Dental pain related to quality of life and mental health in South Korean adults

Depression Symptoms Linked to Multiple Oral Health Outcomes in US Adults

BACKGROUND

Individuals with mental illness have poor oral health compared to those without mental health conditions. However, the literature is still lacking regarding the specifics of this relationship.

OBJECTIVE

This study aims at examining the relationship between depression and oral health problems such as oral conditions, access to dental care, and oral hygiene measures.

METHODS

A cross-sectional study using a secondary data analysis of 9,693 participants from the 2017 to March 2020 prepandemic National Health and Nutrition Examination Survey (NHANES). The independent variable was severity of depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9). Proportional odds and binary logistic regression were used to calculate crude and adjusted odds ratios (AORs) between depression and 8 oral health outcomes and oral hygiene-related behaviors.

RESULTS

After adjusting for sociodemographics, health conditions, and behaviors, individuals with depression were significantly more likely to have dental aches in the past year (AOR = 1.70; 95% confidence interval [CI], 1.13-2.56), difficulty getting dental care when needed (AOR = 1.93; 95% CI, 1.45-2.58), and difficulty at their jobs due to a problem in their mouth (AOR = 1.63; 95% CI, 1.07-2.49) compared to individuals without depression.

CONCLUSION

Individuals with depressive symptoms often neglect oral hygiene and self-care practices and are less likely to seek medical care for oral health problems, making them at increased risk of poor oral health outcomes. These findings can be applied by dentists, psychologists, and therapists to increase awareness of links between depression and oral health and to encourage patients with depression to seek oral hygiene preventative care.

KNOWLEDGE TRANSFER STATEMENT

Health care professionals can be on the frontline in creating awareness in the general public about the links between depression and oral health and hygiene. Applying the findings from this study can help communicate about the relationship between depression and poor oral health and relieve some burden on the American health care sector, which often struggles to provide medical care to patients with depression and oral health issues.

The Association between Dental Pain and Psychological Symptoms: Evidence from a Population-Based Study in Indonesia

OBJECTIVES

 This study aimed to determine the prevalence and distribution of dental pain and its association with psychological symptoms: stress and depression.

MATERIALS AND METHODS

 The 2014 Indonesia Family Life Survey data were used for the abovementioned purposes. Records of self-reported dental pain and stress as well as the occurrence of depression based on the 10-item Center for Epidemiologic Studies-Depression scale were analyzed. Multivariable ordinal regression models were fitted to test the hypothesized associations between dental pain and each of the psychological symptoms, controlling for age, sex, education, wealth, and religiosity.

RESULTS

 Dental pain prevalence among Indonesian population was approximately 15%. The adjusted odds ratios (ORs) from the ordinal regression models indicated that dental pain was related to the increase of the stress and depression level (OR: 1.31, 95% confidence interval [CI]: 1.14-1.49 and OR: 1.59, 95% CI: 1.41-1.79, respectively). Higher education, higher wealth, and being male are risk factors for stress. However, higher wealth and being male are protective factors for depression. Furthermore, higher religious level was a protective factor for both stress and depression.

CONCLUSION

 Dental pain was associated with a higher level of stress and a higher score of depression, even after being adjusted with age, sex, education, wealth, and religiosity.

Placebo hypoalgesic and nocebo hyperalgesic effects in post-extraction patients-A cross sectional study

Background and objectives

Pain is an unpleasant sensory and emotional experience that affects people's physical, mental, and social health. Patients at times present with postoperative pain with no clinical signs after the surgical dental procedures and adequate pharmacological management. This can be due to the amplified emotional component of the individual in their postoperative period. Hence, this study aimed to estimate the association between placebo, nocebo effects, and postoperative pain associated with tooth extraction procedures.

Methods

A cross-sectional study was conducted among 301 patients attending the Department of Oral and Maxillofacial Surgery for tooth extraction. Preoperatively, the expected postoperative pain score was recorded using the "Numerical Rating Scale" (NRS), Anxiety and Depression were assessed using the "Hospital Anxiety and Depression Scale" (HADS), and Patients' expectancy regarding the treatment outcome was assessed using the "Credibility Expectancy Questionnaire" (CEQ). Observed postoperative pain scores at the 6th hour, 24th hour, and peak pain score of the day were recorded using the NRS.

Results

There were statistically significant associations (p < 0.05) found between expected and observed postoperative pain, preoperative anxiety and observed postoperative pain, preoperative depression and observed postoperative pain, placebo, nocebo effects, and observed postoperative pain.

Interpretation and conclusion

Our study showed a strong association between these variables suggesting that post-extraction pain is a multifaceted condition wherein pain expectation, preoperative anxiety, depression, and expectancy regarding the treatment outcome should be scrutinized before the extraction procedure.

Fractional amplitude of low-frequency fluctuation changes of specific cerebral regions in patients with toothache: A functional magnetic resonance imaging study

BACKGROUND

Previous studies have indicated that pain-related diseases can result in significant functional alterations in the brain. However, differences in spontaneous brain activity in toothache (TA) patients remain unclear.

