The Unique Connection Between Oral Health and Mental Health

Key takeaways about oral health and mental health:

• Poor mental health can lead to dental complications, and poor oral health can worsen mental health conditions. The two are more deeply linked than most people realize.
• Depression, bipolar disorder, and eating disorders each present unique oral health challenges, from tooth decay and gum disease to enamel erosion and dry mouth.
• Mental health professionals have both an opportunity and a responsibility to incorporate oral health awareness into their care strategies for better patient outcomes.

The link between oral health and physical health is well established. For example, poor oral hygiene has long been associated with serious conditions like heart disease and stroke. But the relationship between oral health and mental health is just as significant, and far less talked about.

The truth is, the two are more deeply connected than most people realize.

The physical health and oral health disconnect

To understand the connection between oral health and mental health, it helps to know why physical and oral health were ever separated in the first place.

Centuries ago, dentistry and medicine were practiced as one. That changed in the mid-1800s when the creation of separate dental and medical schools effectively split oral health from the broader medical field. As a result, mental health care, which falls under medicine, was historically overlooked in its connection to oral health.

Today, efforts are being made to reintegrate these disciplines and take a more holistic approach to patient well-being. One driving force behind this movement is the growing recognition that dentists are often the first to spot signs of systemic conditions, which can then be addressed by a physician.

Some of the conditions a dentist may detect include diabetes, oral cancer, osteoporosis, anemia, GERD, HIV, and eating disorders such as bulimia nervosa.

Mental health impacts on oral health

The connection between oral health and mental health is an increasing area of focus for both dental and mental health professionals.

A study published in Psychiatric News revealed that individuals with mental disorders are less likely to maintain regular dental visits, putting them at a higher risk for dental disease and other health complications.

The type of mental disorder someone has can lead to different dental problems. Here are just a few ways poor mental health can cause poor oral health:

Depression

Depression can take a significant toll on oral health in more ways than one. People with depression are more likely to use substances like alcohol, which contribute to tooth decay and erosion. They're also less likely to maintain daily self-care habits like brushing and flossing, increasing the risk of gum disease and other dental conditions.

Bipolar affective disorder (BD)

Bipolar disorder can also affect oral health in unique ways. People with BD are more likely to aggressively brush their teeth, which can damage the gums and cause enamel to wear away.

Additionally, according to the research journal Healthcare, “Psychotropic medications for bipolar disorder frequently cause xerostomia, compromising oral health by decreasing saliva’s natural cleansing action and increasing vulnerability to oral pathogens.”

Eating disorders

Individuals with eating disorders, particularly bulimia nervosa, are more susceptible to tooth decay and serious dental complications. Frequent purging exposes teeth to stomach acid, which erodes enamel over time, leading to sensitivity, discoloration, and decay. Because these signs are often visible during a routine dental visit, dentists are frequently among the first to recognize the condition.

Oral health impacts on mental health

Oral health and mental health are deeply intertwined, and the relationship goes both ways. Much like poor mental health can lead to poor oral health, neglecting your smile can also worsen existing mental health conditions.

Here are just a few ways poor oral health can exacerbate mental health problems, according to the American Psychiatric Association:

• People with severe mental health issues often find it hard to maintain dental hygiene or access dental care.
• Many people, including those with mental health conditions, avoid dental care due to anxiety. However, untreated oral pain can worsen mental health, making care even harder.
• Poor oral health affects eating, speaking, and self-esteem, which can reduce social interaction and harm mental well-being.

Embracing the connection between oral health and mental health

The link between oral health and mental health is becoming increasingly difficult to ignore. With that recognition comes a real opportunity to improve patient outcomes through meaningful changes in mental health care.

A study published in the International Journal of Environmental Research and Public Health highlights the importance of this integration, noting that mental health professionals should incorporate oral health care into their daily responsibilities, prioritize awareness of associated risks, and develop long-term strategies to improve their patients' oral health.

By weaving oral health into mental health care, professionals have the opportunity to elevate overall well-being, delivering better health outcomes and a higher quality of life for their patients.