Relationship between depression and stress and oral-health behavior among Koreans before and during the COVID-19 pandemic

Objectives: This study aimed to analyze the relationship between depression and stress and oralhealth behavior among Koreans before and during the coronavirus disease 2019 pandemic to provide basic data for systematically managing oral health in future infectious disasters and for developing mental-health policies based on oral health.Methods: We used raw national health and nutrition research data for the years 2018-2021.The years 2018 and 2019 were classified as 'the pre-pandemic period' and 2020 and 2021 were classified as 'the pandemic period.'The pre-pandemic and pandemic groups included 16,102 and 14,449 individuals, respectively.We excluded individuals aged <20 years, patients with cancer which could affect the research results, and individuals with missing data.Finally, 20,924 individuals were included in the study, of which, 10,988 and 9,936 were classified into the pre-pandemic and pandemic groups, respectively.Results: Oral-health behavior in patients with depression was significantly different between the pre-pandemic and pandemic periods.The proportion of participants with ideal oral-health behavior was significantly higher among individuals without depression than among those with depression.In the pre-pandemic and pandemic groups, the odds ratios for practicing ideal oral-health behavior among individuals with low stress perception were 1.182 (P=.002) and 1.148 (P=.010), respectively.Conclusions: In preparation for a future pandemic, identifying and supporting individuals with high levels of depression or stress is necessary to establish guidelines for regular mental-health checkups in the dental-care environment.Additionally, integrative standard policies must be framed considering the complex interactions between mental health and stress and oral-health behavior.