Relationship of depressive symptoms to edentulousness, dental health, and dental health behavior.

We investigated the relationship of edentulousness, dental health, and dental health behavior to depressive symptoms in the 55-year-old population of Oulu (a medium-sized Finnish town), 780 of whom (78%) participated. The dental examination included an assessment of oral health status. Depressive symptoms were determined with the Zung Self-Rating Depression Scale (ZSDS). The participants were also asked about their dental health behavior, smoking habits, health, life satisfaction, and factors related to their work. Depressive symptoms were associated with edentulousness among non-smoker men. When further evaluated by logistic regression analysis, edentulousness was independently associated with depressive symptoms in this subpopulation (odds ratio = 6.4, confidence interval = 1.4-29.2) after adjusting for confounding factors. Depressive symptoms were not associated with dental caries, periodontal status, or number of teeth. The dentate women with high rates of depressive symptoms had a more negative attitude towards preserving their natural teeth, used sugary products more frequently, reported a longer time since their last dental visit, and tended to have a lower percentage of filled tooth surfaces than the non-depressed dentate women. The aspect of depression should be borne in mind by dentists when treating edentulous patients. On the other hand, certain subgroups of depressed patients might benefit from dental implant therapy. Thus, the importance of teamwork between clinicians, psychiatrists, and dentists is emphasized.

Depressive symptoms favor abundant growth of salivary lactobacilli.

OBJECTIVE: The purpose was to study the growth of lactobacilli in subjects with depressive symptoms in the total 55-year-old population of Oulu (a medium-sized town in Finland); 780 people participated. METHODS: The dental examination included measurements of salivary lactobacillus growth with the Dentocult-LB method; measurements of salivary flow rate, pH, and buffering capacity; and assessment of oral health status. Depressive symptoms were determined with the Zung Self-Rating Depression Scale (ZSDS). Participants were also asked about their health, medication, smoking, and dietary habits. RESULTS: The prevalence of high lactobacillus counts (> or =100,000 CFU/ml) was 22% among women and 31% among men (p = .02). Thirty-seven percent of the subjects with a high rate of depressive symptoms (ZSDS score of > or = 40) and 23% of those with an ZSDS score of < or = 39 had high counts of lactobacilli (p = .003). A logistic regression analysis with improvement of goodness of fit was made to confirm the relation between abundant lactobacilli and a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with abundant lactobacillus growth. CONCLUSIONS: The association between high lactobacillus counts and depressive symptoms suggests that depressed subjects are at risk of having caries and possibly other dental diseases that should be recognized in the treatment of these patients.

Lifestyle, gender and occupational status as determinants of dental health behavior.

The aim was to compare how general lifestyle, gender and occupational status determine dental health behavior. All the 1012 55-year-old citizens of Oulu (a medium-sized Finnish town) were invited to participate in this study. 780 of them did so. Information about frequency of toothbrushing, use of extra cleaning methods, use of sugar in coffee or tea, and time of the last dental visit, lifestyle, occupational status and gender was gathered from the 533 dentate subjects. Lifestyle was measured by means of questions about physical activity, tobacco smoking, alcohol consumption and dietary habits. Females and people with a healthy lifestyle brushed their teeth more often. Extra cleaning methods were used more often by people with a healthy lifestyle, whereas gender and occupational status had a weaker association. Males and people with a lower occupational status used sugar in coffee or tea more often. The time from the last dental visit was longer among workers and men; lifestyle had no significant association. At the population level oral cleaning habits are a matter of a health-oriented lifestyle and gender-related behavior. The dental visiting habit has a weaker association with general lifestyle.

Depressive symptoms as an underlying factor of the sensation of dry mouth.

OBJECTIVE: The purpose of this survey was to study the sensation of oral dryness and its underlying factors in the 55-year-old population of Oulu (a medium-sized Finnish town), 780 of whom (77%) participated. METHOD: In addition to the examination of oral health status and salivary flow rate measurements, depressive symptoms were determined on the basis of the Zung Self-Rating Depression Scale (ZSDS). The participants were also interviewed about their health, medication, physical health, physical activity, smoking habits, alcohol consumption, and factors related to their work. RESULTS: The prevalence of subjective sensations of dry mouth was 25.8% among men and 33.3% among women (p = 0.025). A statistically significant association was found between a subjective sensation of dry mouth and a low unstimulated flow rate, regular smoking, xerogenic medication, and the presence of at least one illness connected with dry mouth. Those who had a sensation of dry mouth also thought their physical condition and their health to be poorer and more often had a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with the sensation of oral dryness. CONCLUSIONS: When evaluating the causes of the sensation of dry mouth, the possibility of depression as an underlying factor should be considered.

The association of yeasts and denture stomatitis with behavioral and biologic factors.

OBJECTIVES: This study describes the association of yeasts and denture stomatitis with behavioral and biologic factors. STUDY DESIGN: Seven hundred eighty 55-year-old citizens of Oulu, Finland, were examined clinically; 452 of them had complete dentures. Salivary yeasts and lactobacillus counts were detected through the use of Oricult-N and Dentocult-LB dip-slide techniques. Lifestyle factors were measured by means of questions concerning physical activity, tobacco smoking, alcohol consumption, and dietary habits. Other background variables used in cross-tabulations and logistic regression analysis were unstimulated salivary secretion rate, retention of denture, oral hygiene, gender, and socioeconomic status. RESULTS: The prevalence of denture stomatitis was greater among subjects with an unhealthy lifestyle, subjects with higher lactobacillus counts, and subjects with poor oral hygiene. Salivary secretion rate and smoking were associated with the presence of yeasts, but general lifestyle measures were not. CONCLUSION: The presence of yeasts tended to be associated with biologic factors, but behavioral factors reflecting lifestyle may be more important in the development of denture stomatitis.