Healthy Mouth, Healthy Mind?


“All areas in his life were being negatively affected, and to my horrific dismay, even his teeth were deteriorating!” recalled practicing dental hygienist Lisa Stillman in RHD Magazine. Stillman’s son was diagnosed with schizophrenia at 19-years old. Her son is just one of many individuals with a severe mental illness (SMI) that will face oral health problems in addition to their mental health troubles.


Stillman’s son struggled with schizophrenia and attempted to overcome the symptoms with medications and brain therapy until he ended his life five years after being diagnosed. While trying to support her son during this difficult time, Stillman noticed the negative consequences her son’s medication and symptoms had on his oral health. She now attempts to educate others about mental illnesses through the field of dentistry.


It’s safe to say that mental disorders are fairly common in the United States with an estimated 26.2% of Americans age 18 and older with a diagnosable mental disorder. Some of these mental disorders include mood disorders, schizophrenia, panic disorder, generalized anxiety disorder, eating disorders, Alzheimer’s disease, and more.

Behavioral patterns and self-care are closely associated with mental health, and not surprisingly, they are also important factors when it comes to keeping a healthy smile. There have been many studies that show overall wellness is connected to the health of our smile.


From a medical standpoint, your body is in a state of inflammation with poor oral health, which is also a characteristic that occurs in several mental disorders. Also, you can understand how poor oral health can translate to low self-confidence, social anxiety, and depression.

Mind-Body Connection and Dental Health

When we discuss overall wellness, this includes all aspects of health, including physical and mental health. Many of us can also dismiss the fact that our body is a singular unit that works together as one. However, there isn’t one aspect of your health that won’t impact other areas of your wellness.


The Substance Abuse and Mental Health Services Administration (SAMHSA) defines overall health through eight dimensions of wellness. Our physical health is all encompassing and it will end up having an effect on other areas of wellness including our oral health and mental health.


There are plenty of examples that showcase the connection between our overall wellness and the health of our smile. The most simple way to see how these two relate is to take a look at the number of systemic disorders that are consistent with gum disease. Some of these overall health issues include:


Heart Disease: Studies have shown that heart disease is related to periodontal disease. Researchers can’t establish a causal relationship, but they have been able to prove that poor gum health is a risk factor associated with heart disease. Most researchers believe that these two health issues are related because of inflammation.


Diabetes: Periodontal disease and diabetes are related because individuals with diabetes are more susceptible to contracting infections. If periodontal disease is severe enough, it can even increase blood sugar, which will increase the likelihood of complications of diabetes.


Osteoporosis: Osteoporosis is related to oral health because bone density in the jawbone can decrease, which then weakens the foundation for your teeth. Individuals with osteoporosis are then more likely to experience tooth loss.


Cancer: There are also certain types of cancers that have been connected to poor oral health and periodontal disease. For example, studies have shown that men with gum disease are 54% more likely to develop pancreatic cancer.


So, how does this relate to mental health? This is precisely where the mind-body connection comes in. Like we said before, the physical and mental health of an individual are fundamentally linked.


In fact, most doctors would advise patients to focus on their mental health because they believed emotions were tied to illnesses up until the 1800s. After the 1800s, we began focusing on bacteria and toxins related to illness. Recently, doctors have  begun to recognize the power of the mind-body connection again.


The connection between our mind and body is a difficult one to understand but mind-body specialist, Dr. James Gordon summed it up perfectly by saying, “ “the brain and peripheral nervous system, the endocrine and immune systems, and indeed, all the organs of our body and all the emotional responses we have, share a common chemical language and are constantly communicating with one another.”

Can Poor Oral Health Cause Mental Health Problems or Vice Versa?

