Association of oral health behaviors and status with depression: results from the Korean National Health and Nutrition Examination Survey, 2010

Objective To examine the association of depression with oral health behaviors and oral health status in a large nationwide sample of Korean adults. Methods This study included 6,139 participants aged 19 years or older who participated in the fifth Korean National Health and Nutrition Examination Survey. Binary and polychotomous logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95 percent confidence intervals (CIs). Results Participants with lifetime depression (self-report of past or present depression) brushed their teeth less frequently (AOR=1.30, 95 percent CI 1.03-1.65) and were more likely not to receive treatment when experiencing dental problems (AOR=1.43, 95 percent CI 1.23-1.66) than those without lifetime depression after adjusting for sociodemographic factors, gender, and age. After adjusting for significant oral health behaviors, current smoking status, and sociodemographic factors, participants with lifetime depression had poorer oral health status than those without this disorder: uncomfortable mastication (AOR=1.25, 95 percent CI 1.05-1.50), toothache (AOR=1.18, 95 percent CI 1.01-1.39), temporomandibular joint symptoms (AOR=1.41, 95 percent CI 1.08-1.85), and maxillary periodontal bleeding (AOR=1.29, 95 percent CI 1.03-1.61 for the right side; AOR=1.40, 95 percent CI 1.13-1.74 for the left side). Conclusion Depression was significantly associated with oral health status, even after adjusting for the impact of oral health behaviors in Korean adults. Thus, our findings suggest the necessity of further investigation to detect underlying mechanisms in the relationship between depression and oral health that are not mediated by oral health behavior.