Effect of psychological distress on oral health: a cross-sectional study

Background: Individuals with psychological distress are at significantly higher risk of arthritis, cardiovascular disease, and chronic obstructive pulmonary disease. However, influence of psychological distress on oral health remains a concern. The purpose of this study was to evaluate psychological distress and its relationship with caries, oral hygiene status, gingival health, and other factors among adults.

Methods: This cross-sectional study included a sample of 558 adult patients at the Dental Hospital College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. The World Health Organization criteria were used to perform an oral examination of participants who responded to a self-administered questionnaire. Psychological distress was evaluated by using the General Health Questionnaire-12 (GHQ-12), which consists of 12 items on a 4-point Likert scale and its score ranges from 0 to 36. The oral health of participants was assessed using the DMFT, plaque, gingival, and simplified oral hygiene indices.

Results: In this study, 21.5% of participants demonstrated psychological distress, with 16.80% having mild distress and 4.70% having severe distress. The mean score of GHQ-12 of the study sample was 10.47 ± 5.77. Significantly higher median scores of GHQ-12 were observed among participants over the age of 30 years (p = 0.021), low-income individuals (p = 0.008), smokers (p = 0.019), and those with medical problems (p < 0.001). Participants with psychological distress demonstrated significantly higher caries, poor gingival health, and compromised oral hygiene (p < 0.005). Multiple linear regression models revealed significant relationships between psychological distress and the DMFT index (p < 0.001), plaque index (p < 0.001), gingival index (p < 0.001), and simplified oral hygiene index (p < 0.001) after adjusting for age, sex, nationality, income, and education.

Conclusion: Psychological distress was prevalent among the participants. Higher age, low-income status, smoking, and medical problems were significantly related to psychological distress. Additionally, psychological distress was significantly correlated with dental caries experience, gingival health, and oral hygiene.