Oral Health of Individuals with Mental Health Disorders

Abstract

Objective: To analyze the oral and dental health conditions in a population of patients with a history of mental health disorders. Background: Individuals with mental health disorders are susceptible to dental disease related to poor oral hygiene, behavioral changes, medication effects, and systemic disease. Mental health and dental health reciprocally affect one another. Poor mental health has been associated with selfneglect, dry mouth, increased likelihood of substance abuse, and a higher susceptibility to oral infection. Similarly, poor dental health negatively affects mental health. Halitosis, dental caries, missing teeth, and affected speech can exacerbate mental health illness related to self-esteem and social anxiety. Methods: The Dental Registry and DNA repository (DRDR) at the University of Pittsburgh School of Dental Medicine was analyzed for patients with a history of mental health disorder. A total of 6,015 patient records were available from the DRDR at the time of this analysis. 1,068 patient records were available for individuals reporting a mental health disorder. We examined the prevalence of various dental conditions in a population of patients reporting a mental health disorder (N=1,068) in comparison to the rest of the registry (N=4,947), as well as the distribution of disorders and demographics. Mental health disorders included in this study are depression, anxiety, schizophrenia, bipolar disorder, post-traumatic stress disorder (PTSD), and eating disorders. Oral and dental health was assessed by dental caries, periodontal disease, gingivitis, tooth wear, complete and partial edentulism, xerostomia, coated tongue, gingivitis, oral ulceration, periapical lesions, and TMD. The prevalence of smoking, alcohol abuse, and substance abuse was also determined. Sex and ethnicity were also examined. Results: Of 6,015 patients, 1,068 reported a history of mental health disorder. 59.2% reported having depression, 16.7% reported anxiety, 13.3% reported bipolar disorder, 3.6% reported schizophrenia, 2.3% reported post-traumatic stress disorder (PTSD), and 2.3% reported an eating disorder. Mental illness was significantly associated with partial and complete edentulism, dental caries, tooth wear, xerostomia, erosion, TMD, ulceration, and gingivitis. Mental illness was also significantly associated with female sex and Whites. Conclusions: Mental health conditions can significantly affect the dental and oral health of affected individuals. Individuals with mental health conditions may be more susceptible to dental disease including dental caries, tooth wear, erosion, edentulism, dry mouth, gingival inflammation, and TMD. Understanding the association between mental and dental health can help direct prevention and treatment in a multidisciplinary setting.