The relation between oral health, depression, and anxiety among adults in Riyadh city, Saudi Arabia: a cross-sectional study

Background Growing evidence suggests a bidirectional relationship between mental and oral health, with psychological distress having a detrimental impact on oral health behaviors and outcomes, and poor oral health exacerbating mental health symptoms. This study aimed to examine the relationship between depressive and anxiety symptoms and oral health-related quality of life (OHRQoL) among adults in Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted using a self-administered online questionnaire distributed to adults residing in Riyadh. The survey incorporated validated instruments: the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) scale to measure anxiety symptoms, and the Oral Health Impact Profile-14 (OHIP-14) to evaluate OHRQoL. Descriptive statistics and multivariable linear regression analyses were carried out using RStudio (version 2024.9.1.394, Boston, MA, USA) with R version 4.4.2. Statistical significance was set at p < 0.05. Results The analysis included 650 participants. Moderate-to-severe anxiety and depression were reported by 33.7% and 41.1% of participants, respectively. Higher PHQ-9 and GAD-7 scores were significantly associated with higher OHIP-14 scores ( p < 0.001). In multivariable regression analysis, severe depression ( β = 8.24) and severe anxiety ( β = 5.71) demonstrated the strongest associations with increased OHIP-14 scores. Additionally, age ≥ 45 years and monthly family income between 10,000 and 20,000 SAR were independently associated with poorer OHRQoL. Conclusion Severe depression and anxiety symptoms were independently associated with poorer OHRQoL among adults in Riyadh. These findings support integrating mental health assessments into oral healthcare services to enhance comprehensive, patient-centered care.