When we talk about holistic dentistry, we often look at the ways that your oral health and your overall health overlap. However, we have a tendency to focus on physical links between the two. We talk, for example, about how gum disease can impact your heart, or how your diet affects your oral health.
But it’s also important to consider the critical role that psychology plays in achieving and maintaining good oral health. A pair of recently-published studies highlight the important influence that depression and anxiety can have on your periodontal health.
Depression Linked to Poor Oral Health
In the first study, researchers looked at the oral health and mental health of a birth cohort of over 500 individuals from about 5000 enrolled in 1982 in Brazil. They examined all these individuals for periodontal disease. They then compared the findings with the results of a mini psychiatric interview, which had been conducted in 2012, when the birth cohort was age 30. The interview included the Beck Depression Inventory to assess depression symptoms.
Researchers then looked at the association between depression and gum disease. They found that people with symptoms of depression were 19% more likely to have gum disease. Depressive symptoms were even linked to an 18% increase in the risk of moderate or severe gum disease. However, the association didn’t hold for receding gums or bleeding on probing.
Genetics and Childhood Don’t Explain the Association
In the second study, researchers used monozygotic twins (so-called “identical” twins) to look at the possible role of genetics and childhood environment in creating associations between depression and gum disease.
They looked at over 4000 twins to see if gum disease and depression were more associated with genetics than with each other. They found that smoking, anxiety, and depression were linked together. They then looked at 514 individuals in pairs where one twin was affected but not the other. They found that the associations for anxiety linked to gum disease and gum bleeding (in this case, a 60% increase in risk) remained. The link between depression and gum disease (a 68% higher risk) also remained.
What Is the Cause?
Although these studies highlight a proven relationship, they don’t tell us what causes the interaction. In fact, both studies seem to eliminate potential causes of the relationship.
One easy explanation people might come up with is: depressed people don’t take care of their oral health. However, that may not be as simple an answer as you think. The Brazilian birth cohort study specifically looked at flossing as a potential connection, but found that it didn’t explain the link.
Another possible explanation is that gum disease somehow triggers depression through inflammation, as is suspected for Alzheimer’s disease. However, the Brazilian study looked at that, too, and found that c-reactive protein levels (a common indicator of systemic inflammation) didn’t explain the link.
And, of course, the twin study shows us that genetics and childhood environment don’t explain the link.
If we don’t know what is causing the link, we just have to look at the connection and conclude that mental health is somehow linked to oral health. Since we don’t know which is the cause and which is the effect, we have to try to treat both, making oral healthcare part of psychological care and psychological care part of oral healthcare.
Holistic Dentistry in San Jose
If you are looking for an integrative dentist in San Jose who looks at you as a whole person, then you are looking for Dr. Nancy Nehawandian. Dr. Nehawandian has pioneered what she calls the “Top-down” approach to dentistry, which attempts to treat your oral health as holistically as possible, which means considering your overall physical and mental health as part of the process of dental treatment.
To learn how you can benefit from Top Down Dentistry, please call (408) 354-5600 today for an appointment at our office in Los Gatos.
