Mental health’s relationship with oral health

How do mental health and oral health influence one another?  

In today’s blog, we explore the connection that oral health and mental health have with one another and provide some resources that provide further insight into the relationship between the two. This blog references various studies from multiple researchers and serves only to be a general outline.   

Patients living with mental illnesses or other conditions may experience symptoms that may put these individuals’ oral health at risk. A portion of these individuals also experience barriers in acquiring oral healthcare, such as unresolved dental anxiety and unemployment. Various connections with either symptoms of the illness itself or the prescribed medications that a patient may take can influence their oral health and their experience in the operatory. Dr. Kevin McCann’s in-depth article from 2012 goes over common mental illnesses that patients may have and the effects that regular medications have on their bodies, and by extension, their oral health. For instance, McCann points out that individuals taking antidepressants have an increased chance of complications with vasoconstrictors in local anesthesia, particularly in patients with additional underlying medical conditions. Another example is the involuntary muscle movements that affect patients taking antipsychotic medications. These muscle movements may sometimes be noticeable in the operatory chair.  

Other issues that link mental health with oral health are symptoms that make oral hygiene upkeep difficult. Some symptoms of untreated mental illnesses may result in a lack of oral hygiene (e.g., depression). Alternatively, some conditions may cause individuals to perform unhealthy hygiene habits, such as vigorous brushing. Various medications for many mental illnesses are also known to have side effects such as dry mouth or bruxism.   

McCann’s article ends on a holistic note, reminding providers that taking a nonjudgmental approach to obtaining any patient’s health history is crucial. Edwin T. Parks and Cindy Marek provide a comprehensive guide to effectively communicating and working with patients who have mental health issues. Due to the stigma that mental illnesses have had in the past, patients may not share their whole health history with providers, especially if they are not aware that their oral health is affected by their mental health. Parks and Marek explain:  

“An effective way to open discussion when the dentist suspects that the patient has a psychological disorder is to mention a physical finding that may relate to the disorder. For example, because some medications for psychological disorders cause dry mouth, a nonjudgmental, nonthreatening question such as “I notice that your mouth seems much drier than usual. Have there been any changes in your health that could account for this change?” may open a discussion in which the relationship between physical findings and psychological status can be described” (Parks and Marek 2007).  

Parks, E. T., & Marek, C. (2007). Managing the Patient With Psychological Problems. In Treatment Planning in Dentistry (pp. 367-389).

Asking questions directly pertaining to oral health may help patients feel inclined to share any information that they may have initially held back. Making sure your patients are fully aware of how their oral health is impacted, and what they can do to maintain healthy habits is crucial.  

Each patient has different needs, but in general, applying the same empathetic approach to all patients will help motivate your patients to maintain good oral hygiene in between dental appointments. Many resources indicate that listening to patients, having a kind demeanor, and using social skills also does more to help patients with mental illnesses get through their appointments, which to many, may be a source of stress.   

References  

  • Parks, E. T., & Marek, C. (2007). Managing the Patient With Psychological Problems. In Treatment Planning in Dentistry (pp. 367-389). Elsevier. https://doi.org/10.1016/b978-0-323-03697-9.50018-1  
  • McCann, KJ. (2012). Assessment and management of dental patients with mental health issues. Oral Health. 2012:102(6)25-32.   

Encourage ongoing healthy habits through social media and social skills

Some, maybe even most individuals that come to your office are very motivated when it comes to keeping up their oral hygiene routine. For most offices, however, there are a few patients that struggle to allocate time for the necessary hygiene practices that prevent oral disease. Can you do more to ensure your patients are sticking to proper oral health habits in-between visits? In this week’s blog, we are going over some approaches that your office can take that may help prevent your patients from falling back into old habits.  

In comparison to other countries, Canada has great dental care and limited individuals with oral disease. CDA’s status report of Canada’s oral health recognizes the country’s relatively good oral healthcare, particularly when viewed on a global scale. They state in the report that “based on a wide range of metrics, we can state definitively that Canada is among the world leaders when it comes to the overall oral health of its citizens.” The report also acknowledges, though, that there are some groups of people in Canada that suffer from poor oral health due to barriers such as physical, socioeconomic, and geographical restraints. 

