Association of stress, depression, and suicidal ideation with subjective oral health status and oral functions in Korean adults aged 35 years or more

Abstract

BackgroundOral health greatly affects well-being throughout the different stages of life from childhood to late adulthood. Loss of teeth due to poor oral health hinders mastication, leading to poor nutrition absorption, and affects pronunciation and aesthetics, leading to interpersonal difficulties. As social activities become limited, a sense of isolation and loneliness, stress, and depression grows while happiness decreases. This study aimed to examine the association of stress, depression, and suicidal ideation with oral health status and oral functions in a large nationwide sample of Korean adults aged 35 years or more.MethodsThe sample comprised 15,716 adults, selected using a rolling survey sampling method and data were extracted from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES) (2010–2012). Participants were interviewed about their self-evaluation of health including oral health status and mental health, such as stress, depression, and suicidal ideation. Data from 11,347 adults were finally selected after excluding participants with missing answers. The dependent variables were stress, depression, and suicidal ideation. The independent variables were gender, age, household income, education, smoking, drinking, oral health perception, chewing, and speaking. Complex samples logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsParticipants met the criteria for stress (25.4%), depression (13.0%), and suicidal ideation (13.9%). Subjective oral health status was not significantly associated with stress, depression, and suicidal ideation. However, the presence of very uncomfortable chewing problems was significantly associated with stress (OR = 2.294, 95% CI = 1.41, 3.72), depression (OR = 3.232, 95% CI = 1.97, 5.31), and suicidal ideation (OR = 2.727, 95% CI = 1.58, 4.72). The presence of very uncomfortable speaking problems was significantly associated with stress (OR = 1.592, 95% CI = 1.13, 2.24) but not significantly associated with depression and suicidal ideation.ConclusionsOral functional problems including chewing and speaking difficulties can be associated with mental health. It is necessary to develop oral health promotion programs for adults and help them maintain a good quality of life and mental health.

Association between symptoms of depression and oral health conditions

“…As was also the case in the study conducted by Kim et al. (2017), in which depression was 2.8 times higher among the women. According to Kessler (2003), although the gender differences begin in puberty, other situations related to sexual hormone changes (pregnancy, menopause, use of oral contraceptives, and use of hormone replacement therapy) did not significantly influence depression.…”

“…(2015) 22 who conducted a cross-sectional study with 1,047 persons in the Northeastern region of Thailand, and observed that 39% of the men and 48% of women had light to severe symptoms of depression. As was also the case in the study conducted by Kim et al (2017), 23 in which depression was 2.8 times higher among the women. According to Kessler (2003), 24 although the gender differences begin in puberty, other situations related to sexual hormone changes (pregnancy, menopause, use of oral contraceptives, and use of hormone replacement Oral health and symptoms of depression therapy) did not significantly influence depression.…”

“…In a study conducted with 15,716 adults in South Korea, Kim et al. (2017) observed that self‐perception of oral health presented no statistically significant relationship with depression. However, they observed that the rates of depression were 3,232; 1,431; 1,773; and 1,217 times higher for self‐perception about “very uncomfortable,” “adjusted,” and “comfortable” chewing, respectively, in comparison with "very comfortable” chewing.…”

Relationship between Subjective Oral Discomfort and Health-Related Quality of Life in the South Korean Elderly Population

“…With the global aging of the population and increasing life expectancies, the issue of QOL in the elderly population, i.e., how people can remain healthy in later years, has gained great attention [6,11,18].…”

“…Not only does reduced saliva secretion lead to increased vulnerability to dental caries and periodontal diseases in the elderly, but it can also result in oral ulcer and erythema, causing severe discomfort when wearing dentures [3,4]. In addition, oral health has a great impact on self-esteem and quality of life (QOL) in the elderly because it affects pronunciation and physical appearance, which are both of vital importance to social life and interpersonal relationships [5,6]. Finally, tooth loss as a result of oral diseases weakens masticatory function and causes oral discomfort while chewing.…”