Document Type


Publication Date



School of Dentistry


Dental Practice & Rural Health


Background: Depression has been linked to poor oral health among patients seeking dental care. However, systematic research on the relationship between depressive symptoms and oral health is limited. Objective: To examine the association of depressive symptoms with untreated dental caries among adults aged 21-64 years. Basic Research Design: Cross-sectional secondary analysis. Setting: The data were extracted national data collected in the United States (2013-2014 National Health Nutrition and Examination Survey). Participants: The sample consisted of 3,127 non-institutionalized civilians. Main outcome measure: Untreated coronal dental caries (yes, no) was the key outcome variable. Depressive symptom categories (none, moderate, and severe) were derived from the Patient Health Questionnaire-9 Depression Scale. Results: In the study sample, 33.4% of adults had untreated coronal dental caries. Most participants (77.9%) did not report depressive symptoms; 13.9% had mild and 8.2% had moderate or severe depressive symptoms. In unadjusted analyses, individuals with mild (Odds Ratio = 1.62 [95% CI: 1.26, 2.08] and moderate/severe depressive symptoms (Odds Ratio = 2.70 [95% CI: 1.81, 4.02]) were more likely to have untreated coronal caries as compared with individuals without depressive symptoms. When sex, race, age, education, family income-to-poverty ratio, dental visits, history of previous dental restorations, health insurance, and smoking were included into the model, the associations were no longer statistically significant (1.27 [95% CI: 0.96, 1.69] and 1.61 [95% CI: 0.95, 2.73], respectively). Conclusion: The relationship between depressive symptoms and untreated coronal dental caries failed to remain significant after the addition of tobacco usage in the analysis.

Source Citation

Wiener RC, Shen C, Findley PA, Dwibedi N, Sambamoorthi U. Depressive symptoms and untreated coronal dental caries among adults ages 21-64 years, NHANES 2013-2014. Community Dental Health. 2018;(35):179-185. doi:10.1922/CDH_4304Weiner07