What is the Link between Mental Health and Oral Health?

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By Cassie Steele

Our mental and physical health are inexorably linked and nowhere is this more obvious than in our oral health. The relationship between the two is complex and bi-directional. That is, psychiatric disorders lead to a higher likelihood of caries, gum disease, and tooth loss, but having serious oral problems can also affect our mental health and wellbeing. For members of the general population, keeping teeth and gums in an optimal state can therefore contribute to general wellbeing. For those living with a mental condition, meanwhile, it is crucial to enjoy functionality and aesthetics in the short- and long-term.

Why do People with Mental Illness Have More Dental Problems?

A study published by S Kisely et al noted that people with severe mental conditions have a 2.7 times greater likelihood of losing all their teeth than the general population. One issue that many people have with visiting the dentist is anxiety. The fear of pain, alongside drills and other dental equipment, can bring on the ‘fight or flight’ response. A patient’s perception of pain can be greater when they have depression and anxiety. As noted in Kisely’s study, people with these conditions can additionally have ‘burning mouth syndrome’ – a somatic symptom in people with a clinically healthy mouth.

Mental Illness and Preventive Oral Care

People with conditions like depression can neglect their everyday hygiene routines. Thus, they may have less motivation to brush and floss regularly, and may be less likely to visit their dentist regularly for check-ups. They can also consume unhealthy diets and take part in habits that affect health negatively – including smoking and the consumption of alcohol and stimulants. Those with mental conditions should aim to take extra care of their teeth, owing to their potentially greater pain perception. In addition to brushing and flossing, the use of water picks (which release fine jets of water to clean in between teeth) can reduce the need for professional cleaning and significantly reduce the likelihood of cavities.

How do Dental Problems Affect our Mental Wellbeing?

When we are missing various teeth, experiencing regular facial pain, or facing gum disease (which can be painful and cause bleeding), we can be reticent to smile and to socialize with others. We can feel isolated and lament the fact that we cannot enjoy food as much as in the past (since chewing becomes difficult). Dental problems can also wrest from our wellbeing because solving them can be expensive. Those who are not earning a regular salary can become anxious about finding the money they need to fill cavities, or have more costly treatments such as root canals, implants, etc.

It is important for health professionals treating those with mental illness to be aware of the strong relationship between illness and tooth loss. Treatment should be centered on ensuring patients are motivated enough to care for their teeth daily, and to see their dentist for regular cleaning and check-ups. Doctors should opt for treatment that does not cause dry mouth (which can increase the rate of cavities) and recommend patients to receive cognitive behavioral therapy (CBT) or other therapies that stress the importance of oral care, exercise, and other activities that can improve oral health and the patient’s general wellbeing.