A Cycle between Oral and Mental health

Authors: Manisha Sharvananthan, Sephora Djomo Ngwamou, Taylor Gowans

October 1st, 2025

(Rudovska)

The World Health Organization defines mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community” (WHO). Although mental health and oral health are often viewed separately in healthcare settings, they are actually closely connected, especially in shaping quality of life and health disparities. When an individual’s mental health is affected by conditions like depression or anxiety, it not only affects their emotional well-being but also their behaviours in maintaining oral hygiene (Kisely 278). Simultaneously, poor oral health may exacerbate feelings of isolation and shame, issues with body image, and negatively impact an individual’s mental health (Tiwari et al. 2). This relationship between oral and mental health creates a cycle of disparities, especially in marginalized populations, affected by barriers like socioeconomic status (Tiwari et al. 2).

Connection between Oral and Mental Health

It has been recognized through studies that mental health and oral health are correlated, as issues in one can influence the other (Tiwari et al. 1; Z et al. 1). Research studies have demonstrated an association between mental health problems and a higher prevalence of tooth loss, periodontal disease, and tooth decay (Tiwari et al. 1). One systematic review highlighted significant associations between poor oral health and common psychological disorders such as depression, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder (Tiwari et al. 1). Individuals with these conditions showed higher rates of dental decay and tooth loss, with those who have a severe mental illness being 2.7 times more likely to lose all their teeth, compared to the general population (Kisely 277; Tiwari et al. 1). In particular, depression and anxiety have been shown to affect oral health behaviours and use of oral health services. Symptoms such as fatigue, lack of motivation, and feelings of worthlessness can lead to reduced daily hygiene practices, including brushing and flossing, while also discouraging routine dental visits (Tiwari et al.). This neglect of oral hygiene habits increases the risk of dental disease, like chronic periodontitis, in people struggling with mental health conditions (Tiwari et al.; Z et al. 4). 

Beyond oral hygiene behaviours, psychiatric medications prescribed to manage mental illnesses can also contribute to oral health problems (Z et al. 4). Antidepressants, antipsychotics, and mood stabilizers are well known to cause xerostomia, commonly known as dry mouth. This condition reduces salivary flow and impairs the mouth’s natural ability to protect against bacteria (Z et al. 3). Reduced saliva leads to an increased risk of cavities, gum disease, and oral infections, and thus prolonged use of such medications can lead to significant long-term dental problems (Skallevold et al. 547). 

Additionally, poor oral health, such as untreated dental caries, can also contribute to deteriorating mental health, by leading to low self-esteem and social avoidance (Z et al. 4). For instance, missing, stained, or decayed teeth can harm self-esteem and body image, leading to embarrassment, stigma, and social withdrawal (Kaur et al. 6-7; Z et al. 4). The systemic inflammation from untreated oral diseases, like periodontitis, can also diminish overall quality of life and worsen existing psychological conditions such as anxiety and depression (Z et al. 2). This cycle demonstrates how oral and mental health reinforce each other, creating a feedback loop of health inequities (Z et al. 2).

Disparities

Vulnerable groups face unique challenges at the intersection of oral and mental health, where stigma, socioeconomic and societal barriers influence disparities. People with mental illness often experience stigma in healthcare settings, which can discourage them from seeking both dental and mental health care. These individuals may feel misunderstood by health care providers and stigma associated with psychiatric conditions further prevents individuals from accessing care (Z et al. 5). Mental illness is also disproportionately associated with unemployment, low socioeconomic status, and unstable housing, determinants that also limit oral health care access (Johnson et al.; Z et al. 5). The cost of dental visits, lack of insurance coverage, and logistical barriers mean that many patients with mental health challenges are unable to receive regular dental preventive care (Johnson et al., Tiwari et al. 4). This shows that many of the disparities found at the intersection of oral and mental are not individual issues, rather shaped by systemic barriers that limit equitable access to healthcare.

Interventions

Breaking the cycle between poor oral health and mental health requires more holistic, integrated and accessible interventions (Z et al. 6). An approach to this is the development of collaborative care models that incorporate oral health screening into mental health services (Z et al. 8). This integration ensures that patients with psychiatric diagnoses are not overlooked in dental settings and that oral health concerns are recognized as part of overall well-being. This can also facilitate closer collaboration between mental health clinicians and dentists, thereby reducing both psychosocial and financial barriers, and ensuring that both oral and mental health concerns are identified and addressed early (Kisely 280). Community-based programs are also essential for reducing disparities, as interventions like mobile dental clinics, school-based initiatives, and outreach programs can make preventive care more accessible to low-income and marginalized populations who face barriers to both dental and mental health services (Z et al. 8)

Conclusion

Ultimately, there is a strong connection between oral and mental health that significantly influences the prevalence of health disparities. Mental health conditions can influence oral health outcomes, and simultaneously, oral health conditions can exacerbate mental health conditions. This feedback loop is further affected by social stigma surrounding oral and mental health, as well as societal barriers that perpetuate inequities in health. Recognizing this correlation allows dentists and mental health care professionals to work collaboratively to help break this cycle and promote health equity.

Works Cited

Johnson, Alisha M., et al. “Oral health knowledge, attitudes, and practices of people living with mental illness: a mixed-methods systematic review.” BMC Public Health, vol. 24, no. 2263, 2024. doi:10.1186/s12889-024-19713-1

Kaur, Puneet., et al. “Impact of Dental Disorders and its Influence on Self Esteem Levels among Adolescents.” Journal of Clinical and Diagnostic Research, vol. 11, no. 4, 2017. doi:10.7860/JCDR/2017/23362.9515

Kisely, Steve. “No Mental Health without Oral Health.” Canadian Journal of Psychiatry, vol. 61, no. 5, 2016, pp. 277-82. doi:10.1177/0706743716632523

Rudovska, Irena. Illustration of brain, person, and tooth representing mental and oral health. Intouch Public Health, 29 Nov 2023. intouchpublichealth.net.au/mental-and dental/.

Skallevold, Hans Erling., et al. “Importance of oral health in mental health disorders: An updated review.” Journal of Oral Biology and Craniofacial Research, vol. 13, no. 5, 2023, pp. 544-552. doi:10.1016/j.jobcr.2023.06.003

Tiwari, Tamanna, et al. “Association Between Mental Health and Oral Health Status and Care Utilization.” Frontiers in Oral Health, vol. 2, 2022. doi:10.3389/froh.2021.732882

World Health Organization: WHO. “Mental Health.” World Health Organization, 8 October 2025. www.who..int/news-room/fact-sheets/detail/mental-health-strengthening-our response.

Z, Khairunnisa et al. “Mental and Oral Health: A Dual Frontier in Healthcare Integration and Prevention.” Cureus, vol. 16, no. 12, 2024. doi:10.7759/cureus.76264