Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2019, vol. 56, nr 2, April-June, p. 197–201

doi: 10.17219/dmp/105253

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Negative synergy of mental disorders and oral diseases versus general health

Efekt negatywnej synergii zaburzeń psychicznych i chorób jamy ustnej w odniesieniu do zdrowia ogólnego

Artur Pitułaj1,A,B,C,D, Andrzej Kiejna2,A,C,E, Marzena Dominiak1,A,E,F

1 Department of Dental Surgery,Faculty of Dentistry, Wroclaw Medical University, Poland

2 Psychology Research Unit for Public Health, University of Lower Silesia, Wrocław, Poland


In recent years, the World Health Organization (WHO) has undertaken wide-ranging epidemiological research with the purpose of discovering and confirming correlations between mental disorders and somatic diseases. Despite strong evidence for the existence of a two-way dependence between psychological disorders and general diseases, interest in studying the similar impact of oral health is still low. The purpose of this paper was to investigate the multidirectional dependencies between mental, oral and somatic health, and the importance of an interdisciplinary approach to each psychiatric patient. The PubMed, MEDLINE, Web of Science, and Google Scholar databases were searched for articles published between 1994 and 2018 which involved studies examining the interdependencies between oral, general and mental health, using the following keywords: “comorbidities”, “common mental disorders”, “mental health”, “oral health”, “depression”, “periodontitis”, and “WHO”. This review highlights the fact that there is still limited discussion on the importance of the impact of oral health on the general health of psychiatric patients. Data gathered in this paper suggests that an oral examination of mentally ill patients should be considered mandatory.

Key words

mental health, oral health, World Health Organization, interdisciplinary approach

Słowa kluczowe

zdrowie psychiczne, zdrowie jamy ustnej, Światowa Organizacja Zdrowia, podejście interdyscyplinarne

References (44)

