Journal List > J Korean Acad Oral Health > v.40(3) > 1057692

Ma and Cho: Association of sleep time, stress, and depression with the oral health status of Korean adolescents



This study aimed to assess the association between the stress or depression and oral health status of Korean adolescents.


The subjects were 1,180 participants of the Sixth Korea National Health and Nutrition Examination Survey (KNHANES), aged 12 to 18 years. All the collected data were analyzed by using the chi-square test, t test, analysis of variance, and multiple regression analysis with the SAS version 9.3 software. Multiple regression analysis was performed to analyze the relationship of stress or depression to oral health status, and 95% confidence intervals were computed.


Cognitive stress and depression levels for >2 weeks correlated with permanent teeth caries index. In terms of cognitive status, oral health of “a little feeling” was poorer than that of “almost no feeling,” with significant statistical difference (P<0.05).


The present study provides further evidence to support the establishment of a school oral health clinic for adolescents and hopefully provide guidance in the planning for oral health education.


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Table 1.
Characteristics of the study subjects
Variables N=1,180 (%)
Gender Male 626 (53.1)
Female 554 (46.9)
Age 12 214 (18.1)
13 197 (16.7)
14 207 (17.5)
15 162 (13.7)
16 125 (10.7)
17 158 (13.4)
18 117 (9.9)
Home income Low 171 (14.5)
Middle-low 296 (25.1)
Middle-high 361 (30.6)
High 352 (29.8)
Alcohol experience No 835 (70.8)
Yes 345 (29.2)
Smoking experience No 1,009 (85.5)
Yes 171 (14.5)

The data were analysed by reflecting complex weighted sample design.

Table 2.
Mental health status of the study subjects
Variables N (%)
Sleeping hours
≤6 hours 307 (26.0)
7 hours 353 (29.9)
8 hours 326 (27.6)
9 hours 193 (16.4)
Non-response 1 (0.1)
Level of cognitive stress
A lot of feeling 276 (23.4)
A little feeling 734 (62.2)
Almost no feeling 167 (14.2)
Non-response 3 (0.3)
Depression more than two weeks
Yes 103 (8.7)
No 1,074 (91.0)
Non-response 3 (0.3)

The data were analysed by reflecting complex weighted sample design.

Table 3.
Oral health status
Variables N Mean±SD
Permanent teeth caries index 1,180 0.72±0.06
Table 4.
Difference of oral health status according to mental health status
Variables N Permanent teeth P-value
caries index
Sleeping hours
≤6 hours 307 0.78±0.12
7 hours 353 0.79±0.10 0.191
8 hours 326 0.54±0.09
9 hours 193 0.83±0.18
Level of cognitive stress
A lot of feeling 276 0.83±0.12a,b
A little feeling 734 0.76±0.08b 0.001**
Almost no feeling 167 0.41±0.08a
Depression more than two weeks
Yes 103 1.16±0.21 0.027*
No 1,074 0.68±0.06 0.027*

Mean±SD. *P-value<0.05, **P-value<0.01. *P-value are determined from complex samples general linear model.

a ,bDifference letters denote there are significant difference by Bonferroni test.

Table 5.
Association between mental health status and permanen teeth caries (DMFT) index
Variables B SE P-value
Female Ref.
Male 0.246 0.11 0.026*
Age 0.078 0.04 0.049*
Home income
High Ref.
Middle-high 0.078 0.11 0.494
Middle-low 0.041 0.12 0.729
Low 0.301 0.21 0.494
Alcohol experience
Yes Ref.
No 0.129 0.14 0.348
Smoking experience
Yes Ref.
No ―0.234 0.20 0.239
Level of cognitive stress
Almost no feeling Ref.
A little feeling 0.330 0.11 0.002*
A lot of feeling 0.182 0.13 0.145
Depression more than two weeks
No Ref.
Yes 0.253 0.17 0.131

*P-value<0.05 by multiple regression.

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