Abstract
BackgroundThis study assessed the association of mental health problems and risk indicators of mental health problems with caries experience and moderate/severe gingivitis in adolescents.MethodsA cross-sectional household survey was conducted in Osun State, Nigeria. Data collected from 10 to 19-years-old adolescents between December 2018 and January 2019 were sociodemographic variables (age, sex, socioeconomic status); oral health indicators (tooth brushing, use of fluoridated toothpaste, consumption of refined carbohydrates in-between-meals, dental services utilization, dental anxiety and plaque); mental health indicators (smoking habits, intake of alcohol and use of psychoactive drugs) and mental health problems (low and high). Gingival health (healthy gingiva/mild gingivitis versus moderate/severe gingivitis) and caries experience (present or absent) were also assessed. A series of five logistic regression models were constructed to determine the association between presence of caries experience and presence of moderate/severe gingivitis) with blocks of independent variables. The blocks were: model 1—sociodemographic factors; model 2—oral health indicators; model 3—mental health indicators and model 4—mental health problems. Model 5 included all factors from models 1 to 4.ResultsThere were 1234 adolescents with a mean (SD) age of 14.6 (2.7) years. Also, 21.1% of participants had high risk of mental health problems, 3.7% had caries experience, and 8.1% had moderate/severe gingivitis. Model 5 had the best fit for the two dependent variables. The use of psychoactive substances (AOR 2.67; 95% CI 1.14, 6.26) was associated with significantly higher odds of caries experience. The frequent consumption of refined carbohydrates in-between-meals (AOR: 0.41; 95% CI 0.25, 0.66) and severe dental anxiety (AOR0.48; 95% CI 0.23, 0.99) were associated with significantly lower odds of moderate/severe gingivitis. Plaque was associated with significant higher odds of moderate/severe gingivitis (AOR 13.50; 95% CI 8.66, 21.04). High risk of mental health problems was not significantly associated with caries experience (AOR 1.84; 95% CI 0.97, 3.49) or moderate/severe gingivitis (AOR 0.80; 95% CI 0.45, 1.44).ConclusionThe association between mental problems and risk indicators with oral diseases in Nigerian adolescents indicates a need for integrated mental and oral health care to improve the wellbeing of adolescents.
Highlights
This study assessed the association of mental health problems and risk indicators of mental health problems with caries experience and moderate/severe gingivitis in adolescents
The aim of the study was to assess the risk for mental health problems and the prevalence of oral disease among 10–19-year-old adolescents in South-West Nigeria
The study showed that the risk of mental health problems was high and the prevalence of caries experience and moderate/severe gingivitis were low in our adolescent cohort
Summary
This study assessed the association of mental health problems and risk indicators of mental health problems with caries experience and moderate/severe gingivitis in adolescents. Pharmacological management of depression can cause xerostomia, with associated risk of caries and gingival inflammation [4]. Tobacco smoking, which has been associated with mental health problems [7, 8], induces hyper-inflammation, with systemic changes in inflammatory cytokine levels and immunoglobulins. This can contribute to worsening of chronic inflammatory conditions such as multiple sclerosis, with concomitant deterioration in periodontal health [9]. Patients with poor mental health (severe mental illness, affective disorders, and eating disorders) often neglect their oral health, and have worse oral health status than otherwise healthy individuals [10]
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