Dental health and mental health are closely connected. In fact, a dentist may be the first medical professional to help identify behavioral health issues just by looking into the mouth. It's another reason why making dental visits every six months should be a priority for everyone at every age.
The prevalence of mental health issues for 18 to 49-year-olds is on the rise, with the most significant increase in the younger generation of 18 to 25-year-olds (Oral Health in America, Figure 3). In the U.S. in 2019, approximately half of the 19.3 million adults with a substance use disorder (SUD) also had a mental disorder (Oral Health in America, Figure 4). Smoking and using alcohol, marijuana, opioids, or other drugs to self-medicate can all be detrimental to oral health.
Here's a look at the relationship between mental health disorders, SUD, and oral health and how they can be damaging when they are combined.
Tobacco Products: Smoking cigarettes or using smokeless tobacco significantly impacts oral health. Tobacco use is a major risk factor for gum disease (periodontitis), which can lead to tooth loss. It also stains teeth, causes bad breath, and increases the risk of oral cancer. Additionally, smoking impairs blood flow to the gums, inhibiting their ability to heal after dental procedures (CDC, 2023).
Alcohol Consumption: Excessive alcohol consumption elevates the risk for many serious diseases and oral health problems, such as cancers of the oral cavity (Priyanka K. et al. 2017). Alcohol reduces saliva production, which washes away the bacteria from food that increases the risk of tooth decay and gum disease. Alcohol abuse can also lead to poor oral hygiene habits and neglected dental care, exacerbating oral health issues (Wang et al. 2016).
Illicit Drugs: Illicit drugs such as methamphetamine, heroin, and cocaine can have severe consequences for oral health. Methamphetamine use, for example, often leads to "meth mouth," characterized by extensive tooth decay, gum disease, and tooth loss. This is partly due to the drug's acidic properties and its tendency to cause dry mouth. Heroin and cocaine use can also lead to tooth decay and gum disease, often worsened by poor nutrition and hygiene practices due to drug addiction (Teoh L., 2019).
Neglect of Oral Hygiene: SUD can often lead to neglect of oral hygiene, including regular brushing, flossing, and dental check-ups. This neglect, combined with the harmful effects of substances on oral health, accelerates the development of dental problems and increases the likelihood of more severe oral health issues over time (Shekarchizadeh H. et al., 2013).
Overall, substance use disorders can have devastating effects on oral health, ranging from tooth decay and gum disease to oral cancer. Addressing SUD through prevention, education, and treatment programs is crucial not only for overall health, but also for preserving oral health and well-being.
Even without SUD, there can be a direct relationship between mental health and dental health that is harmful.
The Bidirectional Impact of Stress: Stress can negatively affect both mental health and dental health. Chronic stress may lead to conditions such as bruxism (teeth grinding), temporomandibular joint disorder (TMJ), and gum disease (Mayo Clinic). Conversely, poor dental health, such as tooth pain or missing teeth, can cause stress and impact self-esteem, contributing to mental health issues like anxiety and depression.
Psychological Factors in Dental Care Avoidance: Individuals experiencing mental health challenges, such as anxiety or depression, may avoid seeking dental care due to fear or feelings of helplessness. This avoidance can make dental problems worse, leading to more severe issues later (Wide U., Hakeberg M., 2012).
Oral Health and Eating Disorders: Eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder can significantly impact dental health. For example, frequent purging in bulimia can erode tooth enamel due to exposure to stomach acid, leading to tooth sensitivity and decay (Oral Health Foundation). Dentists can play a crucial role in identifying signs of eating disorders and referring patients to appropriate mental health professionals for support.
Improving Mental Health Through Oral Health Interventions: Oral health interventions can positively impact mental well-being. Studies have shown that regular dental check-ups and treatments can improve self-esteem and quality of life, especially in individuals with pre-existing mental health conditions (Cleveland Clinic, 2022).
These ideas highlight the intricate relationship between mental health and dental health, emphasizing the importance of integrated approaches to healthcare.
