively), pain (beta=11.3 and 15.4; p<0.001, respectively) and general health (beta=16.6 and 22.7; p<0.001, respectively) in unadjusted analysis. After controlling for confounders, these relationships were moderately attenuated (20-45%), persisted significantly across all dependent variables, and did not significantly differ across racial/ethnic groups.

Conclusions: Oral health is an independent, significant contributor to self-reported depression, pain, and general health, even after adjustment for potential confounders. Practitioners should be made aware of these relationships because they may affect patients' behavior regarding care and treatment.