How do mental health and oral health influence one another?
In today’s blog, we explore the connection that oral health and mental health have with one another and provide some resources that provide further insight into the relationship between the two. This blog references various studies from multiple researchers and serves only to be a general outline.
Patients living with mental illnesses or other conditions may experience symptoms that may put these individuals’ oral health at risk. A portion of these individuals also experience barriers in acquiring oral healthcare, such as unresolved dental anxiety and unemployment. Various connections with either symptoms of the illness itself or the prescribed medications that a patient may take can influence their oral health and their experience in the operatory. Dr. Kevin McCann’s in-depth article from 2012 goes over common mental illnesses that patients may have and the effects that regular medications have on their bodies, and by extension, their oral health. For instance, McCann points out that individuals taking antidepressants have an increased chance of complications with vasoconstrictors in local anesthesia, particularly in patients with additional underlying medical conditions. Another example is the involuntary muscle movements that affect patients taking antipsychotic medications. These muscle movements may sometimes be noticeable in the operatory chair.
Other issues that link mental health with oral health are symptoms that make oral hygiene upkeep difficult. Some symptoms of untreated mental illnesses may result in a lack of oral hygiene (e.g., depression). Alternatively, some conditions may cause individuals to perform unhealthy hygiene habits, such as vigorous brushing. Various medications for many mental illnesses are also known to have side effects such as dry mouth or bruxism.
McCann’s article ends on a holistic note, reminding providers that taking a nonjudgmental approach to obtaining any patient’s health history is crucial. Edwin T. Parks and Cindy Marek provide a comprehensive guide to effectively communicating and working with patients who have mental health issues. Due to the stigma that mental illnesses have had in the past, patients may not share their whole health history with providers, especially if they are not aware that their oral health is affected by their mental health. Parks and Marek explain:
“An effective way to open discussion when the dentist suspects that the patient has a psychological disorder is to mention a physical finding that may relate to the disorder. For example, because some medications for psychological disorders cause dry mouth, a nonjudgmental, nonthreatening question such as “I notice that your mouth seems much drier than usual. Have there been any changes in your health that could account for this change?” may open a discussion in which the relationship between physical findings and psychological status can be described” (Parks and Marek 2007).Parks, E. T., & Marek, C. (2007). Managing the Patient With Psychological Problems. In Treatment Planning in Dentistry (pp. 367-389).
Asking questions directly pertaining to oral health may help patients feel inclined to share any information that they may have initially held back. Making sure your patients are fully aware of how their oral health is impacted, and what they can do to maintain healthy habits is crucial.
Each patient has different needs, but in general, applying the same empathetic approach to all patients will help motivate your patients to maintain good oral hygiene in between dental appointments. Many resources indicate that listening to patients, having a kind demeanor, and using social skills also does more to help patients with mental illnesses get through their appointments, which to many, may be a source of stress.
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