OBJECTIVE

To investigate altered spontaneous brain activity in patients with TA and its underlying mechanisms using the resting-state functional magnetic resonance imaging-fractional amplitude of low-frequency fluctuation (rsfMRI-fALFF) technique.

METHODS

Twelve patients with TA and 12 non-toothache controls (NTCs) (matched for sex, age, and level of education) were enrolled. Spontaneous cerebral activity variations were investigated using the rsfMRI-fALFF technique in all individuals. The mean fALFF values of the TA patients and NTCs were classified using receiver operating characteristic (ROC) curves. The correlations between fALFF signals of distinct brain regions and clinical manifestations of TA patients were evaluated using Pearson's correlation analysis.

RESULTS

TA patients showed lower fALFF values in the left superior frontal gyrus, medial; right superior frontal gyrus, dorsolateral; and left median cingulate and paracingulate gyri (LDCG) than the NTCs. Moreover, ROC curve analysis indicated that the area under the curve of each cerebral region studied had high accuracy. Besides, in the TA group, the visual analog scale score was negatively correlated with fALFF signal values of the LDCG (r = .962, p < .001).

CONCLUSION

Abnormal spontaneous activity was detected in numerous brain regions in patients with TA, which may be valuable for understanding the brain processing mechanism underlying TA. These regional changes in brain activity may serve as effective clinical indicators of TA.

Oral Health-Related Quality of Life in Anticoagulated Patients with Warfarin Treatment: A Cross-Sectional Study

To evaluate factors associated with oral health-related quality of life (OHRQoL) in patients under oral anticoagulant therapy with warfarin, a cross-sectional study was conducted. Validated questionnaires assessed self-reported periodontal disease, demographic variables, and OHRQoL using the short version of the Oral Health Impact Profile (OHIP-14) instrument. After calibration (Kappa > 0.60), an examiner evaluated patients' experience with dental caries and the need for dental prostheses. Statistical analysis involved proportions and measures of central tendency. Negative binomial regression models were used to estimate the rate ratios (RR) and the corresponding 95% confidence interval (CI). The sample consisted of 158 individuals, with a mean age of 58.8 years (SD = 12.1), of which 62.7% of the participants were women. The OHIP-14 mean was 10.62 (SD = 10.92). A higher OHIP-14 total score (worse OHRQoL) was associated with ethnic group, age, periodontal disease self-report, dental caries, and oral health self-report. Demographic and clinical factors can negatively influence the perception of anticoagulated patients on OHRQoL.

Breaking the vicious circle of diet, malnutrition and oral health for the independent elderly

Aging impairs senses, mastication, oral status and function, causing nutritional needs and diet insufficiencies. The present needs of independent older adults suggest that health research and oral health care should shift from reductionist disease management to integral and personal treatment plans, including lifestyle, psychological, nutritional and oral health coaching approaches. Dentists and other medical professionals that work in the field of gerodontology should be educated on the macro and micronutrient needs of the elderly and incorporate certain nutritional plans early in the life of their patients with their approval and cooperation, in order to postpone tooth loss and masticatory impairment. Old recipes such as the Mediterranean diet should be kept as a base for all the elderly and be enriched in a customized interpersonal way from the dentist as well as the medical professional according to the specific needs of one's oral and general health status. In this nonsystematic review paper, the basic aspects of the vicious cycle of nutrition and oral health status are discussed and suggestions of major nutrients' influence and needs for independent elders are reported. Based on the scientific data collected, suggestions are made for the food industry for better quality and dosage of foods for this category of individuals. Such strategies can be a whole new area of interest for the food industry in order to obtain better quality of food packaging for the independent OA with accepted texture, odor, colors, macronutrients and micronutrients' consistency and in specific portions.

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

This study examined the relationship between oral discomfort and health-related quality of life (HRQOL) in the Korean elderly, using the datasets provided by the Korea National Health and Nutrition Examination Survey (KHNANES) over 6 consecutive years (2010-2015). A total of 13,618 participants aged 65 years and over were included in the final analysis. A complex sample logistic regression was performed to determine the impact of oral discomfort on HRQOL. The results revealed that toothache, masticatory discomfort, and pronunciation problems caused by oral health conditions were all risk factors for decreased HRQOL. In particular, masticatory discomfort (adjusted odds ratio (AOR) 1.63, Model III (adjusted for all covariates)) and pronunciation problems (AOR 1.64, Model III) negatively impacted the HRQOL of the elderly to a great extent. Masticatory discomfort had a stronger negative impact on HRQOL in the domains of "self-care" (AOR 1.83) and "usual activities" (AOR 1.66), while pronunciation problems had a similar impact on all five domains of the EuroQol 5-Dimension (EQ-5D). These findings could serve as baseline data for setting up early intervention programs for the timely prevention of oral health-related discomfort problems that greatly affect the QOL of the elderly population, and for the development of comprehensive and efficient dental insurance policies.

