I’ll admit it – I’m tooth-ambivalent.
I think most of us are, particularly in New Zealand where there’s no subsidies on dental treatment for adults. That annual reminder card comes around, and you just… well… file it with the supermarket leaflet and “good news” from the local Baptists.
I am quite attached to my teeth, however. I wouldn’t want to lose them – my dad had false teeth from a very young age, and only fairly recently was able to afford to have them replaced with a new set. The old ones had become worn down to nothing over years of use.
There is a new study which suggests that us mentals have more cause for concern when it comes to our oral health. Conducted in Australia and published in the latest issue of the British Journal of Psychiatry, it found that people with “severe mental illnesses like schizophrenia or bipolar disorder are over three times more likely to lose their teeth because of poor oral health than the general population.”
Why?
“People with severe mental illness may not be able to prioritise their oral health, or be unable to clean their teeth properly because of poor housing or homelessness. They may be reluctant to see a dentist because of they are scared of treatment, or worried about the cost. Some medications such as antidepressants and mood stabilisers can also reduce the flow of saliva and cause dry mouth (xerostomia), which increases plaque formation.”
For me, I’d say it’s a combination of worrying about the cost and laziness. I’ll go to the dentist if something is dreadfully wrong, eg. Something is hurting or I’ve chipped a tooth.
Dry mouth has never been a major side effect for me from medication, but I did find a couple of years back that I was a chronic tooth-grinder, mostly in my sleep, and caused by anxiety. This had worn my back teeth down to the point where I had to have them “rebuilt”, just like the Six Million Dollar Man, and with nearly as high a price tag.
But while the bacteria that causes plaque can eat away at your teeth (remember that old urban legend about putting a tooth in a glass of Coke and having it dissolve overnight?), there’s some new emerging evidence to show that other forms of bacteria could actually help us feel better.
Probiotic yoghurt is showing promising signs of having a positive effect on brain chemistry:
Professor John Cryan of University College, Cork, said: ‘By affecting gut bacteria, you can have a very robust and quite broad-spectrum effects on brain chemistry and behaviour.
‘Without overstating things, this does open up the concept that we could develop therapies that can treat psychiatric disorders by targeting the gut.
‘You could take a yoghurt with a probiotic in it instead of an antidepressant.’
Some good potential news for the future then, especially for those of us who don’t like taking pills. I can certainly vouch for the effectiveness of probiotics when you’ve got an upset stomach. In addition, there’s much evidence already to suggest that food affects mood, something I’ve been sharply reminded of lately with my crap diet and resulting tiredness.
Maybe if we feel just a little bit better, we’ll be more motivated to go and make that dental appointment? Like other medical issues, we can put looking after our teeth down the priority list, but as one horrific recent case in the US has shown – some dental problems, left untreated, can kill you.
If for no other reason than they usually have interesting posters on the roof.
I think the connection between medication and dry mouth is strong but it is also worth mentioning that inflammation (of the subtle but systemic type) is also correlated with mental illness, as is poor gum/tooth health. Inflammation in the gut/gums due to infection of dysregulation
Of the mucosal immune system is controversially thought to play a role in pathogenesis of depression and mental illness. Chicken n egg scenario here though. Also worth mentioning that carbohydrate craving is assoc with some mental health conditions, excess sugar/refined carbs also being a source of decay in teeth.
Thanks Jad, it’s a constant battle for me to resist sugar. It’s another form of self-medication to watch, along with the booze.
Love my teeth, hate my dentist (and all dentists in general) Have all my original ones and plan on having it stay that way! Bad experience at a very young age taught me the value of oral hygine… Brush twice a day and you’ll be laughing. =D
Love this talk about the sweet details of bipolarism – My mouth has been dry for 20 years, my breath gets nasty and metallic (and that’s on a good day), and my teeth are losing their will to live…..
I’m lucky to have dental insurance here in the US, for which I have no co-pays or other out of pocket expenses for routine cleanings and bitewing x-rays of my teeth twice a year. I go religiously now. From 2000 (when I was in college) until 2009, I did not see a dentist — even though I had insurance. I was just afraid to go. I finally broke down in ’09 to find that I had eight cavities — and thank God that was the extent of it.
I’ve heard that here in the US that dentist’s and optometrist/ophthalmologist’s visits have been down due to the economy — when you lose your insurance here, they’re one of the first things to go before seeing regular medical doctors, for which many people can’t afford to go to either.
Additionally, I am a writer for a university, and I wrote a story about some pre-med students here in an undergraduate dental student association who volunteered at a local free dental clinic. People are now under the impression that my university has a dental clinic and school, and I hear the disappointment in their voices when I tell them that we don’t and refer them to other places for which waiting lists are full. The state dental association had a 3-day massive free clinic for a wide range of dental services for people who couldn’t afford it — cleanings, x-rays, extractions, dentures, etc.– thousands of people lined up everyday, sometimes camping out overnight to hold places in lines.
You sound like young people – wait until they tell you you have gum disease, you need a root canal, or you need five fillings and THEN see how much it costs. You will have no choice and it will put about a hundy onto your mortgage. Dr George is correct, bad dental condition can lead to serious health problems, which you don’t need on top of everything else. Do you? Ask to pay the bill off over time, but GO TO THE DENTIST!
Don’t worry Alex, I won’t be waiting that long. The rinsy mouth stuff more than makes up for the drilling.
For me personally, I don’t get regular dental checkups because of the cost, pure and simple. It isn’t just the cost of the checkup itself either – it’s the exorbitant cost of any treatment that may be necessary.
I think that the contribution of reduced saliva is greatly under estimated in these studies.
Many of the mood drugs whether they be ssri’s mood stablilzers or antipsychotics cause a significant reduction in saliva.
This leaves the teeth without their antibacterial protection and are sitting ducks for decay.
Some people recommend chewing gum can help this.
There is now good evidence that poor dental condition is associated with chronic inflammation in the body that can lead to accelerated heart disease and other aliments.
Here in Australia there is a good dental scheme to help people who are not able to afford it get dental care.
It’s a shame you guys don’t have a similar program.