Association between Self Reported Oral Health and Hepatitis C Virus

Objective: Examine 1) association between poor self reported oral health (PSROH) and Hepatitis C Virus(HCV) and 2) potential utility of using PSROH to screen for HCV. Methods: We used data for adults, aged 20 years and older, from the National Health Examination and Nutrition Survey 1999-2002. We examined the association between PSROH (dependent variable) and socio-demographic variables (age, race/ethnicity, gender, dental insurance, and family income <=00% FPL), other health conditions, and HCV with a logistic regression model. Individuals reporting the condition of their mouth and teeth as fair or poor were classified as having PSROH. We used self reported general health and activity limitations due to presence of a health condition as proxies for presence of other health conditions. To examine the feasibility of using PSROH to screen for HCV, we estimated the sensitivity, specificity, positive-, and negative-predictive value. Results: Among the study sample (8,828 adults had data for SROH and HCV representing 187,021,839 persons), the mean age was 46.1 years and 72.3% were non-Hispanic whites. The prevalence of HCV and PSROH were respectively, 2.0% (se=0.2%) and 34.8% (se=1.1%). All independent variables, with the exception of activity limitations, were significant (p<0.05) in the logistic regression. The variables with the highest odds ratios were poor or fair self reported general health, 3.8 (95%CI: 3.0-4.7), and HCV, 3.9 (95%CI: 2.1-7.2). The sensitivity and specificity of PSROH were 68.9% and 66.2%, respectively. The positive- and negative-predictive values were 4.0% and 99.0%, respectively. Conclusion: Our findings suggest a strong association between HCV and PSROH. The utility of PSROH as a screening tool for HCV depends upon the benefit of identifying HCV cases relative to the costs.