Anxiety symptoms have a direct effect on oral health perception in young women

PURPOSE

Assess the influence of anxiety symptoms on oral health related-quality of life in young women from a cohort study in Southern Brazil.

METHODS

A sample of 535 young mothers were analyzed. Interviews and psychological evaluations were carried out by trained psychologists. The Brazilian version of the Corah's dental anxiety scale and the Beck anxiety inventory were used to evaluate dental anxiety and anxiety symptoms, respectively. The oral health-related quality of life (OHRQoL) was assessed by the Oral Impacts on Daily Performance instrument. Dental examinations were performed by trained dentists to assess oral health status (DMFT). The effect of anxiety symptoms on oral health-related quality of life was estimated using the parametric g-formula.

RESULTS

The prevalence of negative impact on OHRQoL was of 46.3 and 28% of the women presented anxiety symptoms. Unadjusted analysis showed that women with anxiety symptoms had 2.5 higher impact on OHRQoL (OR 2.55; CI 95% 1.72-3.79). The parametric g-formula revealed that anxiety had a direct effect on oral health perception (OR 1.16; CI 95% 1.04-1.30), not mediated by dental anxiety.

CONCLUSION

Oral health-related quality of life is influenced by anxiety symptoms, regardless of dental anxiety.

Association between dental pain and tooth loss with health-related quality of life: the Korea national health and nutrition examination survey: A population-based cohort study

Dental pain and tooth loss are global public health concerns. However, there have been no large cross-sectional epidemiologic studies of a representative sample of an entire country's populations. The purpose of this study was to evaluate the relationships between dental pain and tooth loss with health-related quality of life (HRQOL) using a well characterized, nationally representative, population-based study.This study analyzed data of 3924, representing 21,836,566 adults from the 2012 Korea National Health and Nutrition Examination Survey. Subjects were divided into 4 groups as follows: tooth loss of up to 8 teeth without dental pain, tooth loss of up to 8 teeth with dental pain, tooth loss of 8 to 28 teeth without dental pain, and tooth loss of 8 to 28 teeth with dental pain. Logistic regression was applied to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CI), controlling for a range of covariates.Among the 3924 subjects, representing an estimated 21,836,566 adults, the prevalence of tooth loss of 8 to 28 teeth was 24.6% and the prevalence of dental pain was 35%. The tooth loss of 8 to 28 teeth with dental pain group showed the highest level of impaired HRQOL in all 5 dimensions, and the tooth loss up to 8 teeth without dental pain group showed the lowest level. The proportion of both groups without dental pain decreased significantly from the younger age to older age group. After adjustment for sociodemographic factors, the ORs (95% CI) of mobility, self-case, usual activity, pain/discomfort, and anxiety/depression were 1.93 (1.32-2.84), 1.90 (1.25-2.90), 1.46 (0.88-2.43), 1.48 (0.88-2.49), and 1.46 (0.85-2.51) in tooth loss of 8 to 28 teeth with dental pain group. Although the ORs of tooth loss of 8 to 28 teeth without dental pain group did not significantly increase.Dental pain and tooth loss has a considerable impact of HRQOL in the Korean adult population. In our study, HRQOL is more closely associated with dental pain than with tooth loss.

Impact of oral health on health-related quality of life: a cross-sectional study

Background

Despite the consensus regarding the existence of a relationship between “impacts on oral health” and “health-related quality of life”, this relationship, considering the latent nature of these variables, is still poorly investigated. Thus, we performed this study in order to determine the magnitude of the impacts of oral health, demographic and symptom/clinical variables on the health-related quality of life in a Brazilian sample of dental patients.

Methods

A total of 1,007 adult subjects enrolled in the School of Dentistry of São Paulo State University (UNESP) - Araraquara Campus for dentistry care between September/2012 and April/2013, participated. 72.4 % were female. The mean age was 45.7 (SD = 12.5) years. The Oral Health Impact Profile (OHIP-14) and the Short Form Health Survey (SF-36) were used. The demographic and symptom/clinical variables collected were gender, age, economic status, presence of pain and chronic disease. The impact of studied variables on health-related quality of life were evaluated with a structural equation model, considering the factor “Health” as the central construct. The fit of the model was first analyzed by the evaluation of the goodness of fit indices (χ²/df ≤ 2.0, CFI and TLI ≥ 0.90 and RMSEA < 0.10) and the evaluation of the variables’ impact over health-related quality of life was based on the statistical significance of causal paths (β), evaluated by z tests, for a significance level of 5 %.

Results

We observed adequate fit of the model to the data (χ²/df = 3.55; CFI = 0.95; TLI = 0.94; RMSEA = 0.05). The impacts on oral health explained 28.0 % of the variability of the health-related quality of life construct, while the total variance explained of the model was 39.0 %. For the demographic and symptom/clinical variables, only age, presence of pain and chronic disease showed significant impacts (p < 0.05).

Conclusion

The oral health, age, presence of pain and chronic disease of individuals had significant influence on health-related quality of life.