The association of oral health with anxiety symptoms among older adults in China: a cross-sectional study

Oral health status has been shown to be associated with mental health. However, its association with anxiety remains insufficiently understood. The present study is the first to investigate the association between oral health and anxiety among elderly Chinese individuals. This study included 11,034 participants aged ≥ 65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey. Oral health habits were assessed based on the number of natural teeth, frequency of tooth brushing, and denture wearing status. The 7-item Generalized Anxiety Disorder scale was used to screen for anxiety symptoms, and logistic regression analysis was performed to calculate the odds ratios (ORs) with 95% confidence intervals (CIs). The prevalence of anxiety symptoms was 12.04% among Chinese older adults. In the fully adjusted model, participants with ≥ 20 teeth exhibited significantly lower odds of anxiety symptoms compared to those with fewer than 20 teeth (OR = 0.84; 95% CI = 0.72–0.98). Compared with never brushing, brushing once daily (OR = 0.83; 95% CI = 0.70–0.98), twice daily (OR = 0.73; 95% CI = 0.60–0.90), and three or more times daily (OR = 0.68; 95% CI = 0.49–0.92) each showed an inverse association with anxiety symptoms. Similarly, denture use was also associated with lower odds of anxiety symptoms (OR = 0.80; 95% CI = 0.71–0.91). Notably, a significant interaction was observed between tooth brushing frequency and smoking status. This study indicates that retaining ≥ 20 teeth, brushing at least once daily, and using dentures are associated with a lower likelihood of anxiety symptoms among the elderly population. Further prospective studies are warranted to confirm these associations.