We know that oral health is linked to overall health. But it’s too easy for many people to imagine that this stops with physical health. But we’re finding that oral health may have links beyond gut health and heart health. It may be linked to your mental health as well.
That’s according to two different studies published recently that looked at this question from two very different angles but came to the same conclusion: gum disease is linked to mental health problems of depression and/or anxiety.
In one of the studies, researchers used a birth cohort from Brazil in 1982. Although the original cohort included about 5000 people, only about 500 had suitable data for this study, which included a follow-up in 2012. The follow-up included a periodontal exam and a version of the Beck Depression Inventory to assess symptoms of depression.
In this study, researchers found that depression was linked to gum disease. People with depression were 19% more likely to have gum disease. Depressive symptoms tended to be linked to more severe gum disease, with an 18% risk. However, the mental health condition was not associated with receding gums or bleeding on probing, which are symptoms of gum disease.
It’s important to note that this is a simple association. It doesn’t give us good information about any potential causal link between the two conditions.
Genetics and Childhood Don’t Explain the Association
However, the second study comes to more robust conclusions about the association between the two conditions. This study used “identical” twins (technically monozygotic twins) to try to determine whether genetics or childhood environment could explain the association between the two conditions.
They looked initially at over 4000 female twins age 20-91 to see how the conditions might be related to either genetics or early childhood environment. They found that smoking, anxiety, and depression were all linked together with each other and with gum disease.
To test whether these conditions were linked primarily through genetics, they analyzed data using only 514 individuals in twin pairs where only one person was affected by gum disease. They found that the links between gum disease, depression, and anxiety all remained significant. Anxiety was associated with a 60% higher risk of gum disease, and depression was associated with an almost 70% higher risk of gum disease.
What Is the Cause?
With these two studies coming up with the same basic conclusions, it’s hard to dismiss the link between these conditions. However, these studies don’t do a good job of telling us about the possible causal links between oral health and mental health.
But the studies do eliminate some causes, leaving us with a better sense of what might be responsible.
You might think that oral hygiene is the link: people who are depressed don’t care for their teeth as well, leading to an increased risk of gum disease. However, the Brazilian study specifically looked at flossing as a potential link and found that it could not explain the association.
We might also look at inflammation as a possible cause. After all, this is the likely link between gum disease and Alzheimer’s disease. However, the Brazilian study looked at common inflammation markers, and found that it couldn’t explain the association, either.
And, of course, the twin study was designed to eliminate genetics and early childhood environment as potential causes.
Without knowing what is the true cause of the association between the two conditions, we can’t recommend treatment for the one to address the other. Instead, we have to recommend that people should treat both aspects in concert to try to address this potentially serious association of conditions.
Comprehensive Dentistry in Scripps Ranch
If you are looking for a dentist in Scripps Ranch who understands that the impacts of your oral health go far beyond your mouth, you should schedule an appointment with Dr. Ramin Goshtasbi at Oasis Dental Arts. Please call today for your appointment.