The Association Between Depression and Use of Dental Services Among U.S. Adults

AIM: To assess the use of dental services among depressed individuals and whether the association is independent from the need for dental care. METHODS: Data were from the National Health and Nutrition Examination Survey (NHANES) (2017-2020), a cross-sectional survey of U.S. adults. Depression status was assessed using the Patient Health Questionnaire-9 (PHQ-9), dental visits and routine dental visits were assessed through self-reported questionnaires in NHANES. Licensed dentists assessed participants' need for immediate dental care. Caries was also assessed using WHO (2013) criteria. Two weighted regression models were used to evaluate the association between the depression and use of dental services. RESULTS: A total of 6565 participants aged 20 years and older were included. Participants with depression had lower odds for visiting the dentist in the previous year, Odds Ratio (OR) 0.72, 95% Confidence Interval (CI): 0.57, 0.91, p < 0.01 and lower odds for routine dental visits (OR 0.66, 95% CI: 0.50, 0.86, p < 0.01) than those without depression in models adjusting for gender, age, race/ethnicity, number of decayed teeth and dental care recommendation. After additionally adjusting for smoking, education and income, the relationships lost significance in both models. Higher socioeconomic conditions were significantly associated with routine dental visits. CONCLUSIONS: Even though they needed dental care, people with depression were less likely to see a dentist; however, this association disappeared when socioeconomic factors were taken into consideration. For people with depression, adverse socioeconomic status was an additional barrier to dental visits.