Mental Disorders and Oral Diseases: Future Research Directions

Abstract

The poor physical health (including oral health) of people with mental disorders is a global problem. The burden of oral diseases among this group is substantial given their high prevalence and ability to increase the personal, social, and economic impacts of mental disorders. This article summarizes causes of mental disorders and oral diseases, critically reviews current evidence on interventions to reduce the burden of oral diseases in people with mental disorders, and suggests future research directions. The relationship between mental disorders and oral diseases is complex due to the shared social determinants and bidirectional interaction mechanisms that involve interconnected social, psychological, behavioral, and biological processes. Research has, to date, failed to produce effective and scalable interventions to tackle the burden of oral diseases among people with mental disorders. Transformative research and actions informed by a dynamic involvement of biological, behavioral, and social sciences are needed to understand and tackle the complex relationship between mental disorders and oral diseases, as well as inform the design of complex interventions. Examples of future research on complex public health, health service, and social care interventions are provided. The design and testing of these interventions should be carried out in real-world settings, underpinned by the principles of coproduction and systems thinking, and conducted by a transdisciplinary team. We propose this starts with setting research priorities and developing complex intervention theory, which we report to support future research to improve oral health and hence physical and mental health in this disadvantaged group.

Relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults: a cross-sectional study

“…Depressive symptoms, such as lowered mood (sadness, despondency, reliving of negative events, anhedonia, and indifference); decreased psychomotor drive (psychomotor retardation or inhibition, loss of energy, and persistent fatigue); abnormal circadian rhythm; and somatic symptoms (hyposomnia, hypersomnia, dry mucous membranes in the mouth, and weight changes), may also occur in people who do not meet the clinical diagnostic criteria for depression and who experience subthreshold depression. Many recent studies suggest the existence of a relationship between oral health and the occurrence of depressive symptoms [ 3 , 4 ]. One of the most severe oral conditions is tooth loss [ 5 , 6 ].…”

Relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults

“…Depressive symptoms, such as lowered mood (sadness, despondency, reliving of negative events, anhedonia, and indifference); decreased psychomotor drive (psychomotor retardation or inhibition, loss of energy, and persistent fatigue); abnormal circadian rhythm; and somatic symptoms (hyposomnia, hypersomnia, dry mucous membranes in the mouth, and weight changes), may also occur in people who do not meet the clinical diagnostic criteria for depression and who experience subthreshold depression. Many recent studies suggest the existence of a relationship between oral health and the occurrence of depressive symptoms [3,4]. One of the most severe oral conditions is tooth loss [5,6].…”

Salivary signatures of oral-brain communication in sleep bruxers

“…Similarly, as the second largest and most diverse microbiota in the human body, the oral microbiota and its derived metabolites interact closely with hosts ( Peng et al., 2022 ). Despite the consensus that oral bacteria are closely linked to oral diseases ( Giordano-Kelhoffer et al., 2022 ), new evidence has been reported suggesting that mental health and oral diseases are closely interconnected due to shared social determinants ( Peng et al., 2022 ; Joury et al., 2023 ). Anxiety and depressive-like behaviors have been observed in periodontitis animal models ( Martínez et al., 2021 ).…”