title: Current stress and poor oral health.
abstract: BACKGROUND
  Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship.
  
  
  METHODS
  Data from a cross-sectional study of 2,412 participants between the ages of 25-64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers.
  
  
  RESULTS
  A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26-0.38; general oral health coefficient 0.28, 95 % CI 0.19-0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position.
  
  
  CONCLUSIONS
  Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.
authors: Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors: A
authors: A
authors: Vasiliou
authors: Department of Health Sciences, Wilfrid Laurier University, 75 University Ave West, Waterloo, ON, N2L 3C5, Canada. kshankardass@wlu.ca.|Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada. kshankardass@wlu.ca.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. kshankardass@wlu.ca.
authors: K
authors: K
authors: Shankardass
authors: Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors: R
authors: R
authors: Nisenbaum
authors: Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors: C
authors: C
authors: Quiñonez
mesh_terms: D003430:Cross-Sectional Studies; D003729:Dental Care; D006801:Humans; D007347:Insurance, Dental; D009909:Oral Health; D012959:Socioeconomic Factors
keywords: Dental insurance; General oral health; Oral pain; Stress