The more we study mental and overall health, the more we see that they are intimately linked. Similarly, as we study oral health and overall health, it becomes clear that they are intrinsically connected. For this reason, dentists are sometimes the first ones to recognize signs of mental health issues based on what they see in the mouth.
For instance, if you live with a lot of stress and/or anxiety, you may have wear patterns on your teeth from clenching or grinding during the day or night. You may also have gum recession or tooth erosion near the gumline for the same reason. If you are severely depressed, some of the first tasks that get neglected are brushing and flossing. These observations are not meant as a scare tactic. If you are dealing with mental health issues, please don’t avoid the dentist for fear that they might rebuke you in some way. That’s not our job. Our job is to clean your teeth and provide you with the tools and knowledge necessary to make your home care routine easier and more effective than what it has been.
A recent study conducted by the International Association for Dental Research found that “providers should expect higher levels of oral disease among patients with adverse mental health conditions.” Some theories as to why this might be, include insufficient nutrition and its contributions to substandard dental health, anxiety surrounding dental procedures and an intentional avoidance of needed care, as well as difficulty maintaining daily dental routines while struggling with serious mental illness. Unfortunately studies have also shown that “the social and biological impacts of untreated oral diseases often work cyclically to worsen oral, mental, and overall health.” So how do we move forward?
It's been proven that mental illness and poor oral hygiene can feed off of one another, each one intensifying the other. Now, we’re dentists, not psychiatrists, so we can’t solve the mental health problems that plague some of our patients. What we can recommend is fully utilizing seasons of good mental health to take excellent care of your teeth and creating a simple dental routine to try to maintain when the darkness of mental illness closes in.
Baseline dental care includes brushing your teeth morning and night, which stimulates the gum tissue surrounding your teeth. However, it’s also crucial to floss regularly. Because most people are consistent tooth brushers but inconsistent flossers, the most common cause of issues like gum disease isn’t insufficient brushing, it’s insufficient flossing. I see supporting evidence of this in my office every day. Tartar — the built-up substance that occurs when plaque and bacteria harden over time — is found much more frequently between the teeth than on the cheek or tongue-facing surfaces of the teeth. Remember how we talked about utilizing seasons of good mental health to prepare for the bad? Well, flossing is a key component in that. We want to consistently remove plaque so that it can’t turn into tartar. Meaning, you should aim to floss every day, twice a day if you can.
Floss has two jobs. The first is to disrupt plaque formation between the teeth and the second is to stimulate the gum tissue. Disrupting plaque helps to prevent the formation of tartar, which harbors bacteria and makes properly cleaning the areas between your teeth much more difficult. Whereas stimulating the gum tissue helps to increase blood flow which decreases inflammation, redness, bleeding, and tenderness. If we don’t regularly or properly clean the areas between our teeth, bacteria gets trapped under the gumline and causes inflammation. This inflammation causes the tiny blood vessels in the gums to dilate or get bigger. This creates an open highway for oral bacteria to readily enter the bloodstream. These bacteria can cause problems in several areas of your body, from your heart to your lungs to your kidneys and even your brain. So flossing can potentially prevent the start and/or advancement of other physical ailments.
Now, although we hope your daily dental care includes brushing, flossing, and even mouthwash, we understand that variables like mental illness can disrupt those routines. So on days when everything feels impossible, we hope that you find a way to care for your teeth in any capacity. Ask your dentist for help and advice. Buy a new toothbrush or even a new flosser. 😉 Try anything you can to make dental care feel more doable. We’re understandably biased in our love for the Slate Electric Flosser but if you need a tool for maximum efficiency with the shortest amount of time and effort then we think you should give it a try. Regardless, we hope you’ll take care of yourself, and your teeth.