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Does Psychological Stress Mediate Social Deprivation in Tooth Loss?

¹ Institute of Dentistry, Barts and the London, Queen Mary University of London, London, UK;
² Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide, Adelaide, Australia, 5005; and
³ School of Public Health, Queensland University of Technology, Brisbane, Australia

Correspondence: ^* corresponding author, anne.sanders{at}adelaide.edu.au

It is unclear which theoretical dimension of psychological stress affects health status. We hypothesized that both distress and coping mediate the relationship between socio-economic position and tooth loss. Cross-sectional data from 2915 middle-aged adults evaluated retention of < 20 teeth, behaviors, psychological stress, and sociodemographic characteristics. Principal components analysis of the Perceived Stress Scale (PSS) extracted ’distress’ (a = 0.85) and ’coping’ (a =0.83) factors, consistent with theory. Hierarchical entry of explanatory variables into age- and sex-adjusted logistic regression models estimated odds ratios (OR) and 95% confidence intervals [95% CI] for retention of < 20 teeth. Analysis of the separate contributions of distress and coping revealed a significant main effect of coping (OR = 0.7 [95% CI = 0.7–0.8]), but no effect for distress (OR = 1.0 [95% CI = 0.9–1.1]) or for the interaction of coping and distress. Behavior and psychological stress only modestly attenuated socio-economic inequality in retention of < 20 teeth, providing evidence to support a mediating role of coping.

Key Words: psychological stress • tooth loss • mediator • health inequalities • risk behavior

Journal of Dental Research, Vol. 86, No. 12, 1166-1170 (2007)
DOI: 10.1177/154405910708601205


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