What Is The Association Between Dental Health And Mental Health?

A new study published in the Journal of Dental Research looked at dental health and mental health in a nationally representative cohort.

“The purpose of this study was to examine the relationship between oral health and mental health both cross-sectionally and longitudinally,” study author A. Kalaigian told us. “In addition, we sought to evaluate the impact of mental problems (i.e., internalizing, externalizing, and substance abuse) on adverse oral health conditions (i.e., bleeding gums, loose teeth, self-rated oral health, tooth extraction, gum disease, and bone loss around teeth) when controlling for potential confounders. Through this work, we hoped to inform dental practitioners in treating patients experiencing mental illness.” 

Prior to analysis, the research team theorized that patients with symptoms of mental illness would present with a higher prevalence of adverse oral health conditions. Past research found that people with poor mental health face barriers to dental care as well as potential behavioral oral health risks, including tobacco and substance use. 

“My interest in the association between oral health and mental health stems from my passion for holistic healthcare,” Kalaigian told us. “Dentists are trained to treat patients on an individualized level, accounting for multiple factors from cardiovascular health to personal aesthetics. One component of holistic healthcare that often receives less attention in the dental profession is mental condition. By improving the dental community’s knowledge on this topic, we hope to improve the treatment of patients experiencing mental illness.”

The research team used data from the Population Assessment of Tobacco and Health Study, which is a nationally representative, ongoing prospective cohort study of more than 30,000 Americans. Participants in the study were asked detailed questions about their health, including recent experience of symptoms that have been shown to be related to certain mental health conditions, like depression and anxiety. The researchers grouped participants into different categories depending on how recently and how many mental health symptoms they said they had been experiencing. Two years later, participants were asked about their health again, and the researchers compared the frequency of having certain oral health problems according to those mental health categories. 

“Study participants with more symptoms of mental health problems were also more likely to report having problems with their oral health,” study author B.W. Chaffee told us. “This was especially true for individuals who reported internalizing problems, which are associated with depression and anxiety. Even after accounting for other factors like age, income, gender, and tobacco smoking, participants with the most internalizing problems were at higher odds of saying two years later that they had noticed bleeding gums, loose teeth, had a tooth extracted, or characterizing their overall oral health as only fair or poor.” 

The authors believe the results should influence the treatment of mental illness moving forward. Both medical and dental practitioners should anticipate a higher prevalence of adverse oral health outcomes among individual with mental illness (specifically depression and anxiety). There is a need for improved collaboration across mental and oral healthcare.

“Mental health symptoms and oral health problems affect so many people, yet they are often overlooked in conversations about health and healthcare,” Chaffee told us. “These study findings also suggests that these two types of conditions are related. There are already significant barriers to accessing dental care in this country, and for individuals with mental health needs, those barriers can be even higher. We’d like to see mental health practitioners anticipate and address oral health needs among their patients, and we’d also like to see dental care become more accessible for everyone, particularly those with mental health needs.”  

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