Poor perceived oral health is associated with adverse mental health outcomes among Syrian refugees in Canada

Abstract

While inadequate oral health has been linked to adverse mental health outcomes, there is limited understanding of such implications among refugees who bear a disproportionate burden of oral health disparities. This study aims to examine the effect of self-rated oral health on depression, anxiety, and stress among Syrian refugee parents resettled in Ontario. In this cross-sectional study, a total of 540 Syrian refugee parents who resided in Ontario for an average of 4 years and had at least one child under 18 years old were interviewed between March 2021 and March 2022. Information about self-rated oral health was gathered based on the question “In general, how would you rate the health of your teeth and mouth”. Responses ranged from 1 representing “excellent” and 5 representing “very poor”. The mean score (SD) of self-rated oral health was 3.2 (1.2). Mental health outcomes of depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales (DASS-21). Multiple linear regression analyses were performed to assess the independent relationship between self-rated oral health and depression, anxiety, and stress, adjusting for other variables including, sociodemographic-, migration-, and health-related factors. Among participants, 6.3% rated their oral health as excellent, 26.9% as good, 23.1% as fair, 24.8% as poor, and 18.7% as very poor. Results of the multiple linear regression analyses indicated that poorer self-rated oral health was significantly associated with higher levels of depression (Adjβ = 0.98; p = 0.002; 95% CI = 0.38–1.59), anxiety (Adjβ = 1.03; p< 0.001; 95% CI = 0.54–1.52), and stress (Adjβ = 1.25; p< 0.001; 95% CI = 0.61–1.88). Further efforts and targeted interventions are needed to address the unmet oral health needs of Syrian refugees to improve mental health outcomes within this vulnerable population.