Oral health-related quality of life among Brazilian adults with mental disorders

Association between cognitive rumination and periodontal disease, tooth loss and oral health-related quality of life in a rural Southern Brazil population

OBJECTIVES

Rumination is a maladaptive emotion regulation strategy. It has been associated with several psychological disorders and physical problems. This cross-sectional study aimed to evaluate whether cognitive rumination is associated with periodontal disease (PD), tooth loss (TL), and oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

A population-based sample from a rural area in southern Brazil was evaluated. Calibrated examiners carried out a complete periodontal examination at six sites-per-tooth. Rumination and Reflection (RRQ) and Oral Health Impact Profile (OHIP-14) questionnaires were administered. Regression modeling was used to assess the prevalence ratio (PR) between rumination and PD and to estimate the rate ratio (RR) between rumination and TL and rumination and OHIP.

RESULTS

Severe periodontitis prevalence of 33% was observed in the sample. In the Poisson-adjusted model (n = 587), individuals who ruminate more have 27% more periodontal disease (PR: 1.27, 95%CI:1.02 - 1.60). Regarding TL and OHIP, negative binomial regression (n = 672) showed an association with rumination, but it was not significant (RR 1.14, 95%CI 0.99 - 1.31) and (RR 1.20, 95%CI 0.98 - 1.48), respectively.

CONCLUSIONS

Cognitive rumination was independently associated with periodontal disease in individuals living in a rural area. Borderline non-significant estimates were observed regarding TL and OHRQoL. More research using different populations and focusing on individual's responses to psychological stress may confirm these results.

CLINICAL RELEVANCE

Emotional regulation is crucial to deal with stress, anxiety, and depression. Since psychopathologies are among the most prevalent diseases in the world, it is critical to understand the role of these issues in dental outcomes.

Structure and replicability of oral health-related quality of life networks across patients with schizophrenia and the general community

OBJECTIVES

Schizophrenia is a disabling mental disorder associated with severe social dysfunction. Individuals with long-term mental conditions have poorer Oral Health-Related Quality of Life (OHRQoL) compared to the general population, but little is known about the measurement properties of OHRQoL instruments in this group of patients. This study aimed to examine the replicability of OHRQoL networks across samples of the general community (GC) and patients with schizophrenia (PWS).

METHODS

Data were obtained from 603 community-dwelling participants and 627 patients with schizophrenia. OHRQoL was measured using the short form of the Oral Health Impact Profile (OHIP-14) questionnaire. A regularized partial correlation network was estimated for each sample. The number of dimensions and structural stability were assessed using Exploratory Graph Analysis. Global strength, edge weights and centrality estimates were compared. Network replicability was examined fitting the PWS data to the GC network structure.

RESULTS

A single OHIP-14 dimension was identified in the GC sample, whereas three dimensions were detected in the PWS sample. Structural consistency was perfect in the network of GC participants (1), and considerably low in at least two dimensions of the PWS network (0.28; 0.65; 0.16). A moderate correlation for node strength estimates was observed (τ: 0.43; 95% CI: 0.13, 0.72), although edge weights were not correlated (τ: 0.025; 95% CI: -0.11, 0.16). The fit of the PWS data to the GC network structure was deemed unacceptable.

CONCLUSION

Network models of OHRQoL did not replicate across samples of the general community and outpatients with schizophrenia. Prudent use of OHIP-14 to compare measures of OHRQoL between groups with significant cognitive impartment and the general population is recommended.

How Mental Health Correlates with Subjective Oral Health Status: A Cross-Sectional Study among a Group of University Students

AIM

This cross-sectional study aimed to assess the association between subjective oral health status and mental illness in a group of university students in Riyadh City of Saudi Arabia.

MATERIALS AND METHODS

A self-report questionnaire collected data on demographics, subjective oral health and mental health. The Arabic version of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scales were administered. Students' participation was voluntary. Data were analysed using the Statistical Package for Social Sciences (SPSS).

RESULTS

A total of 614 students participated in the study, 45.28% (n = 278) were males and 54.72% (n = 336) were females. Oral health status was assessed, and most participants rated their oral health status as good 53.75% (n = 330). This study also assessed mental health among the participants and found that 50.49% (n = 310) of students were suffering from different degrees of depression. Approximately, 46.74% (n = 247) of students reported experiencing certain degrees of generalized anxiety disorder. Mental disorders were significantly correlated with subjective oral health status, since participants who rated their oral health as poor or very poor tended to have higher PHQ-9 and GAD-7 scores. In conclusion, the findings showed a notable relationship between mental disorders and subjective oral health status among a group of university students. Therefore, the results can be used to help improve service provision, which would ultimately enhance students' mental health.

Potential association of anticholinergic medication intake and caries experience in young adults with xerostomia

Background/purpose

Growing prescription of anticholinergic medications has a critical effect on oral health. A link between anticholinergic medication-induced xerostomia (subjective feeling of oral dryness) and a high Decayed, Missing, and Filled teeth (DMFT) index has been reported in the older population. The purpose of this retrospective study is to determine anticholinergic exposure and prevalence of the most frequently used anticholinergic medications in adults 18-44 years of age, as well as to explore xerostomia and its association with caries status.

Materials and methods

We performed a retrospective study of adults between the age of 18 and 44 years who received a dental examination between January 2019 and April 2010, at Eastman Institute for Oral Health (EIOH), Rochester, NY. We reviewed the electronic dental charts and medical records of 236 adults with xerostomia.

Results

71% of young adults with xerostomia were prescribed at least five or more medications (polypharmacy), and 85% took at least one anticholinergic drug. The average anticholinergic drug scale (ADS) was 2.93. We found systemic conditions such as cardiac, neurological, and sleep apnea affecting the DMFT index by predicting the caries status (P < 0.001).

Conclusion

Anticholinergic exposure and medication-induced xerostomia in younger adults are associated with dental caries and require complex interdisciplinary therapy.

A Cross-Sectional Survey on the Association between Dental Health Conditions and University Personality Inventory Scores among University Students: A Single-Center Study in Japan

This study examined the association between dental health conditions and scores on the University Personality Inventory (UPI) among university students in Japan. Participants were freshmen at Yamagata University between 2010 and 2019. Dental check-ups, including dental caries, periodontal disease, malocclusion, and temporomandibular disorders (TMD), and mental health screening using the UPI were performed; 12,433 students were included in the final analysis. A logistic regression analysis was performed to confirm the association between dental health conditions and >30 UPI scores, which indicate the need to consult mental health professionals. Overall, students who required treatment for TMD had a 3.165-fold higher risk of >30 UPI scores (OR = 3.165, 95% CI = 1.710−5.857). Periodontal disease and TMD in male participants (periodontal disease: OR = 1.329, 95% CI = 1.108−1.595; TMD: OR = 3.014, 95% CI = 1.107−8.204) and TMD in female participants (OR = 2.938, 95% CI = 1.340−6.445) were significant risk factors for >30 UPI scores. Students requiring treatment for TMD were at risk of obtaining >30 UPI scores. Although our study has several limitations, students with subjective symptoms (e.g., disturbance in opening the mouth) should take the UPI test or in some cases consult mental health professionals.