Poor Mental Health Days as a Risk Factor for Decreased Oral Healthcare Utilization and Poorer Oral Health Outcomes

Abstract

Objectives To test the hypothesis that among individuals in the 2020 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional anonymous health survey in the United States (US), after controlling for confounding, an increasing number of poor mental health (MH) days in the past month is associated with decreases in oral health (OH) care utilization and poorer OH outcomes. Material and Methods Adjusted logistic regression models were developed with poor MH days as the exposure to predict two dependent variables (DVs): Most recent dental visit longer than one year ago (yes/no), and having lost 6 or more teeth (yes/no). Results Approximately one third (32%) reported most recent dental visit more than one year ago, and 17% had lost 6 or more teeth. Those in the second quartile of poor MH days had 11% higher odds of delayed dental visit, and those in the highest quartile had 26% higher odds, compared to the reference group. For having lost 6 or more teeth, compared to the reference group, those in the third quartile had 8% higher odds and those in the fourth quartile had 18% higher odds. Conclusions Poor MH days is an independent predictor of poor OH utilization and OH in the US above and beyond diagnosed mental and physical conditions. Clinical Relevance: Policymakers in the US should expand health insurance plans to include dental insurance, and should increase access to MH care, especially for the aging population, and those with chronic conditions.