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The link between mental and dental health is bidirectional
September 27, 2023

This article is for dentists, oral surgeons, behavioral health providers, and primary care providers caring for our members

Over their lifetime, 50 percent of Americans will be affected by some type of mental health issue, according to estimates from the U.S. Centers for Disease Control and Prevention1.  A growing body of research shows that these conditions can affect a patient’s oral health, and vice-versa. People with mental health conditions face challenges that prevent them from taking care of their oral health, and emerging evidence is showing a direct impact that poor oral health care can have on mental and cognitive health2.

The reasons for these connections are complex. Patients with mental health conditions may experience one or more of these symptoms that degrades their dental health3, including:

  • Neglect that can result in gum disease and tooth decay
  • Anxiety and dental phobia that prevents patients from seeking dental care
  • Eating disorders or over-vigorous brushing that cause dental erosion
  • Dry mouth caused by mental health medications that can exacerbate tooth decay

Poor dental health can also impact a person’s mental health. As with many types of health conditions, inflammation and bacteria that occur in the mouth can have negative impacts on mental health, such as depression4. Dental decay and tooth loss can also result in pain, social isolation, low self-esteem, and other factors that influence quality of life. Greater risk for decay and tooth loss can lead to more frequent dental pain, social isolation, and low self-esteem.  This reduces the quality of life of the individual and can be associated with poorer mental and overall health5.

How Blue Cross is working to support our members

Because of these interactions between dental health and mental wellbeing, we are expanding our Enhanced Dental Benefits for dental members with mental health conditions. Members who have dental coverage with Blue Cross may receive additional cleaning, periodontal maintenance, oral cancer screening, and fluoride treatment benefits after their physician has signed an enrollment form to indicate their eligibility. These new benefits are available starting October 1, 2023 when the member’s account renews with us.

What can providers do?

With an understanding of the relationship between oral and mental health, both dentists and medical professionals have a role to play in helping their patients.

  • Dental professionals can listen to their patients for signs and symptoms of mental health challenges and refer them to mental health professional for further screening. Dentists can play a particularly important role for patients in communities where mental health care may be stigmatized or hard to access6. When Dental Blue patients disclose a mental health challenge that they face, you can also provide them with the Enhanced Dental Benefits enrollment form. A member fact sheet can be given to all Dental Blue members recommending that they work with their physician or clinician to enroll.
  • Mental health professionals and physicians can ask their patients whether they have experienced any dental problems since their last visit and educate the patient on the link between mental and dental health. Be sure to complete your patient’s Enhanced Dental Benefits enrollment form for those who are eligible.
1 Centers for Disease Control and Prevention. (n.d.). Data and Publications. Retrieved March 19, 2019 from https://www.cdc.gov/mentalhealth/data_publications/index.htm.
2 thenationalcouncil.org/dental-as-mental-health/?gad=1&gclid=EAIaIQobChMIwo_V1vn1gAMVwVFyCh3i_QN2EAAYASAAEgKo_vD_BwE
3 www.dentalhealth.org/mental-illness-and-oral-health
4 familiesusa.org/wp-content/uploads/2019/09/OH_Mental-and-Oral-Health_Fact-Sheet.pdf
5 Gift HC, Atchison KA. Oral health, health, and health-related quality of life. Medical care. (1995) NS57–77. 10.1097/00005650-199511001-00008
6 californiahealthline.org/news/dental-clinic-screens-for-depression-other-mental-health-issues-during-visits-to-dentist/