A population-based study of edentulism in the US: does depression and rural residency matter after controlling for potential confounders?

Abstract

BackgroundOral health is an integral component of general health and well-being. While edentulism has been examined in relation to socioeconomic status, rural residency, chronic disease and mental health, no study that we know of has examined edentulism and these factors together. The objective of this study was to determine whether depression and rural residency were significantly associated with partial and full edentulism in US adults after controlling for potential confounders.Methods2006 Behavioral Risk Factor Surveillance Survey (BRFSS) data were analyzed to identify factors associated with increased odds of partial or full edentulism. This year of BRFSS data was chosen for analysis because in this year the standardized and validated Personal Health Questionnaire-8 (PHQ-8) was used to measure current depression. This measure was part of the optional questions BRFSS asks, and in 2006 33 states and/or territories included them in their annual surveillance data collection. Bivariate and logistic regression analyses were performed on weighted BRFSS data.ResultsLogistic regression analysis using either full or partial edentulism as the dependent variable yielded that rural residency or living in a rural locale, low and/or middle socioeconomic status (SES), depression as measured by the PHQ-8, and African American race/ethnicity were all independent risk factors when controlling for these and a number of additional covariates.ConclusionsThis study adds to the epidemiological literature by assessing partial and full edentulism in the US utilizing data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Examining data collected through a large national surveillance system such as BRFSS allows for an analysis that incorporates an array of covariates not available from clinically-based data alone. This study demonstrated that current depression and rural residency are important factors related to partial and full edentulism after controlling for potential confounders.

Comorbid depression/anxiety and teeth removed: Behavioral Risk Factor Surveillance System 2010

“…Although not studying the comorbidity of depression and anxiety, Saman et al. determined that edentulism was associated with depression using BRFSS 2006 data . Their study differed from this study in the data source, focus, and variables chosen (rurality and depression were the primary independent variables and they created computed variables for health service deficits and socioeconomic status).…”

Association between symptoms of depression and oral health conditions

“…Disturbances of the stomatognathic system are capable of causing pain and discomfort, interfering in eating, communication, and appearance, contributing to low self‐esteem and interfering in social life activities . Some studies have suggested an association between psychiatric problems and those related to the stomatognathic system …”

“…7 Some studies have suggested an association between psychiatric problems and those related to the stomatognathic system. [8][9][10][11][12][13][14] Depression is considered a disease of modern times with high prevalence worldwide and increasing incidence over time. Therefore, knowledge about its symptomatology, medication therapy used, and its mechanism of action, in addition to adverse reactions resulting from some medications, will enable dentists to understand the presence of possibly related oral comorbidities, and thus diagnose and treat them correctly.…”

Edentulismo e fatores associados à necessidade de uso de prótese superior e inferior entre idosos

“…No que se refere à perda dentária dos entrevistados, evidenciou-se, através da elevada porcentagem encontrada do uso e necessidade de prótese, com predominância de prótese total, a alta prevalência de edentulismo, condizente com a realidade encontrada em outros estudos [4][5][6]9,13,[18][19][20][21][22][23] . Reflexo da cultura histórica curativista dos serviços de saúde bucal brasileiros representados por ciclos restauradores repetitivos e mutilações dentárias 6,23 , com pouca ou nenhuma ação preventiva e com exclusão dos adultos e idosos dos programas públicos de atenção 6 .…”

“…Coadunando com estudos que demonstram que as desigualdades socioeconômicas indicam diferentes tempos e formas de adoecer e diferentes necessidades e capacidades de procurar e usar serviços de saúde [4][5]21,[26][27] . O mesmo foi evidenciado com a satisfação bucal e ocorrência de dor, tendo em vista que usuários que necessitavam de prótese apresentaramse proporcionalmente mais insatisfeitos com a sua condição de saúde bucal e com maiores frequências e intensidades de dor.…”