Satisfaction With Social Relationships and Roles Predicts Incident Gum Bleeding

Objectives: While physical health status is known to impact social functioning, less research addresses how social wellbeing may affect health. This analysis evaluated satisfaction with social relationships as a potential influence of gingival inflammation.
Methods: Data were from the Population Assessment of Tobacco and Health Study, a nationally representative cohort of US adults, Wave 4 (2016-2018) to Wave 6 (2021). Satisfaction with social relationships and roles was analyzed as sum score on two correlated items (Cronbach alpha=0.70; Spearman rho=0.54) from the validated PROMIS-10 health and wellbeing instrument, categorized for longitudinal analysis as high, moderate, or low during Waves 4-5 combined. The main outcome was incident self-reported gum bleeding (past 12-months) assessed at Wave 6. A survey-weighted logistic regression model adjusted for overall health status, sociodemographic (e.g., age, sex, race/ethnicity), socioeconomic (e.g., income, education), and behavioral (e.g., tobacco and alcohol use) confounders and was used to predict marginal mean risks of gum bleeding. Excluded were participants with <20 teeth or pregnant at the time of outcome assessment; missing covariables multiply imputed.
Results: Cross-sectionally at Wave 4 (N=23,679), gum bleeding prevalence followed a stepwise gradient along satisfaction with social relationships (extremely satisfied: 20.4%; not at all: 40.1%). Longitudinally, among participants with no history of gum bleeding through Wave 4 (N=8,178), Wave 6 marginal predicted gum bleeding risk was higher with each category of lower Wave 4-5 satisfaction with social relationship and roles (high satisfaction: 7.8%; moderate: 8.6%; low: 12.2%; high vs. low: P=0.006). Findings were robust to alternative model specifications. Results should be interpreted in light of study limitations (e.g., potential unmeasured confounding; outcome self-report).
Conclusions: Social wellbeing may affect physical health. Specifically, social activities, roles, and relationships may influence inflammatory conditions, like gingivitis. Confirmatory research is needed, along with efforts to advance policies and interventions that promote social wellbeing.