Association of Stressful Life Events with Oral Health Among Japanese Workers

Background: Psychological stress can cause various mental and physical health problems. The previous results on stress and oral health are inconsistent, possibly because of the narrow stress measurements. We aimed to examine the association between a broader range of stressful life events and oral health among workers.Methods: This cross-sectional study analyzed anonymous individual data from a national survey in Japan. Data on stressful life events, oral health problems which are one or more of tooth pain, gum swelling/bleeding, and difficulty chewing, and covariates were obtained using a self-reported questionnaire. Covariates used were gender, age group, disease under treatment, etc. Logistic regression analysis was used to estimate the association between stressful life events and oral health problems. We then estimated the causal treatment effects of stress using the augmented inverse-probability weighting (AIPW) method.Results: Among the 274,881 subjects, 152,850 men (55.6%) and 122,031 women (44.4%) with a mean age of 47.0 (SD=14.4), 4.0% reported oral health problems, with a prevalence of 2.1% among those without any stress. The prevalence increased with stress score, reaching 15.4% for those with the maximum stress score. The adjusted odds ratio of this group compared to those without any stress was 9.2 (95% confidence interval (CI)=8.2-10.3)). The estimated prevalence of oral health problems by the AIPW analysis was 2.2% (95%CI, 2.1-2.3) for those without any stress and 14.4% (95%CI, 12.1- 16.7) for those with the maximum stress scores.Conclusion: There was a clear dose-response association between stressful life events and oral health problems.