Oral Hygiene Neglect in Indian Teens and Young Adults Due to Depression Caused by Internet Addiction

Abstract

Background:

Internet addiction is increasingly prevalent among adolescents and young adults, contributing to mental health issues and self-care neglect, including oral hygiene.

Aim:

To assess the correlation between internet addiction-induced depression and oral hygiene neglect among Indian youth.

Methods:

A cross-sectional survey was conducted among 382 university students aged 17–25 using a validated online questionnaire. Data were analyzed using Chi-square tests.

Results:

Significant associations were found between high screen time, depressive symptoms (P = 0.001), and reduced brushing frequency (P = 0.015).

Conclusion:

Internet addiction is linked to depression and neglect of oral hygiene in young adults.

INTRODUCTION

In the modern digital landscape, internet usage has transcended its utilitarian roots and become a pervasive behavioral phenomenon. What begins as a voluntary choice often evolves into compulsive use, especially among adolescents and young adults, due to the reward-based algorithms of social media and gaming platforms. Features like counts, notifications, and auto-play functions stimulate dopamine-driven responses, creating patterns of dependency that are difficult to break.

This excessive digital engagement has significant psychological repercussions. Numerous studies have linked internet addiction with elevated levels of depression, anxiety, and social withdrawal. In a Korean adolescent study, 38% of participants were classified as possible internet addicts, with a strong correlation observed between their internet use and depressive symptoms and suicidal ideation.[1] Similarly, research among university students highlighted that increased screen time is associated with depression, insomnia, and low self-esteem, further exacerbating mental health deterioration.[2]

Depression, as a psychological condition, impairs motivation and executive function, often leading to neglect of self-care routines, including oral hygiene. The frequency and quality of tooth brushing serve as visible proxies for daily wellness behaviors. Adolescents and young adults—typically aged 17–25—are especially vulnerable to this cycle of digital dependency, depression, and hygienic neglect, particularly in the wake of the COVID-19 pandemic, which intensified screen time and social isolation.

This study explores the triadic relationship between internet addiction, resultant depressive symptoms, and their impact on oral hygiene practices in Indian youth, aiming to generate awareness and evidence to inform targeted interventions.

METHODS

A cross-sectional analytical survey was conducted to explore the correlation between internet addiction-induced depression and oral hygiene neglect among university students aged 17–25 years in the Delhi NCR region. This age group was specifically chosen due to its high susceptibility to both internet addiction and emerging mental health concerns.

Participants were selected using convenience sampling and included only those enrolled in higher education institutions within the designated geographic area. Exclusion criteria ruled out individuals outside the 17–25 age range or not affiliated with a university in Delhi NCR.

Data collection was performed using a pre-validated, self-administered, semi-structured questionnaire distributed via Google Forms. The questionnaire consisted of 18 items grouped into the following domains: demographics, screen time and usage patterns, depression indicators (based on common symptoms), and oral hygiene habits. Notably, screen time above 3 h was flagged as a potential indicator of internet addiction, particularly when time was spent on nonwork-related activities.

To ensure reliability and validity, the questionnaire was reviewed by three subject experts from Public Health Dentistry, Endodontics, and Pedodontics, and was subsequently pilot tested on 10 students. Minor syntactical and sequencing adjustments were made based on the feedback. Confounding factors were also considered during finalization. The target sample size was calculated using Slovin’s formula with a 95% confidence interval and 0.05 margin of error, after expert statistical consultation.

RESULTS

This study revealed a significant relationship between excessive screen time and mental as well as oral health indicators among Indian youth. Over half the respondents (55.8%) showed symptoms of depression, with a higher prevalence among those with screen time exceeding 7 h per day. While the majority (96.6%) brushed daily, only 48.7% brushed twice a day, indicating suboptimal oral hygiene practices. Notably, 8.4% reported experiencing bleeding gums every time they brushed, as seen in Table 1.

Table 1.

Summary of key results (n=382)

Parameter		Categories		Frequency (n)		Percentage (%)
Age group		17–20 years		174		45.5
		21–25 years		206		53.9
Gender		Female		261		68.3
		Male		121		31.7
Screen time (>10 h/day)		Yes		36		9.4
Tried reducing screen time		Yes		323		84.6
Depression (feeling down)		Yes		213		55.8
Brushing frequency		Daily		369		96.6
Bleeding gums while brushing		Twice daily		186		48.7
		Every time		32		8.4
		Rarely		154		40.3
		Never		196		51.3
Use of other oral hygiene products		Mouthwash		188		49.2
		Dental floss		56		14.7
		No other product		138		36.1

Statistical analysis showed that higher screen time was significantly associated with reduced brushing frequency (P = 0.015), increased depression symptoms (P = 0.001), and greater incidence of bleeding gums (P = 0.001). Additionally, individuals with depressive symptoms were less likely to maintain regular oral hygiene, as evidenced by the significant association between brushing frequency and depression (P = 0.047) as observed in Table 2.

Table 2.

Key statistical associations

Association		P
Screen time vs. brushing frequency		0.015*
Screen time vs. bleeding gums		0.001*
Screen time vs. depression		0.001*
Brushing frequency vs. depression		0.047*

*Significant

DISCUSSION

This study investigated the correlation between internet addiction, depression, and oral hygiene neglect among Indian adolescents and young adults. The findings revealed a significant association between prolonged screen time and both depression and compromised oral hygiene behaviors.

A substantial proportion of respondents (55.8%) exhibited depressive symptoms, with this prevalence increasing alongside screen time. These findings align with previous research where excessive internet use was linked to poor mental health outcomes, including depression and anxiety.[2] Kim et al.[1] also reported similar outcomes among Korean adolescents, reinforcing the impact of digital overuse on psychological health.

Furthermore, a notable decrease in brushing frequency was observed among those with longer screen exposure, mirroring results from a Japanese study that linked excessive gaming with poor toothbrushing habits.[3] In this study, 8.4% of participants reported experiencing bleeding gums every time they brushed, a sign of possible gingivitis or early periodontal disease, which may reflect neglected oral hygiene.

Depression itself has been linked to reduced self-care practices, including oral hygiene.[4] The bi-directional relationship between mental health and oral health behaviors is increasingly being recognized, suggesting that deteriorations in one domain can reciprocally affect the other.

The findings are further supported by Al-Ansari et al.,[5] who observed a direct link between internet addiction and poor oral health behaviors among Saudi youth. Another cross-sectional study by Mustuloğlu and Tezol[6] and Saikia et al.[7] similarly highlighted poor oral hygiene among children with problematic media use.

Limitations

The study utilized convenience sampling, which may limit generalizability across broader Indian youth populations. Self-reported data via online questionnaires may be subject to response and recall bias. The cross-sectional design precludes establishing causal relationships between internet use, depression, and oral hygiene behaviors.

CONCLUSION

Excessive screen time among youth is associated with both depressive symptoms and oral hygiene neglect. Targeted health education programs addressing digital wellness and mental health could indirectly promote better oral care practices and overall well-being.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.