Toothbrushing habits are associated with self perceived stress

Abstract Background Personal self-care is one of the most important factors in maintaining and improving oral health. Public health guidelines are recommending tooth brushing at least twice daily, once before bed time and at least on one occasion. On the other hand, our regular routines and caring for our own health is influenced by different factors including stress. We wanted to research how much does daily stress influencing tooth brushing habits. Methods We analyzed data from 2020 CINDI nationwide cross-sectional survey in Slovenia. Tooth brushing once a day or less was assessed as inadequate. Stress was assessed with question >>How often in the last 14 days have you felt tense, stressed or under a lot of pressure? << Participants who chose often or always as an answer were assessed as persons under stress. Method of binary logistic regression was used for statistical analysis of association between tooth brushing frequency and self-perceived stress, modified for some socioeconomic factors. Results Prevalence of inadequate frequency of tooth brushing was present in 31,6 % of sample, 31,5% in participants who were not feeling tense and 31,8% in participants who often felt tense or stressed. At first it seemed stress is not associated with tooth brushing habits. We adjusted this association for gender, education level and age and this association became clearer. Participants who felt stress and/or under pressure had higher odds for poor tooth brushing habits, their odds ratio was 1,283 (p < 0,001; 95% CI 1,124; 1,464) when adjusted for aforementioned factors. Conclusions Oral health is integral part of general health. Association between oral and mental health is often overlooked even though psycho-social aspects are part of modern oral health definition. As personal self-care is cornerstone of maintaining and improving oral health, implementation of mental health aspects should be incorporated in public health advises and programmes for promoting oral health. Key messages • Self-perceived stress is associated with toothbrushing habits. • People who are under stress less regularly brush their teeth.