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:
- 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.
- Minor depressive disorder is when an individual experiences at least two depressive symptoms for two weeks
- 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.
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