  1. Prince M, Patel V, Saxena S, et al. No health without mental health. Lancet. 2007;370(9590):859–877.
  2. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, eds. Global Burden of Disease and Risk Factors. Washington, DC: The International Bank for Reconstruction and Development / The World Bank; New York, NY: Oxford University Press; 2006.
  3. Common mental health disorders (National Institute for Heath and Care Excellence (NICE) clinical guideline 123). In: National Collaborating Centre for Mental Health (UK). Common Mental Health Disorders: Identification and Pathways to Care. Leicester, UK: British Psychological Society; 2011.
  4. Demyttenaere K, Bruffaerts R, Posada-Villa J, et al.; WHO World Mental Health Survey Consortium. Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004;291(21):2581–2590.
  5. Kessler RC, Aguilar-Gaxiola S, Alonso J, et al. The global burden of mental disorders: An update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009;18(1):23–33.
  6. Kessler RC, Ustün TB. The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res. 2004;13(2):93–121.
  7. Scott KM, Alonso J, de Jonge P, et al. Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys. J Psychosom Res. 2013;75(2):121–127.
  8. Stein DJ, Aguilar-Gaxiola S, Alonso J, et al. Associations between mental disorders and subsequent onset of hypertension. Gen Hosp Psych. 2014;36(2):142–149.
  9. Scott KM, de Jonge P, Alonso J, et al. Associations between DSM-IV mental disorders and subsequent heart disease onset: Beyond depression. Int J Cardiol. 2013;168(6):5293–5299.
  10. O’Neill S, Posada-Villa J, Medina-Mora ME, et al. Associations between DSM-IV mental disorders and subsequent self-reported diagnosis of cancer. J Psychosom Res. 2014;76(3):207–212.
  11. De Jonge P, Alonso J, Stein DJ, et al. Associations between DSM-IV mental disorders and diabetes mellitus: A role for impulse control disorders and depression. Diabetologia. 2014;57(4):699–709.
  12. Dimberg L, Arnrup K, Bondemark L. The impact of malocclusion on the quality of life among children and adolescents: A systematic review of quantitative studies. Eur J Orthod. 2015;37(3):238–247.
  13. Kisely S. No mental health without oral health. Can J Psychiatry. 2016;61(5):277–282.
  14. Cormac I, Jenkins P. Understanding the importance of oral health in psychiatric patients. Adv Psychiatr Treat. 1999;5(1):53–60.
  15. Hsu CC, Hsu YC, Chen HJ, et al. Association of periodontitis and subsequent depression: A nationwide population-based study. Medicine (Baltimore). 2015;94(51):e2347.
  16. Heaton LJ, Swigart K, McNelis G, Milgrom P, Downing DF. Oral health in patients taking psychotropic medications: Results from a pharmacy-based pilot study. J Am Pharm Assoc. 2016;56(4):412–417.e1.
  17. Okoro CA, Strine TW, Eke PI, Dhingra SS, Balluz LS. The association between depression and anxiety and use of oral health services and tooth loss. Community Dent Oral Epidemiol. 2012;40(2):134–144.
  18. D’Avila OP, Wendland E, Hilgert JB, Padilha DMP, Hugo FN. Association between root caries and depressive symptoms among elders in Carlos Barbosa, RS, Brazil. Braz Dent J. 2017;28(2):234–240.
  19. Wallin MS, Rissanen AM. Food and mood: Relationship between serotonin and affective disorders. Acta Psychiatr Scand. 1994;377(Suppl):36–40.
  20. Anttila S, Knuuttila M, Ylöstalo P, Joukamaa M. Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need. Eur J Oral Sci. 2006;114(2):109–114.
  21. Gholami N, Sabzvari BH, Razzaghi A, Salah S. Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia. J Dent Res Dent Clin Dent Prospect.2017;11(4):247–252.
  22. Lobbezoo F, Van Der Zaag J, Naeije M. Bruxism: Its multiple causes and its effects on dental implants – an updated review. J Oral Rehabil. 2006;33(4):293–300.
  23. Berger M, Oleszek-Listopad J, Marczak M, Szymańska J. Psychological aspects of temporomandibular disorders – literature review. Curr Issues Pharm Med Sci. 2015;28(1):55–59.
  24. Blanco-Aguilera A, Blanco-Aguilera E, Serrano-del-Rosal R, et al. Influence of clinical and psychological variables upon the oral health-related quality of life in patients with temporomandibular disorders. Med Oral Patol Oral Cir Bucal. 2017;22(6):e669–e678.
  25. Alharby A, Alzayer H, Almahlawi A, et al. Parafunctional behaviors and its effect on dental bridges. J Clin Med Res. 2018;10(2):73–76.
  26. Friedlander AH, Mahler ME. Major depressive disorder: Psychopathology, medical management and dental implications. J Am Dent Assoc. 2001;132(5):629–638.
  27. Friedlander AH, Friedlander IK, Gallas M, Velasco E. Late-life depression: Its oral health significance. Int Dent J. 2003;53(1):41–50.
  28. Rettori E, De Laurentiis A, Dees WL, Endruhn A, Rettori V. Host neuro-immuno-endocrine responses in periodontal disease. Curr Pharm Des. 2014;20(29):4749–4759.
  29. Otomo-Corgel J, Pucher JJ, Rethman MP, Reynolds MA. State of the science: Chronic periodontitis and systemic health. J Evid Based Dent Pract. 2012;12(Suppl 3):20–28.
  30. Gomes-Filho IS, das Mercês MC, de Santana Passos-Soares J, et al. Severity of periodontitis and metabolic syndrome: Is there an association? J Periodontol. 2016;87(4):357–366.
  31. Kozarov EV, Dorn BR, Shelburne CE, Dunn WA Jr, Progulske-Fox A. Human atherosclerotic plaque contains viable invasive Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Arterioscler Thromb Vasc Biol. 2005;25(3):e17–e18.
  32. Suresh S, Mahendra J. Multifactorial relationship of obesity and periodontal disease. J Clin Diagn Res. 2014;8(4):ZE01–ZE3.
  33. Demoersman J, Pochard P, Framery C, et al. B cell subset distribution is altered in patients with severe periodontitis. PLoS One. 2018;13(2):e0192986.
  34. Holt SC, Ebersole JL. Porphyromonas gingivalis, Treponema denti­cola, and Tannerella forsythia: The “red complex”, a prototype polybacterial pathogenic consortium in periodontitis. Periodontol 2000. 2005;38:72–122.
  35. Tribble GD, Kerr JE, Wang B-Y. Genetic diversity in the oral pathogen Porphyromonas gingivalis: Molecular mechanisms and biological consequences. Future Microbiol. 2013;8(5):607–620.
  36. Xu W, Pan Y, Xu Q, et al. Porphyromonas gingivalis ATCC 33277 promotes intercellular adhesion molecule-1 expression in endothelial cells and monocyte-endothelial cell adhesion through macrophage migration inhibitory factor. BMC Microbiol. 2018;18(1):16.
  37. Miyauchi M, Ao M, Furusho H, et al. Galectin-3 plays an important role in preterm birth caused by dental infection of Porphyromonas gingivalis. Sci Rep. 2018;8(1):2867.
  38. Zeng X-T, Luo W, Huang W, Wang Q, Guo Y, Leng WD. Tooth loss and head and neck cancer: A meta-analysis of observational studies. PLoS One. 2013;8(11):e79074.
  39. Wang Y, Peng J, Li Y, et al. Association between tooth loss and risk of oesophageal cancer: A dose–response meta-analysis. Springerplus. 2016;5(1):1020.
  40. Yin XH, Wang YD, Luo H, et al. Association between tooth loss and gastric cancer: A meta-analysis of observational studies. PLoS One. 2016;11(3):e0149653.
  41. Milone SD, Lopes Milone S. Evidence-based periodic health examination of adults. Memory aid for primary care physicians. Can Fam Physician. 2006;52(1):40–47.
  42. Huebner CE, Chi DL, Masterson E, Milgrom P. Preventive dental health care experiences of preschool-age children with special health care needs. Spec Care Dentist. 2015;35(2):68–77.
  43. Schrimshaw EW, Siegel K, Wolfson NH, Mitchell DA, Kunzel C. Insurance-related barriers to accessing dental care among African American adults with oral health symptoms in Harlem, New York City. Am J Public Health. 2011;101(8):1420–1428.
  44. Cashman SB, Savageau JA, Lemay CA, Ferguson W. Patient health status and appointment keeping in an urban community health center. J Health Care Poor Underserved. 2004;15(3):474–486.