Depression and differential oral health status among U.S. adults with and without prior active duty service in the U.S. military, NHANES 2011-2018

Date
2023
DOI
Authors
Ryan, Joseph Brett
Version
OA Version
Citation
Abstract
Veterans suffer from lower overall well-being than non-veterans due to their unique life course. This study aims to compare the impact of depression on oral health for veteran and non-veteran populations. Data from 11,693 adults (18 +) participating in the NHANES (2011-2018) were analyzed. Outcome variables were dichotomous (at/above mean) DMFT, MT, FT, and DT; the primary predictor variable combined depression screening outcome and veteran status (veteran/depressed, veteran/not depressed, non-veteran/depressed, non-veteran/not depressed). Covariates included socioeconomic factors, demographics, wellness factors, and oral health-related habits. Associations between outcome and predictor variables were assessed with a fully adjusted logistic regression analysis. Veterans, regardless of depression status, had more DMFT, FT, MT and DT compared to non-veterans. After controlling for covariates, veterans suffering from depression had higher odds of DT (1.5, 95% CI:1.0-2.4) compared to non-veterans without depression. In general, veterans who screened negative for depression had better oral health compared to all groups, with lower odd of DT (0.7, 95% CI:0.6-0.9) and more FT (1.4, 95% CI:1.1-1.7) compared to non-veterans with and without depression. This study found that veterans not only have higher odds of overall caries experience, but that veterans suffering from depression have higher odds of active caries compared to non-depressed veterans. Most veterans lack VA oral healthcare benefits and face challenges maintaining oral health on top of medical and mental health burdens. Our results add further urgency to increasing dental care access for this vulnerable population due to the exacerbation of unmet oral healthcare needs attributable to the mental health challenges veterans face.
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