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Anxiety, Depression, Stress, and Oral Health

Course Number: 573

Associations of Oral Health and Anxiety and Depressive Disorders

Individuals with psychiatric disorders have higher rates of many systemic diseases than non-affected individuals.51,52 Oral health is also reported to be significantly worse in individuals with mental illness when compared to their counterparts.8,53 Caries, tooth loss, and periodontal disease rates are higher in those individuals with anxiety and depression compared to healthy controls.8,53

It is also well-established that adults with mental health disorders like anxiety and depression and less likely to engage with dental healthcare professionals and seek dental care and they report less frequent health dental home care habits when compared to individuals without mental health disorders.54 Additionally, anxiety and depression have been associated with higher rates of deleterious habits including alcohol and tobacco consumption, which can impact their oral health status.55 Furthermore, many individuals report that dental visits are anxiety inducing. It has been estimated that 20-30% of the US population reports being “somewhat” or “very” nervous about dental procedures and up to 12% of adults are characterized as dental phobic.56

Oral Health is a major determinant of general health, self-esteem, and quality of life, but for patients with mental health disorders, oral healthcare has a low priority for individuals suffering with mental illness. Further, poor oral health may negatively affect mood, confidence/self-esteem, and impact mental health.57,58 In individuals with severe mental illness, the one-year prevalence of suboptimal oral health (oral dryness, dental caries, periodontal disease, DMFT, oral cancer/precancer) was 32% and lifetime prevalence was 61%.57