My first post on the relationship between mental health and oral health focused on risky behaviors like drug, alcohol, and tobacco use, and the damage they cause the teeth, gums, mouth and throat. (http://mydentalhygienist.blogspot.com/2018/01/mind-your-mouth.html )
The link between oral health and mental health, however, is a two way street. People who don’t like how their teeth look or who have crooked, missing, or decayed teeth can suffer from low self-esteem. They may not want to smile or talk and lack confidence because they feel ashamed by the condition of their mouth. They may avoid social situations and have difficulties finding or keeping a job. Isolation, worry, and lack of employment can further deepen a person’s depression. They may blame themselves for how their mouth looks, even if it is not their fault. Some people have dental conditions which may stem from childhood or may be economic in nature, such as a family’s inability to afford braces or to have trauma to the teeth repaired. This can further cause a person to feel helpless and hopeless about the condition of their mouth.
Many people feel anxious about dental treatment but those who avoid going to the dentist out of fear may develop oral health problems due to a lack of regular care and check-ups. Dental phobia, the fear of going to the dentist or having dental treatment, is a recognized condition and a very real problem for some people. It can be caused by fear of pain, lack of control, feelings of shame over neglect of health, or traumatic past experiences. People may wait to seek care until they are in extreme pain, their condition is much worse, or they may not seek treatment at all, which can result in severe or life-threatening infection or tooth loss. Lack of dental care, dental anxiety and oral health problems can be a very damaging combination for a person’s physical overall health and their mental well being.
People with self esteem or depression due to oral health problems and people suffering from dental phobia need help from both dental and mental health professionals. Receiving proper dental care can help to restore a person’s confidence and motivate them to get help for the mental health issues they developed as a result of their poor oral health. Behavioral and cognitive therapies can help a person explore the reasons for their phobia and develop the tools that they need to help get them through dental care visits. Some people may require anti-anxiety or anti-depression medications.
Dental health professionals should recognize that dental phobia affects many people and is more common than people realize. It is estimated that between 9 – 15% of Americans have true dental phobia. Pain management in the dental office through the use of good and proper anesthesia based on a person’s medical, dental, and mental health conditions is needed, as is empathy about the person’s phobia. Patients should be asked about their fears and be invited to use coping strategies, such as listening to music on headphones, or relaxation techniques like deep breathing. Open discussion can help to build trust and get patients to the resources they need to help them heal.
Sources
Kisely S. No Mental Health without Oral Health. Canadian Journal of Psychiatry Revue Canadienne de Psychiatrie. 2016;61(5):277-282. doi:10.1177/0706743716632523.
This blog is not intended to diagnose, advise, or treat any condition. Please get help from your medical, dental or mental health professional if you need it - you'll be relieved that you did.
