Tooth Loss Linked to Depression, Anxiety

Tooth loss from caries and periodontal disease is an outcome from complex, chronic conditions. Several biopsychosocial factors are involved, including accessing care. Individuals reporting dental anxiety may avoid dental care; and individuals with depression may be negligent in self-care. In this study, researchers examined a potential association of tooth loss with depression and anxiety.

The Behavioral Risk Factor Surveillance System (BRFSS) Survey is a complex, telephone survey of the Centers for Disease Control and Prevention and state health departments. In this study, the researchers used the BRFSS 2010 data (451,075 respondents). Analysis involved frequency, Chi square analysis, and complex survey logistic regression. Participants eligibility included being 19 years or older, and having complete data on depression, anxiety and tooth loss.

There were 76,292 eligible participants; and 13.4% of participants reported anxiety, 16.7% reported depression, and 5.7% reported total tooth loss. The sample was evenly distributed between males and females; there were 68.7% non-Hispanic whites, 12.7% non-Hispanic blacks, 12.5% Hispanics, and 6.8% other. In Chi-square analysis by tooth loss: depression, anxiety, and a combined category of depression or anxiety were significantly different in tooth loss (p <0.0001) v. participants without the conditions. The unadjusted odds ratio for tooth loss and anxiety was 1.58 (95% CI: 1.46, 1.71; p<.0001); for depression: 1.64 (95% CI: 1.52, 1.77; p<.0001); and for anxiety or depression as a combined category: 1.55 (95% CI: 1.44, 1.66; p<.0001). The adjusted odds ratio (AOR) for anxiety was 1.13 (95% CI: 0.99, 1.30; p=0.0773); for depression: 1.16 (95% CI: 1.02, 1.32; p=0.0275); and in a separate analysis of the combined anxiety or depression category, the AOR was 1.23 (95% CI: 1.11, 1.36).

At the conclusion of this national study, the researchers found that depression and anxiety are associated with tooth loss.

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