There is a close connection between the health of the body and that of the mind. Mental illness is a major health concern not only in the United States, but worldwide (WHO 2006). In fact, anxiety affects 10% of adults, and depression ranks among the top 10 causes of disability. A lot of people pay attention to just the physical health of people with mental illness’, but not oral health as much, which is certainly an important part of one’s overall physical health and is linked to many chronic diseases like diabetes, cardiovascular disease, and cancer. Greater consideration is should be taken on how enhancing oral health during mental healthcare might reduce the burden of a person’s ill health.
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can make a chart of the fears and add it!!*
There is a strong interaction between oral health and mental health and it can go in both directions. In one way, it’s the patients being scared of the dentist or the dentistry in general. One half of all dental patients experience some anxiety about their visit to the office and in some cases, it could lead to dental phobia. Odontophobia (dental fear), or Dental phobia, is a unique phobia that is more serious condition than anxiety. For some individuals, the fear of going to the dentist is so significant that it can impair their everyday life. This anxiety leaves people terrified, and creates serious panic attacks. Despite the extreme outcome, people that have dental phobia are aware that this fear or anxiety is out of proportion, but cannot control the way they think.
The causes of odontophobia and anxiety could be from several factors: psychological, genetics, medication, and even sexual abuse could have an impact. These could lead to the patient having the fear of pain, fear of helplessness or loss of control, and embarrassment or loss of personal space. Fear of pain is one of the most common reasons why someone could avoid the dentist. A patient could be scared of feeling pain,
for example, because they possibly fear that the injection won’t work or fear of the injection itself. They also may have had this fear since they were a child and it never went away. The causes of dental phobia or anxiety can also lead to feelings of loss of control and helplessness to the individual. These emotions could cause serious stress and may lead to worse cases. Finally, the cause could give rise to embarrassment and loss of personal space. Many patients feel nervous and tense when the dentist is that close to their face. Others many feel self-conscious about the smell of their mouth or possibly even how they look. Unfortunately, there is no other way for the dentist to do their job since their skills require focus and rigorous attention to detail in the mouth and teeth.
Between 9% and 20% of Americans avoid going to the dentist because of anxiety or fear. These individuals usually only go to the dentist under extreme circumstances, when they are in excruciating pain and feel the need to go. The overall effect of the fear can face some serious consequences. Fear and evasion lead to premature cancellation of dental appointments and further worsening of oral health conditions. Because these people not only avoid their dental appointments but also tend to have worse oral health. In a certain study by Moore in 2004, it shows that patients like this can be so embarrassed by their poor oral hygiene that they avoid seeing the dentist out of fear of being asked about it or worried that the dentist or people in the office will think low of them. Dental fears are negatively linked to quality of life with respect to psychological well-being, social functioning, and vitality.
Dental phobia can be different in children than in adults, it may not apply to children yet. The argument for this can be reasonable because managing or dealing with anxiety and pain requires high levels of cognitive functions in the brain and self-control, things that a young child may not have developed yet. However, a child can still develop anxiety or fear toward the dentist, just in a different circumstance. For example, a child could scream at the sight of a drill, not when the drill is actually in their mouth. Another example can be when a child sees their parent worried about them, the child then starts getting scared because they don’t think they are safe
anymore. This is mostly present in children under the age of 8, when the parent-child relationship is extremely strong and separation anxiety may be seen.
Patients with this fear toward dentistry may be aware of their poor oral health, yet they still believe its irrelevant to their lives, so they don’t have to go to the dentist. Over time this often results in significant problems for people because it will lead to worsen conditions. Oral health has significant consequences for the quality of life of patients.]- concluding and add to end nicely
Another way oral and mental health can be correlated is how people with a lived experience of mental illness can suffer with poor oral health. People living with severe mental illness show higher rates of poor oral health, and are more likely to be affected by oral diseases. This can lead to a more complex treatment compared to more common patients. Some of the most frequent mental illnesses that can have a negative impact on a person’s oral health include: panic attacks and anxiety, eating disorders, OCD (obsessive-compulsive disorder), bipolar disorder, and schizophrenia. For example, someone with a bipolar disorder could be having a difficult time with their brushing actions. An individual with bipolar, could be over-vigorous brushing which could result in brushing away the enamel on the surface of the tooth. This will slowly destroy the enamel, making it not possible for it to naturally regenerate. Some of the main issues people with a mental illness could have can include: often experiencing isolation and neglect, compromised education, eating disorders, and taking medication. This, again, reduces a person’s chance to maintain and better their oral health. Research has shown that people that have a mental illness usually avoid dental care and neglect their own oral hygiene. This, regrettably, will lead to tooth decay and gum disease. Periodontal diseases (gum disease) occur only in the presence of dental plaque, and begin with gingivitis. The inflammation then spreads and starts destroying the connective tissue and surrounding bone in the mouth. Furthermore, those who suffer from eating disorders, like bulimia, often suffer from the conditions of the after math. Bulimia is a serious eating disorder that is marked by binging, followed by vomiting (purging) to avoid gain weight. People that have bulimia often experience dental
erosion from the acidity in their vomit. Low levels of calcium are also seen often, which certainly affects the health of the teeth and the individual. Lastly, taking medication can also have a negative impact on an person’s oral health. The impact on the mouth of certain medications prescribed to those with a mental illness are noted as detrimental to oral health and often contributed to the decline of an already poor oral health status. Some participants in the study done in Australia by Clair, showed that some medications cause lack of saliva, also known as dry mouth, while others caused extreme carbohydrate cravings—both of which can lead to the decay and crumbling of a tooth and worse physical health. These patients also noted that they didn’t even know about these side-effects and had no idea it could contribute to their oral health.
