Depression is one of the most common public health issues affecting adults today

Mental health, mental illness, and depression

Mental health is integral to each of our well-being. The World Health Organization (WHO) defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.” Mental illness refers to disorders characterized by dysregulation of mood, thought, and/or behavior. Depression is one of the most common mental illnesses affecting society.

There are 3 main types of depression:

  1. Major depressive disorder is when an individual experiences at least 5 or more of the American Psychiatric Association’s diagnostic criteria for 2 weeks or longer. An episode can occur once or can recur.
  2. Minor depressive disorder is when an individual experiences at least two depressive symptoms for two weeks
  3. Persistent depressive disorder (dysthymia) is when an individual experiences depressive symptoms for at least 2 years, with or without additional major depressive episodes.

Are antidepressants good or bad?  

In 2015, approximately 16.1 million adults in the U.S. experienced at least one major depressive episode. One in six Americans take some kind of psychiatric drug, mostly antidepressants, followed by anxiolytics and antipsychotics to manage the symptoms of depression. Antidepressants can cause unpleasant side effects. Healthcare providers play an important role in educating patients about possible side effects and the dangers of discontinuing the medication without consulting a healthcare provider.


The effect of depression on the mouth 

The oral mucosa is extremely reactive to emotional and psychological alterations such as stress, anxiety and depression. Depression can disturb hormonal, vascular and muscular functions as well, causing pain, burning sensations, and ulcerations in the oral cavity. Oral diseases that may occur in patients with depression include:

  • Recurrent aphthous stomatitis (RAS),
  • Oral lichen planus (OLP), and
  • Burning mouth syndrome

While the above 3 conditions can occur in patients suffering from depression, depressed patients frequently develop cavities and periodontal disease due to neglected oral hygiene. Patients taking antidepressants also often experience xerostomia (dry mouth).

The effect of antidepressants on the mouth 

Antidepressants affect individuals differently but often causes xerostomia (dry mouth), halitosis (chronic bad breath), or an altered taste sensation. Xerostomia may exacerbate cavities and periodontal disease which can then worsen an individual’s depression, creating a never ending cycle. In 2010 the American Dental Association drafted a policy to encourage the FDA to include warning labels for medications that cause xerostomia (dry mouth).


How virtual care can be a powerful tool in mental and dental health

Dental healthcare providers can use virtual care to educate patients on how to manage their oral health while taking antidepressants. These helpful guidelines can be shared with patients to help relieve xerostomia (dry mouth) symptoms:

  • Drink lots of water and sugar free drinks to keep the mouth moist and lubricated
  • Avoid caffeinated drinks, such as coffee, tea, and certain sodas
  • Sip water or a sugar free drink during meals to help improve taste of food
  • Chew sugar free gum or suck on hard, sugar free candy to stimulate saliva flow
  • Reduce tobacco and alcohol intake
  • Reduce intake of spicy or salty foods

Preventative dental education is important for individuals suffering from depression. Collaborative efforts between mental health and dental practitioners can ultimately lead to successful outcomes and reduce the stigma surrounding mental illness.

Want to help your patient improve their symptoms of depression? Join the HealthTap Medical Experts network to build your Virtual Practice profile and connect easily with your patients. Click the button below to start your application.

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Simitha Singh Rambiritch

Simitha Singh Rambiritch is a Dentist from South Africa with a Masters in Science in Oral Medicine and Periodontology from the University of the Witwatersrand (Wits). She was a clinician in the South African public and private sector and an oral medicine and periodontology lecturer for dental and oral hygiene students at the Wits School of Oral Health Sciences for almost 8 years. She also authored several publications in the South African Dental Journal. Simitha was the 2013 recipient of the Margot Lachmann Fellowship, for excellence in cancer research, with a focus on early diagnostic biomarkers in premalignant and autoimmune conditions and their conversion rate to oral cancer. She was invited to present her findings at the 9th International Congress on Autoimmunity in Nice, France.

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