{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:04:46Z","timestamp":1793300686048,"version":"4.5.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of Pennsylvania Institute of Translational Medicine and Therapeutics","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"https:\/\/ror.org\/00b30xv10","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Evidence connects mental illness to other adverse health conditions, including oral health. However, longitudinal associations between mental and oral health remain understudied. We aimed to examine mental health\u2013oral health associations prospectively in a nationally representative US cohort. Data were from the Population Assessment of Tobacco and Health (PATH) Study. The Global Appraisal of Individual Needs\u2013Short Screener measured 3 types of mental health symptoms: internalizing, externalizing, and substance use problems. Six self-reported oral health conditions related to periodontal disease were evaluated: self-rated oral health, bleeding gums, loose teeth, tooth extraction, gum disease, and bone loss around teeth. Cross-sectional analysis within PATH Study wave 4 (2016 to 2018, n\u2009=\u200930,746) compared the survey-weighted prevalence of the 6 oral health outcomes according to severity of mental health problems. Prospectively, oral health outcomes were assessed 2\u2009y later (wave 5, 2018 to 2019) according to wave 4 (baseline) mental health problems ( n\u2009=\u200926,168). Survey-weighted logistic regression models controlled for confounders (age, sex, tobacco use, etc.) with imputation for missing values. All 6 adverse oral health conditions were greater in prevalence among participants with severe internalizing problems. Multiple conditions were also associated with severe externalizing or substance use problems. Longitudinally associations attenuated, but multiple associations of meaningful magnitude persisted, most with internalizing problems. For example, the adjusted odds ratio was 1.27 (95% CI, 1.08 to 1.50) for bleeding gums and 1.37 (95% CI, 1.12 to 1.68) for tooth extraction when we compared severe versus none\/low internalizing problems. Providers should expect higher levels of oral disease among patients with adverse mental health symptoms. Independent of externalizing and substance use problems, symptoms of internalizing problems (related to depression and\/or anxiety) are plausible risk factors for future oral disease. Better integration and coordination of mental and oral health treatment and prevention are recommended.<\/jats:p>","DOI":"10.1177\/00220345231171108","type":"journal-article","created":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T08:17:17Z","timestamp":1685348237000},"page":"1007-1014","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":55,"title":["Mental Health and Oral Health in a Nationally Representative Cohort"],"prefix":"10.1177","volume":"102","author":[{"given":"A.","family":"Kalaigian","sequence":"first","affiliation":[{"name":"University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.W.","family":"Chaffee","sequence":"additional","affiliation":[{"name":"University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,29]]},"reference":[{"key":"bibr1-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12510"},{"key":"bibr2-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/add.13754"},{"key":"bibr3-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12452"},{"key":"bibr4-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1177\/154405910508401003"},{"key":"bibr5-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-018-2611-y"},{"key":"bibr6-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2005.00878.x"},{"key":"bibr7-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1177\/00220345221086272"},{"key":"bibr8-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520926139"},{"key":"bibr9-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.03.032"},{"key":"bibr10-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12381"},{"key":"bibr11-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1080\/14622200110050457"},{"key":"bibr12-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12179"},{"key":"bibr13-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1080\/10550490601006055"},{"key":"bibr14-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.110676"},{"key":"bibr15-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2002.73.4.441"},{"key":"bibr16-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00395-3"},{"key":"bibr17-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2012.00457.x"},{"key":"bibr18-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2016-052934"},{"key":"bibr19-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4800721"},{"key":"bibr20-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12798"},{"key":"bibr21-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9471-0"},{"key":"bibr22-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.04.040"},{"key":"bibr23-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.02.071"},{"key":"bibr24-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1177\/1039856213486308"},{"key":"bibr25-00220345231171108","unstructured":"Locker D. 2001. Oral health indicators and determinants for population health surveys: a report for Health Canada. Toronto (Canada): University of Toronto."},{"key":"bibr26-00220345231171108","unstructured":"National Addiction & HIV Data Archive Program. n.d. Population Assessment of Tobacco and Health (PATH) Study series [accessed 2023 Feb 17]. https:\/\/www.icpsr.umich.edu\/web\/nahdap\/series\/606"},{"key":"bibr27-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2011.00637.x"},{"key":"bibr28-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051X.2003.00360.x"},{"key":"bibr29-00220345231171108","volume":"1","author":"Robinson DJ","year":"2018","journal-title":"Can J Diabetes"},{"issue":"1","key":"bibr30-00220345231171108","first-page":"16","volume":"32","author":"Roohafza H","year":"2015","journal-title":"Community Dent Health"},{"key":"bibr31-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12429"},{"key":"bibr32-00220345231171108","doi-asserted-by":"publisher","DOI":"10.1111\/jre.12082"},{"key":"bibr33-00220345231171108","unstructured":"Substance Abuse and Mental Health Services Administration. 2021. Key substance use and mental health indicators in the United States: results from the 2020 National Survey on Drug Use and Health. HHS publication Pep21-07-01-003, NSDUH series H-56. 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