Adult mental health impairment and oral health care use in the United States, Medical Expenditure Panel Survey 2017-2021

Background: Mental illnesses can cause mental health (MH) impairments such as decreased interest and generalized fatigue. MH impairments can adversely affect oral health. The aim of this study was to investigate the associations between MH impairment, MH care, and oral health care use.

Methods: This cross-sectional study used nationally representative data of US adults from the 2017-2021 Medical Expenditure Panel Survey. Pearson χ² test and logistic regressions were used to assess the associations between oral health care use and MH impairment and oral health care use and MH care use. Regressions controlled for age, sex, race and ethnicity, income, education, survey year, marital status, geographic region, and dental insurance status.

Results: MH impairment was associated with lower odds of using any dental care (odds ratio [OR], 0.85; 95% CI, 0.81 to 0.90) and preventive care (OR, 0.79; 95% CI, 0.74 to 0.84) and with higher odds of oral surgery (OR, 1.32; 95% CI, 1.20 to 1.46) use. Receiving MH care was associated with higher odds of using overall dental care (OR, 1.62; 95% CI, 1.43 to 1.82; P < .001), preventive care (OR, 1.72; 95% CI, 1.52 to 1.96; P < .001), and restorative care (OR, 1.26; 95% CI, 1.05 to 1.50; P = .01) use.

Conclusions: MH impairment was associated with lower odds of preventive and overall dental care use and with higher odds of oral surgery use. For adults with MH impairment, receiving MH care was associated with higher odds of preventive, restorative, and overall dental care use.

Practical implications: Mental illness can be a barrier in accessing preventive dental care. However, MH care service may aid in increasing preventive, restorative, and overall oral health care use.