Now that we know how our oral health can affect our physical health, let’s take a look at how mental health, oral health, and physical health all integrate to affect one another. Although researchers can definitely see a connection between mental health and oral health, it’s difficult to say if it is a causal relationship. What we do know for sure is that these aspects of health relate to each other in a number of ways. Here’s a brief look at how oral health affects mental health and vice versa:


  • Self-confidence and poor oral health: Smiling is noted as the universal sign of happiness so it’s obviously pretty important for socializing with others. If someone is unhappy with their smile, their social life can suffer, thus affecting their quality of life. Research also shows that from a neurological perspective, smiling can boost endorphins, help relieve stress, and even relax your body to help improve your immune system. By feeling self-conscious about your smile, you are unable to enjoy all of the perks of smiling. Studies have also proven that individuals with oral health problems are more likely to experience social anxiety and depression, which can then translate to additional mental health problems down the line.
  • Medications cause oral health problems: Not only can poor oral health spur on mental health problems, but mental health problems can also result in poor oral health. For example, many medications used to treat depression are also known to cause dry mouth. Dry mouth can then cause patients to experience a range of other oral health problems including tooth decay and gum disease. This can occur because saliva is so important for your oral health. Saliva helps build and maintain the soft and hard tissues in your mouth. It helps prevent tooth decay and gum disease because it washes away bacteria and food particles. Saliva also contains proteins, minerals, and an enzyme known as amylase that is all important for the health of your teeth and gums. It protects your teeth because the thin film of saliva helps protect your smile against bacteria. There are also antimicrobial agents in your saliva that will help kill off bacteria. These medications can also affect an individual’s ability to pursue restorative treatment and studies have shown that antidepressants can lead to dental implant failure.
  • Behavioral issues associated with poor oral and mental health: Since mental health affects an individual’s day-to-day life, it will obviously have an effect on their ability to take care of their smile. This can include difficulty with brushing, flossing or keeping important dental appointments. Since self-neglect is often a characteristic we see in many individuals with mental illnesses, bad oral health is pretty common. This can then exacerbate any of their physical conditions as well as worsen their self-confidence. Instances of oral care can differ among individuals with different mental illnesses. For example, someone with schizophrenia may have hallucinations that cause them to excessively brush their teeth, causing damage to their tooth enamel. While other individuals with depression may be less inclined to brush their teeth at all. It’s important to consider behavior and lifestyle factors that affect the oral health of individuals with mental health issues.
Medications to treat mental illnesses are known to cause oral health problems
Medications to treat mental illnesses are known to cause oral health problems

Research Supporting the Connection

There is plenty of research that supports the connection between the mouth and the mind. Although we don’t understand this connection completely, we definitely know that these two aspects of health have an effect on one another. Some research that supports this connection include these mental health issues:


Alzheimer’s Disease: Researchers have found that chronic periodontal disease quadruples your risk for Alzheimer’s disease. More research is still needed, but if researchers are correct, this can be a preventable way to avoid developing Alzheimer’s disease. Researchers from the University of Central Lancashire noticed the presence of a bacterium associated with gum disease in the brains of dementia patients. This Alzheimer’s study adds to other findings that support the link between long-term gum inflammation and the disease.


Anxiety & Stress: Individuals with anxiety or stress are more also more likely to deal with oral health problems because higher levels of cortisol. Cortisol is a hormone that is produced during times of stress, which can hinder the immune system and make you more susceptible to gum disease. Individuals dealing with a lot of stress are also more likely to engage in bad habits like smoking, drinking or poor self-care. Dr. Darlene Hart of Sweet Hart Dental in Florida confirms the impact of stress on your oral health: “Stress plays a significant role in causing problems for your sleep and dental health.”


Integrating All Aspect of Wellness

Different aspects of health are all intertwined together, meaning that you need to prioritize every aspect of your health for your overall well being. For individuals dealing with mental health issues, we recommend determining how your illness may affect your oral health. From there, you can decide what actions to take in order to best care for your smile.


If you have a family member or close friend with severe mental illness, it’s optimal for your or someone else close to them to help care for their smile. If an individual has significant barriers that keep them from properly caring for their oral health, it may be necessary for someone to intervene. This can include making dentist appointments, reminding them to brush and floss, or other important tasks. Doing so will help benefit their smile, which will, in turn, benefit their overall well-being.


Bottom line? Your health is all encompassing! Take care of each aspect of health to truly enjoy improved mental and physical well-being.