September 2018

Background: Depression has been linked to poor oral health among patients seeking dental care. However, systematic research on the relationship between depressive symptoms and oral health is limited. Objective: To examine the association of depressive symptoms with untreated dental caries among adults aged 21-64 years. Basic Research Design: Cross-sectional secondary analysis. Setting: The data were extracted national data collected in the United States (2013-2014 National Health Nutrition and Examination Survey). Participants: The sample consisted of 3,127 non-institutionalized civilians. Main outcome measure: Untreated coronal dental caries (yes, no) was the key outcome variable. Depressive symptom categories (none, moderate, and severe) were derived from the Patient Health Questionnaire-9 Depression Scale. Results: In the study sample, 33.4% of adults had untreated coronal dental caries. Most participants (77.9%) did not report depressive symptoms; 13.9% had mild and 8.2% had moderate or severe depressive symptoms. In unadjusted analyses, individuals with mild (Odds Ratio = 1.62 [95% CI: 1.26, 2.08] and moderate/severe depressive symptoms (Odds Ratio = 2.70 [95% CI: 1.81, 4.02]) were more likely to have untreated coronal caries as compared with individuals without depressive symptoms. When sex, race, age, education, family income-to-poverty ratio, dental visits, history of previous dental restorations, health insurance, and smoking were included into the model, the associations were no longer statistically significant (1.27 [95% CI: 0.96, 1.69] and 1.61 [95% CI: 0.95, 2.73], respectively). Conclusion: The relationship between depressive symptoms and untreated coronal dental caries failed to remain significant after the addition of tobacco usage in the analysis. Key words: Depressive symptoms, dental caries, NHANES, secondary analysis, United States