People with serious mental illness also have higher morbidity and mortality rates of chronic diseases than the general population and worse dental condition in comparison to the general population. There was a study done on adults with pneumonia and the results for mortality (Bassim et al. 2008). The odds of dying from pneumonia in the group that did not receive oral care was more than three times that of the group that did receive oral care. Bad physical health can lead to the poor quality of their dental and mental health. In addition, mental disorders were more frequent among people with chronic conditions.
Oral health and oral inflammatory disease are the result of lifestyle and behavior, and as Ponizovsky and his colleagues pointed out, mental disorders affect both lifestyle and behavior (Ponizovsky et al. 2009a). Clair Scrine conducted a study in the University of Western Australia, School of Dentistry, about this and said “I think that poor oral health is actually a symptom of their mental illness in the very beginning, then it becomes a chronic condition… poor oral health just reflects that poor self-care”.
Oral health is important for people who experience mental disorders because it could have an impact on the person’s ability to relate to their social environment and worsen the psychosocial features with mental illness like poor self-esteem and social disconnection.
The literature to date recommends the integration of physical health support within the mental health sector to have good oral health. Participants pointed out that delivering preventive and management support
was one of the best ways to get information to people that are not aware of…(HELP). This approach to participants indicated that it was a turning point for the oral health knowledge and behaviors.
Although little has been published regarding oral health support, one study was conducted in Australia at the Melbourne Dental School that focuses on this issue. “The value associated with discussing oral health in community mental health outreach settings was noticeable among participants.”. Although many participants had positive comments on the oral health support received from the study, some individuals reflected on how they were so unaware of the oral health support available. They had no idea that there were oral health services that could help them (ELABORATE). One participant for example said that “I wouldn’t even consider going to get a check-up. The only time I would think about my teeth is when I have a toothache and need to go to the dentist”. Awareness of oral health support is very important and will help the patients and the dentist. It will help the patients relax, and not be as anxious going into the appointment. It will also help the dentist by making it easier to work in the patient’s mouth (EXPLAIN).
There should be a closer collaboration between mental health clinicians and dentists because it’s very important to remove the obstacles to the care, whether its financial or psychosocial. The dentist may be the first specialist to see a diagnosis of an eating disorder so they should recommend these patients for psychiatric treatment. Oral hygienists, for example, can help though education in the use of mouthwashes and fluoride applications. Patients in general should be advised to reduce their intake of alcohol and use of tobacco.
There is also a lot of evidence that the role of community health services is very valuable. A lot of participants in this Australian study were not aware that there were public community dentists or options to see even students for free.
– “helpful in developing management strategies, goal setting, and providing emotional and even physical support. “
The impact of good oral health on quality of life and wellbeing suggests discussion of basic preventive oral health care by mental health providers with their clients is critical. While mental health professionals promoting oral health is an important first step, dentists should do their part as well and provide appropriate resources about dental care for people with mental health disorders and mental health in general. More resources and training are needed to encourage dentist to see the relevance of this approach to their work and how best to integrate it in their practice. [SOMETHING HERE]
– Can talk about how to choose a dentist and how can a dentist make their own office the place to go
– Motivational interviewing and general experience in promoting behavior change was evident in improving… If dentists do this…
Some participants did indicate a low level of health literacy in terms of the knowledge of services available and low engagement in prevention and maintenance behaviors. Health literacy is a strong predictor of a person’s physical health outcomes, in specific health behaviors and practices like brushing or flossing their teeth for example. This is a major issue worldwide regarding dental services. A lot of people do not know dental terms for instance and are too afraid to ask. The dentist should have [something to promote oral health and simple dental terms]—CHANGE TO BETTER. For example, the dental office could have a chart that has the main dental terms and dental health services, explaining what they are and what do they look like. This will help relieve stress from the patient and inform them about what they will be getting done so it’s not a surprise to them. This will also reduce the amount of questions with that will be asked to the dentist about their procedure and possibly just simple terms.
The office’s team can also play an important role in beginning an awareness of necessary oral health care. know about oral health literacy also so if the patients … [COME BACK TO THIS]
Participants that indicated they were previously unaware of the service options available to them appeared less likely to seek oral health services unless under extreme circumstances because they do not know what they
need. The role of these charts or posters promoting and supporting oral health literacy among consumers will be very clear since they will now have the knowledge of the terms and services options.
The complex nature of living with a mental illness can be superior to other aspects of health, especially oral health, however the opportunity to explore oral health will help to…[HERE] Oral health is identified as a need and the value of mental health. Those people suffering with mental health issues need to understand value of good oral health and be motivated to maintain good dental habits. The link between mental illness and oral health still requires further exploration, and should have an increased focus on this connection and include interventions that help with oral hygiene. Despite their needing more research in this subject, the link between oral health and mental health is undeniable.