Association of lifestyle behaviors and oral health care needs: Mediating effects of inflammatory markers

Mounting evidence indicates that modifiable risk factors such as lifestyle behaviors may be involved in the occurrence of oral diseases. However, existing research doesn't come to a unanimous consent. This study aims to evaluate the association between lifestyle behaviors and oral health care needs. This study used the nationally representative dataset from the National Health and Nutrition Examination Survey (NHANES) from March 2017 to 2020 pre-pandemic. Binary logistic regression analysis was used to evaluate lifestyle behavioral factors that influence oral health care needs. Mediation analysis was performed to explore the roles of inflammatory markers in the relationship between physical activities and oral problems. After adjusting for covariates, multivariate analysis indicated that flossing (OR = 0.590, 95% CI, 0.510–0.682, P < 0.001), moderate alcohol consumption (per week: OR = 0.717, 95% CI, 0.588–0.873, P < 0.001; per month/year: OR = 0.794, 95% CI, 0.669–0.942, P = 0.008) and participation in recreational activities (vigorous recreational activities: OR = 0.548, 95% CI, 0.462–0.648, P < 0.001; moderate recreational activities: OR = 0.629, 95% CI, 0.549–0.721, P < 0.001) significantly reduced oral health care needs. In addition, sleep duration of 7–9 h was associated with lower oral health care needs compared to less or more sleep duration (<7 h or > 9 h) (OR = 0.851, 95% CI, 0.741–0.976, P = 0.021). Mediation analysis suggested that white blood cell (WBC) counts and high-sensitivity C-reactive protein (hs-CRP) concentrations acted significant mediating roles in the association between recreational activities and oral problems. The possible beneficial effects of healthy lifestyle behaviors on oral health will guide individuals to develop good habits, thereby reducing the burden of oral diseases.