Studies have begun to spotlight the connection between mental and oral health which has been further informed by the COVID-19 pandemic.
By Susan Richards
The connection between oral health and overall physical wellness has long been established in medicine. And there is a conclusive tether connecting physical health and mental health. So, it’s no surprise that the quality of oral health can be greatly impacted by one’s emotional wellbeing.
Throw in a pandemic and the intersections have become even more prominent.
While many parts of the world are moving toward pre-COVID-19 normalcy, experts agree that the pandemic has not yet reached endemic status – which means the presence of a disease is more steady and predictable as with influenza. Research and immunizations may have the U.S. more optimistic when addressing evolving variants, while the actual push to call it “over” is more socially driven.
However, with lingering mental health concerns, ongoing cases of Long COVID, and major delays in dental care, it’s worth considering what the mental and oral health landscape will look like in the coming months and years.
Researching the Links
There has been a scarcity of research addressing the links between oral and mental health, according to a recent study conducted by the School of Dental Medicine, University of Colorado, CareQuest Institute for Oral Health, and the Department of Oral Health Sciences, University of Washington School of Dentistry, and published by Frontiers in Oral Health – but they have increased in recent years. In the 2021 review, the impact of COVID was also examined as another significant factor in the connection of mental and oral health.
Some of the common psychological disorders that were included in previous studies are depression, anxiety disorder, post-traumatic stress disorder (PTSD), and phobias. Those diagnosed with one or more of these conditions were shown to have higher rates of tooth decay, fillings, and missing teeth.
Because of the prevalence of fatigue and lack of motivation or feelings of worth with depressive patients, some studies noted the predictable cycle of poor oral health and the lagging pursuit of care. Tooth loss and decay often resulted in reduced self-esteem and quality of life, exacerbating mental and physical health issues.
The Impact of COVID-19
The Incisor has previously written of the various ways COVID-19 affected the dental industry and patients’ oral health throughout the past two years. Multiple studies indicated stress wreaking havoc on both physical and emotional wellbeing. In addition to increased layers of plaque due to delayed dental appointments, hygienists also reported accumulative stress and even tears in returning patients. And often, that pandemic tension manifested physically in temporomandibular disorders (TMD).
When COVID-19 entered the picture, things only got worse for those struggling with mental and oral health concerns. Isolation, anxiety, potential job loss or financial hardship, all contributed to a growing problem and the lack of access to dental care for months only compounded it.
The survey of a representative sample of households conducted by the CareQuest Institute found approximately 20% reported poor mental health, which aligns with U.S. statistics. They concluded that the pandemic had a disproportionate and negative impact on those respondents with mental health concerns. Subsequently, the same group was three times more likely to consider their oral health poor as well.
Severe dental anxiety in the time of COVID has also presented challenges to dentists. In one distressing case study, a woman diagnosed with PTSD – made worse upon seeing someone wearing a mask – was unable to receive the dental care she needed without ultimately seeking psychiatric help and medication.
Disparities in Care
Unfortunately, the intersections aren’t confined to mental health, dental care, and the COVID crisis. Researchers also recognized that the same factors that contributed to poor oral health may also be reflected in those individuals with mental health disorders, and vice versa: poverty, unemployment, lack of insurance, comorbidities, less education, and physical barriers to care such as rural locations, to name a few.
Not surprisingly, these are some of the same communities hit hardest by COVID-19. In the CareQuest Institute study, not only did respondents with lower income and education levels report poor mental health, but they were also more likely to have had the virus at some point.
More to Learn
It’s important to recognize the repercussions of COVID-19 on the dental community as well, which ultimately affect their patients. Incisor reported on the mental health concerns of healthcare providers during the pandemic, and the additional stressors experienced by dental professionals. Burnout has resulted in a decrease in the healthcare workforce which will make it even more difficult for those in need to receive the medical, dental, and mental health care necessary to move on.
It’s uncertain how the pandemic will evolve, but researchers across the board agreed that further study will be needed as the consequences of COVID-19 become evident. To resurrect the overused word of 2020, these issues are unprecedented. The relationship between oral health, mental health, and the pandemic will need to be addressed accordingly.
Author: Susan Richards is a staff writer at DOCS Education. With over 20 years of experience in local journalism and business marketing, Susan’s career includes award-winning feature writing, as well as creating content with context for a wide variety of industries.
