Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
Faculty of Dentistry, Alexandria University, Alexandria, Alexandria Governorate, Egypt.
PLoS One. 2021 Feb 25;16(2):e0247073. doi: 10.1371/journal.pone.0247073. eCollection 2021.
Oral health is a less-recognized correlate of overall and mental wellbeing. This study aimed to assess the relationship between suicidal behavior (ideation and attempt) and oral health practices and status, and to determine the effect of sex on these associations among Nigerian adolescents.
Household survey data were collected from 10 to 19-year-old adolescents in southwestern Nigeria. Dependent variables were daily tooth brushing, daily consumption of refined carbohydrates between meals, and oral hygiene status (measured by plaque index). The independent variable was lifetime suicidal ideation/attempt, dichotomized into 'yes' and 'never'. 'Daily tooth brushing' and 'daily consumption of refined carbohydrates between meals' were included in two separate logistic regression models, and 'oral hygiene status' was included in a linear regression model. The models were adjusted for sex, age, and socioeconomic status. The linear regression model was also adjusted for frequency of daily tooth-brushing and of consumption of refined carbohydrates between meals. Interactions between sex and suicidal ideation/suicide attempt in association with dependent variables were assessed. Significance was set at 5%.
We recruited 1,472 participants with mean age (standard deviation) of 14.6 (2.6) years. The mean plaque index was 0.84 (0.56), and 66 (4.5%) adolescents reported ever having suicidal ideation/attempt. Suicidal ideation/attempt was associated with significantly lower likelihood of tooth brushing (OR = 0.48, 95% CI: 0.26, 0.91), higher likelihood of consuming refined carbohydrates between meals (OR = 2.30, 95% CI: 1.29, 4.10), and having poor oral hygiene (B = 0.18, 95% CI: 0.05, 0.32). Among males, suicidal ideation/attempt was associated with less likelihood of eating refined carbohydrates between meals (OR = 0.96, 95% CI: 0.35, 2.61). Conversely, it was associated with a significantly higher likelihood of this outcome (OR = 4.85, 95% CI: 2.23, 10.55) among females.
The study findings suggest that poor tooth brushing habits and poor oral hygiene are indicators for risk of suicidal behavior for adolescents in Nigeria, while high sugar consumption may be an additional risk factor for adolescent females. These findings support the role of dental practitioners as members of healthcare teams responsible for screening, identifying and referring patients at risk for suicidal ideation/attempt.
口腔健康是整体和心理健康的一个较少被认识到的相关因素。本研究旨在评估自杀行为（意念和尝试）与口腔健康行为和状况之间的关系，并确定性别对尼日利亚青少年这些关联的影响。
从尼日利亚西南部 10 至 19 岁的青少年中收集家庭调查数据。因变量为每天刷牙、每天在两餐之间食用精制碳水化合物和口腔卫生状况（用菌斑指数衡量）。自变量为终生自杀意念/尝试，分为“是”和“否”。“每天刷牙”和“每天在两餐之间食用精制碳水化合物”被纳入两个单独的逻辑回归模型，“口腔卫生状况”被纳入线性回归模型。这些模型根据性别、年龄和社会经济地位进行了调整。线性回归模型还根据每天刷牙和两餐之间食用精制碳水化合物的频率进行了调整。评估了性别与自杀意念/自杀企图之间的交互作用与因变量的关系。显著性水平设定为 5%。
我们招募了 1472 名参与者，平均年龄（标准差）为 14.6（2.6）岁。平均菌斑指数为 0.84（0.56），66（4.5%）名青少年报告曾有过自杀意念/尝试。自杀意念/尝试与刷牙的可能性显著降低相关（OR=0.48，95%CI：0.26，0.91），两餐之间食用精制碳水化合物的可能性增加（OR=2.30，95%CI：1.29，4.10），口腔卫生状况较差（B=0.18，95%CI：0.05，0.32）。在男性中，自杀意念/尝试与两餐之间食用精制碳水化合物的可能性降低相关（OR=0.96，95%CI：0.35，2.61）。相反，在女性中，它与这种结果的可能性显著增加相关（OR=4.85，95%CI：2.23，10.55）。
研究结果表明，在尼日利亚，青少年中不良的刷牙习惯和较差的口腔卫生状况是自杀行为风险的指标，而高糖摄入可能是青少年女性的另一个风险因素。这些发现支持牙科医生作为医疗团队成员的作用，负责筛查、识别和转介有自杀意念/尝试风险的患者。
