The Interplay between Rapid Mental Health Screening and Oral Health Behaviors: A Population-Based study with a Focus on Toothbrushing Frequency and Dental Attendance

ObjectivesLittle is known about how major mental distresses such as depression, anxiety, and suicide impact key oral health behaviors, particularly in low- and middle-income countries (LMICs) like Iran. This study assesses whether depressive and anxious moods and suicidal ideation, rapidly screened indicators of these distresses, relate to toothbrushing frequency and dental attendance among a sample of Iranian adults. MethodsThis cross-sectional study used data from the Integrated and Repeated Public Health Surveillance project (May-September 2023) in southern Tehran Province, Iran. Stratified random sampling was used to survey adults aged [&ge;]18 via telephone. A validated questionnaire assessed depressive mood, anxious mood, suicidal ideation, toothbrushing frequency, and 6-month dental attendance. A "composite mental distress" variable was also created by combining the three mental distresses. Binary logistic regression analyzed associations, adjusting for covariates. ResultsAmong the 1,282 participants (mean age 40.1, SD = 13.3, 60.6% female), 23.5% toothbrushed twice a day and above, and 33.2% attended dental visits in the past 6 months. Moderate and high depressive mood levels, higher depressive mood scores, and higher anxious mood scores were all related to toothbrushing less than twice daily (AOR = 0.65, p = 0.004, AOR= 0.54, p = 0.037, AOR = 0.85, p = 0.006, and AOR = 0.87, p = 0.021, respectively). Moderate composite mental distress levels and higher composite mental distress scores were also related to toothbrushing less than twice daily (AOR = 0.52, p < 0.001, and AOR: 0.94, p = 0.019, respectively). None of the mental distress indicators were associated with 6-month dental attendance. ConclusionsTo address findings, oral healthcare providers should be trained in rapid mental health screening, provide toothbrushing support for those screened, and refer them to mental healthcare when necessary. Similarly, mental healthcare providers should be trained to recognize mental distress indicators of poor toothbrushing, promote toothbrushing among therapeutic goals, and refer patients to oral healthcare when necessary