Oral Health And Mental Health Go Hand In Hand — Prof Seow Liang Lin

Poor oral health, from neglect, poor lifestyle habits, or other factors, can lead to tooth decay and cavities, inflammation, or infection of the gums, shaky teeth, and other problems.

World Oral Health Day, which was recently celebrated, carried a very meaningful theme this year. Advocating that “A Happy Mouth is… A Happy Body!” underscores the very important role that oral health and hygiene plays in our overall health, including our mental health.

To understand the connection between oral health and mental health, we must appreciate both the function and appearance or aesthetics of our teeth and gums. 

At its most basic, healthy teeth allow us to enjoy a variety of foods. Balanced nutrition, in turn, provides a wide range of nutrients that are important for overall health and prevent a range of illnesses.

Living with an unhealthy body will take a toll on mental wellbeing. Meanwhile, aesthetics or the appearance of our teeth and gums plays a big role in our self-confidence and self-esteem. 

These functions intersect in a variety of ways.

Poor oral health, from neglect, poor lifestyle habits, or other factors, can lead to tooth decay and cavities, inflammation, or infection of the gums, shaky teeth, and other problems. These can directly impact both the functionality and the aesthetics of our teeth. 

Thankfully, these problems are reversible with early detection and appropriate care. For example, the early stage of gum disease is inflammation (gingivitis), and good oral hygiene can resolve the problem.

In its more advanced stage however, inflammation can lead to bone loss (periodontitis) which is irreversible, and eventually lead to shaky teeth, needing extraction.

Sore gums and severe tooth decay can take a heavy toll on your quality of life. Imagine being unable to eat your favourite food, or only being able to eat soft foods like porridge and tofu because chewing meat or vegetables is simply too painful.

This can lead to nutritional deficiencies and seriously affect your health. Going out for a great meal with family and friends no longer looks like a social event that one looks forward to. 

Meanwhile, tooth decay or cavities and frequent gum infections can lead to chronic pain that leads to loss of productivity and missed school or workdays. It can also affect the way we smile, not to mention how often.

This goes beyond vanity and can affect our social interactions at every stage of life, sometimes to the point of avoidance or self-isolation.

Just picture a child being teased at school or a teenager too insecure to mingle. In the workplace, a young professional may feel undue stress at an important meeting or an experienced worker may lose out on career opportunities.

All these situations and more can contribute to poor confidence and self-image. This can be compounded by how they are perceived or even judged by others around them, placing a strain on their mental health.

Clearly, oral health and mental health is a two-way street. Research has found that those with mental health problems are less likely to visit a dentist and more likely to experience tooth decay, gum diseases, dry mouth (xerostomia), which may be a side effect of certain medications, and teeth grinding (bruxism), which wears down teeth enamel over a long period.

People with severe mental illness have 2.7 times the likelihood of losing all their teeth, compared with the general population.

Moving Towards Better Care 

Understanding this interconnected relationship is the first step towards bridging the gap between oral health and mental health, with professionals on both sides of the fence playing an important role.

For example, dentists may notice signs such as eroded teeth that could indicate bulimia, an eating disorder characterised by binge-eating followed by forced vomiting or other forms of purging food.

As gastric juices are highly acidic, repeated vomiting can damage the teeth. Approximately one third of patients with eating disorders suffer from tooth erosion.

In such cases, the dentist may be able to broach the subject and suggest that the patient may benefit from counselling or therapy. 

Likewise, those treating patients who struggle with mental health problems may notice their difficulties maintaining personal care routines like brushing and flossing, or even seeing a dentist regularly.

Xerostomia (dry mouth) may be a side effect of commonly used psychotropic medications, particularly those with anticholinergic effects.

Patients like these, whose needs are more complex, could benefit from improved interprofessional collaboration, where health care professionals form a symbiotic relationship with those in other medical fields to care for their patients in a more holistic manner.

Moving forward, it is essential for us to change our perception about oral health and our relationship with dentists. 

For too long and for too many, oral health has been a low priority, with dental checkups few and far between. Because of this, small problems that could be easily remedied or even reversed are allowed to worsen, which would require more extensive and costly treatment.

Regular check-ups could be the difference between simple scaling to maintain gum health and loss of teeth because the gums have deteriorated to the point where it can no longer support the teeth, not to mention the various ways it can affect our mental health.

These potential outcomes are a heavy price to pay for the sake of avoiding the mild discomfort and limited expense of getting an annual checkup. What’s more, your dentist can be your friend and partner in health, if you let us.

Prof Seow Liang Lin is the Dean of the School of Dentistry at IMU University.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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