Association Between Chewing Difficulty and Symptoms of Depression in Adults: Results from the Korea National Health and Nutrition Examination Survey

Objectives To assess the association between chewing difficulty and symptoms of depression in a representative sample of the Korean population. Design Cross-sectional. Setting Korea National Health and Nutrition Examination Survey (KNHANES). Participants KNHANES participants (N = 5,158). Measurements Chewing difficulty was assessed according to the self-reported presence of chewing problems using a structured questionnaire. Symptoms of depression were defined as having feelings of sadness or depression consecutively over 2 weeks during the last 12 months. Multivariable logistic regression analysis was used to determine the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of the associations between chewing difficulty and symptoms of depression, adjusted for age; sex; monthly household income; education; number of teeth; number of decayed, missing, or filled permanent teeth; periodontitis; state of dentition; tooth brushing frequency; regular dental visits; smoking status; alcohol consumption; hypertension; diabetes mellitus; and obesity. The interaction effects between chewing difficulty and confounders were evaluated, and age- and sex-stratified analyses were performed. Results There was a significant positive association between chewing difficulty and symptoms of depression in the fully adjusted model (AOR = 1.86, 95% CI = 1.48–2.33). The strength of the association was highest in men aged 60 and older (AOR = 3.28, 95% CI = 1.54–7.00). Conclusion Chewing difficulty was independently associated with symptoms of depression in a representative sample of Korean adults.