Ensuring your patients are going home with knowledge of proper hygiene upkeep is a crucial part of recall visits, but unfortunately, patients tend to fall back into old habits after a few weeks. Thankfully, there are certain approaches your office can take to counteract this issue and encourage patients to continue their oral hygiene regimens at home.

Prioritize the provider-patient relationship

Having a positive experience at your office is a large factor that contributes to your patients’ at-home care, especially those with anxieties surrounding dental care or healthcare in general. Having a good experience establishes trust with your patients and motivates your patients to continue oral hygiene habits at home. The dentist-patient relationship is defined in this article as “the core of dentistry” (Bishop 2018). Generally, patients are more likely to remember instructions and advice given to them from someone they have a positive relationship with and can relate to on an interpersonal level. The best way to leave a lasting impression on your patients is by showing compassion and maintaining professionalism. Soft social skills make a world of difference when it comes to the patient’s experience. A positive experience at your office will motivate patients to continue proper hygiene at home. 

Encourage healthy habits through your online presence

We have spoken before about the benefits of running a social media page for your practice. Even if your practice has a small following online, posting some generalized oral hygiene tips on your social media page (i.e. Instagram, Twitter, or Facebook) has the chance of making a difference, even it is small. Additionally, using your platform to debunk and discourage “DIY trends” that are harmful for patients may prevent your audience from trying at-home remedies that cause harm to their oral health. 

While social media usage can provide many opportunities for your practice, you must follow the guidelines of professionality to stay in accordance with the associations in your area. RCDSO, for instance, provides an advisory for maintaining dental professionality on social media and offers some insight on best practices for social media use. Whether you are regularly updating your social media outlets, or sporadically posting, your office is still reinforcing good oral hygiene habits for your patients in a virtual and casual fashion. 

While using the approaches mentioned in this blog may help patients become more enthusiastic about their oral health, they may also just serve as regular best practices for your office. Whether or not your patients are influenced by your potential social media usage or nonjudgmental listening, these approaches still work for the betterment of your office. Patient care is the most important, and while dental offices transition towards a post-COVID-19 future, these approaches may not be a priority if your practice is not ready to utilize specific online tools. Prioritizing the provider-patient relationship is prevalent whether you utilize social media or not, as doing this is viable for most appointments and social skills can always be refined.

Revisiting your practice’s vision: remaining adaptable in a changing world

Your mission statement and your practice’s goals  

What is your dental practice’s mission statement? Do you base your practice’s daily operations around your mission statement? How often do you revisit your mission statement, particularly when circumstances change?  

Thousands of dental professionals set their practices apart through mission statements that focus on the quality of services, patient relations, and treatment options. A mission statement reflects the overall goal that you wish to achieve through your practice.  

Various recent changes to the dental field may have been impacting your office’s hours of operation and treatments available, and by extension, impacting your practice’s overall goal. With these changes, it may be an excellent time to evaluate whether your practice still integrates your original values into your everyday routine, or if your core values have shifted. Assessing your mission statement also invites you to revisit your short-term and long-term goals. For example, your office’s primary goals may have changed from acquiring a certain number of new patients per month to ensuring your existing patients have received necessary treatment or are booked.   

Staying realistic in varying circumstances  

Specific, measurable goals are favourable in comparison to vague, overarching goals. Having realistic goals helps keep your team on track throughout the day and helps guide you when making business decisions.   

Some examples of realistic goals are shown in the Nova Scotia Dental Association’s resource for improving your practice’s communication with patients. For instance, NSDA focuses on the patient-provider relationship and outlines the importance of soft social skills in dentistry. More specifically, educating your patients on what your practice is doing to ensure safety is specific and measurable based on patients coming in. 

Unrealistic mission statements can sometimes be misleading for your team. As this article points out, a broad mission statement can sometimes lead you away from the reality of running a dental practice. If you get caught up in thinking about the big picture, you may lose focus on the actions that advance your practice towards your goal. Big aspirations do not bring results quickly, which may cause your team to lose motivation. For this reason, it is important to set realistic goals that everyone in office can achieve, especially during a challenging time. For instance, your schedule may only accommodate for a portion of patients everyday due to social distancing. Adjusting your goals to fit the circumstances may be necessary to encourage your team and set your practice up for success.