Acculturation, depression and oral health of immigrants in the USA

Objectives: The objectives were to describe the oral health status of immigrants in the USA, describe the association between acculturation and oral health by accounting for the effects of depression and to explore the effects of interaction between acculturation and depression on the oral health of immigrants. Methods: Data were from the 2011–2012 National Health and Nutrition Examination Survey (NHANES). Oral health status was assessed by both self-rated oral health and clinically diagnosed periodontitis, each coded as a binary outcome. Acculturation was operationalised as length of stay in the USA and speaking English at home. Depression was assessed using the Patient Health Questionnaire-9. Multiple logistic regression models were used to examine the association of acculturation and depression status with oral health. Results: In 2011–2012, 36.6% immigrants reported poor oral health and 53.0% were diagnosed with periodontitis. A length of stay in the USA of 30+ years (adjusted odds ratio [AOR] = 0.43, 95% confidence interval [95% CI]: 0.21–0.89) reduced the odds of having periodontitis in comparison with a length of stay in the USA of fewer than 5 years. Speaking English at home (AOR = 0.64, 95% CI: 0.43–0.96) reduced the odds of having periodontitis compared with speaking other languages. Depression was negatively associated with self-reported good oral health (AOR = 0.43, 95% CI: 0.20–0.92) and positively associated with clinically diagnosed periodontitis (AOR = 1.89, 95% CI: 1.18–3.04). The effects of acculturation did not differ according to depression status. Conclusion: A longer stay in the USA and speaking English at home were associated with less periodontitis among the immigrants.