Physical activity was negatively associated with perceived stress, which in turn was positively associated with oral symptoms, suggesting the association between physical activity and oral health is mediated primarily through perceived stress rather than a direct effect.
Nearly half of university students had insufficient physical activity and over a third reported high or excessive stress.
Insufficient physical activity and elevated stress levels were each independently associated with increased risk of gingival bleeding and oral ulcers.
Physical activity was negatively associated with perceived stress in structural equation modeling.
Perceived stress was positively associated with self-reported oral symptoms in structural equation modeling.
The direct association between physical activity and oral symptoms was not statistically significant, indicating stress mediated the relationship.
This research suggests that among Chinese university students, there is a meaningful chain of association linking physical activity, mental stress, and oral health problems. Nearly half of the 1578 students surveyed were not getting enough physical activity, and more than a third were experiencing high levels of stress. Both low physical activity and high stress were linked to a greater likelihood of problems like gum bleeding and mouth ulcers. Importantly, the study found that physical activity does not seem to directly improve oral health on its own. Instead, the benefit appears to work indirectly: students who are more physically active tend to experience less psychological stress, and lower stress in turn is associated with fewer oral health complaints. This mediation finding helps explain the mechanism connecting lifestyle behaviors to oral health outcomes. This research suggests that universities looking to improve students' oral health should consider addressing both exercise habits and mental health support together, rather than focusing narrowly on dental hygiene alone. Integrated programs that promote regular physical activity and reduce stress could have broader benefits for student well-being, including their oral health. Because this was a cross-sectional study (a snapshot in time), it cannot prove that changing physical activity or stress levels will directly cause oral health to improve, but it points to stress reduction as a potentially important pathway worth exploring.
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Upload Your LabsLi Q, Chen Z, Sun C, Lin S, Yang X, Li J. (2026). Association among physical activity, stress and oral health among university students: A cross-sectional study.. Medicine. https://doi.org/10.1097/MD.0000000000050759