September 2009

Objectives: The purpose of this analysis was to explore whether, and if so to what extent, there is an association between self-reported oral and mental health problems, and if this association exists after controlling for self-rated physical health and age. Research Design: A large cross-sectional population-based telephone health survey with participants selected using random stratified sampling. The response rate was 71%. Survey weights were used for estimating proportions and for all statistical inferences. Setting and Participants: Participants (n=8,881) were community-dwelling older people (65+ years) living independently in New South Wales, Australia. Measures and Analysis: The following measures were used in the analysis: physical health (1 item); oral health (5 items), mental health (2 items). Trends in prevalences across groups were analysed using the Cochrane-Armitage trend test. Logistic regression modelling was conducted to account for the main confounders of age and self-rated physical health, and attributable fractions calculated. Results: Both measures of mental health, feeling hopeless and feeling depressed, were significantly and positively associated with increased reporting of oral health concerns in both males and females. Logistic regression modelling showed that most of the oral health items remained strongly associated with mental health after controlling for self- rated physical health and age. The attributable fractions demonstrated that a proportion of the mental health problems identified in older people would be reduced if oral health concerns were adequately addressed. Conclusions: The findings highlight the association between oral and mental health, and provide evidence to support the expansion of publicly funded dental health services. Key words: Australia, mental health, older adults, oral health.