When Mental Health Interferes with Dental Health

By Dr. Scott Shamblott

Oral health problems often are connected to other health concerns, such as diabetes and heart disease.

But one additional challenge dentists face is when a patient’s mental health issues get in the way of caring for their oral health.

It’s not unusual for people to be anxious about visiting the dentist, or to fail to properly care for their teeth. But people who have psychiatric disorders struggle with those problems to an even greater degree than the average patient. They may be phobic or distrustful, so a visit to the dentist becomes an even bigger issue for them than for most people.

That means it’s incumbent on dentists to be aware of the special needs of these patients and take steps to provide them the proper care. For example, in some cases the dentist might not be able to accomplish everything they would like in one appointment as they would with another patient. We need to be flexible and willing to adapt.

Some of the ways mental health problems interfere with dental health include:

• Medications. The medications prescribed to treat anxiety and depression can cause dry mouth, which in turn leads to serious oral health concerns. Our mouths produce saliva for a reason. It helps to wash away food debris and reduces plaque. If someone has dry mouth and doesn’t treat it, tooth decay and gum disease can result.
• Lack of oral health care. Patients with mental health issues are in many cases less likely to want to brush their teeth, to floss and to generally take care of their dental health. A 2015 review of studies on mental health issues found that people with severe mental illness had higher numbers of decayed, missing or filled teeth. They were also nearly three times more likely to have lost all their teeth.
• Too much oral health care. While some patients with mental health problems fail to properly care for their teeth, those who suffer from OCD can experience the opposite problem. They focus on dental hygiene too much, brushing and flossing over and over during the day, which can damage their teeth or irritate and damage their gum tissue.

Each of these concerns – and others – can be addressed if dentists demonstrate patience and familiarize themselves with some of the problems surrounding people with mental illnesses. Sometimes it may seem like a patient is making progress, but then they have a relapse and regress to poor oral hygiene again. That’s not unexpected, and can be handled if the dentist continues to show empathy and tolerance for what may seem like eccentric behavior.

Dr. Scott Shamblott is a general dentist and the founder of Shamblott Family Dentistry (www.shamblottfamilydentistry.com) in Hopkins, Minn. He is the author of two books, Help! My Tooth Hurts: Your Guide to Feeling Better Fast, and Fear-Free Dental Care: Finding a Dentist You Can Love. Dr. Shamblott earned a B.S. in Finance at the University of Arizona and a Doctor of Dental Surgery degree with high distinction at the University of Minnesota School of Dentistry. He completed a general practice residency at the University of Tennessee Hospital. Dr. Shamblott earned a fellowship from the Academy of General Dentistry and from the Dental Organization for Conscious Sedation. Also a product evaluator, he is one of 450 dentists worldwide selected to test dental products and techniques.