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Anxiety, Depression, Stress, and Oral Health

Course Number: 573

Influence of Anxiety and Depression on Dental Caries

In addition to the behavioral factors that may reduce oral hygiene measures and result in poor adherence to professional dental preventative measures in patients suffering with anxiety and depression,7,72,73 sympathetic stimulation in patients with anxiety and chronic stress has been associated with reduced salivary flow.74,75 Xerostomia is also a known side effect of many antidepressant and anxiolytic medications.10 Finally, simple carbohydrate intake is elevated in those individuals who are experiencing anxiety and depression.76 All of these factors may combine to increase the risk of caries in individuals with depression and anxiety disorders.

A recent study found that in Finnish adults between 35-54 depression was significantly associated with the number of decayed teeth.8 This is consistent with previous studies that demonstrated that the severity of depression was associated with increased numbers of decayed teeth in adults.7,72,76 It is thus critical that oral health be considered an integral part of physical and psychological health and emphasis be placed upon collaboration between oral and medical healthcare professionals to result in ideal treatment outcomes. Further, in a study that evaluated oral health and depression, controlling for confounders such as alcohol and tobacco consumption, demographic data, mental health treatment, and systemic health, depression was found to be a risk factor for caries [OR 1.27 (1.13,1.44)], tooth loss [OR 1.31 (1.24, 1.37)], and total edentulism [OR 1.17 (1.02, 1.34)].77