The burden of oral health problems in children with mental health disorders in the United States

Abstract

Mental health disorders (MHDs) are major public health concerns with increasing risk of morbidity and mortality among children. Oral health problems (OHPs) are receiving attention as associated comorbidities. This study assessed the burden of oral health problems in children aged 3-17 years with MHD in the United States. Cross sectional analyses was performed using the National Survey of Children's Health database 2016-2017 containing information of 60,655,439 children. Weighted survey binomial logistic regression generating odds ratio for association between MHD and OHP were calculated. Weighted dose-response models captured incremental effects of MHD severity on oral health conditions. Population attributable risk (PAR) to quantify proportions of potentially avertable OHP as a result of intervention targeted at different levels of MHD severity were estimated. Prevalence of OHP among those with any MHD was 22.5percent. Children with MHD were more likely to be non-Hispanic White, living in poorer households, and having private health insurance P< 0.001. Dose-response analyses showed children with mild MHD were 85 percent more likely [OR=1.85 (95% CI: 1.47-2.32)], and those with moderate/severe MHD 93 percent more likely (OR=1.93, 95% CI: 1.50-2.49) to experience OHP, compared to children without MHD. Population attributable risk (PAR) revealed that if mild and moderate/severe MHD were improved by 75 percent, OHP would be averted in 152,206 children with mild and 255,851 with moderate/severe MHD, respectively. Our results suggest that disparities persist among the pediatric population with MHD who suffer OHP in the United States.