Association between oral behaviors and generalized anxiety in a sample of university students: A cross-sectional study

Objective: This study aimed to describe the frequency of oral behaviors and generalized anxiety among university students and assess their association using the Oral Behavior Checklist-21 (OBC-21) and Generalized Anxiety Disorder-7 (GAD-7). Methods: An online questionnaire was sent to students at the University of Trieste, Italy. Mann-Whitney U compared OBC-21 scores by sex; Spearman Correlation and linear regression (adjusted for age and sex) assessed the association between OBC-21 and GAD-7 scores. Fisher's exact test examined categorical relationships. Results: A total of 1,687 students completed the questionnaire (response rate 9.5%; 73% females). Mean OBC-21 and GAD-7 scores were 23.9 ± 8.3 and 9.5 ± 5.2, respectively. Higher OBC-21 scores were associated with younger age (p = 0.004) and females sex (p < 0.001). Oral behaviors and anxiety were moderately correlated (r = 0.42, p < 0.001), confirmed by regression. Categorized scores also showed a significant association (p < 0.001, Cramér's V = 0.308). Conclusion: Oral behaviors are significantly associated with generalized anxiety in university students, underscoring the importance of integrating mental health assessment into oral health care.