Mental health concerns are becoming more important than ever, as a growing number of people struggle with depression, anxiety and other mental disorders. The CDC reports that 50% of Americans will be diagnosed with a mental illness at some point in their lives and 20% will face a mental illness in any given year.
We have talked a lot about some of the more pressing steps that people need to take to prioritize their mental health, including going through therapy. However, there are other aspects of your mental health that don’t get the same level of attention. You might not make the connection between oral health and mental health, but the two are highly intertwined.
Dental health has an impact that goes beyond the scope of your teeth. It clearly affects your overall health as well. Although dental health is a crucial component of physical health, it has received less attention than the poor physical health that individuals with mental disorders often experience.
In our talks with dentist Dr. Don MacRae we were made aware that dental health and mental health go hand in hand. The thought of receiving dental care can cause anxiety and phobia.
In the second, dental diseases such caries, erosion, and periodontitis are linked to a number of psychiatric problems like affective disorders, severe mental illness, and eating disorders. Individuals suffering from severe mental illness face 2.7 times the probability of losing all of their teeth compared to the general population when dental diseases go untreated since they can cause teeth loss.
Dr. Steve Kisely of the School of Medicine at the University of Queensland has talked about the huge connection between dental and mental health. His paper emphasized the importance of taking care of both at the same time.
The care of iatrogenic dry mouth, assistance with oral hygiene, standard checklists for oral health exams that nondental staff may complete, and early dental referral are all potential solutions.
Growing emphasis has been given to the poor physical health that individuals suffering from severe mental illness experience, particularly when it comes to diabetes, chronic lung disease, cardiovascular disease, and cancer. Even though dental health is a crucial component of overall physical wellbeing and is associated with many of the chronic conditions mentioned above, it has received less attention. Eating, speaking, and other psychological and social aspects of life can all be impacted by poor dental health.
Poor dental health can result from psychiatric disorder, which is the topic of this research. Due to poor oral hygiene and nutrition, frequent consumption of sugary beverages, co-occurring substance abuse such as the use of tobacco, alcohol, or psychostimulants, as well as financial or other barriers to dental care, people with mental illness, especially those with severe mental illness, are more likely to experience oral health issues.
A key risk factor for oral health issues is dry mouth (xerostomia), which is made worse by opportunistic gingivitis brought on by dietary inadequacies owing to psychosis or anorexia nervosa. Patients with bulimia have been characterized as having altered salivary production as a result of parotid gland disease. Finally, regularly prescribed psychiatric drugs, especially those with anticholinergic properties, may cause xerostomia as a side effect.
Gingivitis is the first stage of periodontal disorders, which only develop in the existence of tooth plaque. Gums that bleed easily and spaces where the gums have separated from the teeth are warning signs. Following the spread of the infection to the periodontal tissues, the surrounding (alveolar) bone and connective tissues are destroyed.
When the periodontal membrane (periodontitis) is destroyed and the tooth roots are exposed, the illness is more severe and irreversible. These signs and symptoms are frequently connected to halitosis (bad breath).
It was first noted in the late 1970s that eating disorders and dental health issues were related. The most typical diagnosis is erosion brought on by acidic food and drink, along with stomach reflux or recurrent vomiting. Tooth erosion affects between 35% – 38% of persons with eating disorders.
The most vulnerable patients are those who self-induce vomiting (SIV), and palatal surfaces experience the most damage. Dental erosion was five times more likely to occur in eating disorder patients than in controls. The rate of corrosion was seven times higher in SIV patients.
Dental caries are less common than erosion, in part because people who suffer from anorexia are more likely to have obsessional personality traits and, as a result, take better care of their oral hygiene. Anorexic patients had considerably more missing, decaying, and filled surfaces than controls, according to a meta-analysis of four research.
Patients who are depressed may experience caries, which can be brought on in part by poor dental hygiene brought on by self-neglect and in part by xerostomia brought on by antidepressants. Again, using a lot of cigarettes and coffee can make this worse. Additionally, prosthetics could disappear or stop fitting.
Total tooth loss can occur as a result of poor dental hygiene. A study of partial and full edentulism in American adults using information from the Behavioural Risk Factor Surveillance System revealed that people with depression had a 20–30% higher likelihood of having lost all of their teeth.
It is bacterial infection, not erosion, attrition, or abrasion, that causes increased decaying and gum disease in people with severe mental diseases like dementia and schizophrenia. The same causes apply as they do for other psychiatric conditions. These include the unintended consequences of psychotropic drugs such mood stabilizers, antipsychotics, and antidepressants. Barriers to dental treatment, drug, alcohol, and cigarette use, as well as diet, notably the intake of carbonated beverages, are additional contributors.
Final words
Even in nations with universal health coverage, dental care is not completely covered. Due to the former presence of visiting dental experts in many long-stay mental institutions, the shift to community-based care may have unintentionally reduced access to dental care. According to one study, in a facility that was said to offer such a dental service, the need for dental services was decreased.
The impact of oral health on patients’ quality of life is important. In addition to causing issues with speaking and eating, a painful, unattractive dentition or poorly fitting dentures can worsen social disengagement, loneliness, and low self-esteem. Additionally, there is a link between respiratory disease, diabetes, coronary heart disease, and stroke. This is caused by both poor dental hygiene and common risk factors like alcohol usage and tobacco use.