title: Psychological distress and self-rated oral health among a convenience sample of Indigenous Australians.
abstract: OBJECTIVE
  This study sought to: a) estimate the frequency of poor self-rated oral health as assessed by a summary measure; b) compare frequency according to sociodemographic, behavioral, and psychological distress factors; and (3) determine if psychological distress was associated with poor self-rated oral health after adjusting for confounding.
  
  
  METHODS
  Data were from a convenience sample of Indigenous Australian adults (n = 289) residing in Australia's Northern Territory. Poor self-rated oral health was defined as reported experience of toothache, poor dental appearance or food avoidance in the last 12 months. A logistic regression model was used to evaluate socio-demographic, behavioral, and psychological distress associations with poor self-rated oral health (SROH). Effects were quantified as odds ratios (OR).
  
  
  RESULTS
  The frequency of poor SROH was 73.7 percent. High psychological distress, measured by a Kessler-6 score ≥8, was experienced by 33.9 percent of participants. Poor SROH was associated with high levels of psychological distress, being older, being female, and usually visiting a dentist because of a problem. In the multivariable model, factors that were significantly associated with poor SROH after adjustment for other covariates included having a high level of psychological distress (OR 2.74, 95% CI 1.25-6.00), being female (OR 2.22, 95% CI 1.03-4.78), and usually visiting a dentist because of a problem (OR 3.57, 95% CI 1.89-6.76).
  
  
  CONCLUSIONS
  Poor self-rated oral health and high levels of psychological distress were both highly frequent among this vulnerable population. Psychological distress was significantly associated with poor self-rated oral health after adjustment for confounding.
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Najith
authors.initials: N
authors.lastname: Amarasena
authors.affiliation: School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Kostas
authors.identifier: http://orcid.org/0000-0002-3761-9953
authors.initials: K
authors.lastname: Kapellas
authors.affiliation: Indigenous Health Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Brown
authors.affiliation: Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Skilton
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Maple-Brown
authors.affiliation: Colgate Australian Clinical Dental Research Centre, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Bartold
authors.affiliation: Sansom Research Institute, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
authors.affiliation: Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Celermajer
authors.affiliation: School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Gary Douglas
authors.initials: GD
authors.lastname: Slade
authors.affiliation: School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jamieson
mesh_terms: D006801:Humans; D009909:Oral Health; D012647:Self-Assessment; D013021:South Australia; D013315:Stress, Psychological
keywords: Indigenous Australian; poor self-rated oral health; psychological distress