I was standing in my local pharmacy this week, waiting to collect a prescription and I saw a little girl, aged about 2, stroking all the amazing Disney toothbrushes in awe, as her mum gently told her she wasn’t due a new one yet. The little girl was clearly disappointed. Another lady in the queue commented “I wish my teenage son was as interested in his toothbrush as you are in those!”, and it made me think.
It’s fair to say that some teenagers do have an on/off relationship with their toothbrushes and dental hygiene in general.
So how much does this matter and what has it got to do with mental health?
Well, put simply …
dental health = mental health and vice versa!
How brushing their teeth is good for your teen’s emotional wellbeing
There is clear evidence that having good oral health means we are more likely to have good mental health, and having good mental health means we are more likely to look after ourselves better (including our teeth and gums).
However when we feel low/ stressed we may not prioritise our tooth brushing, and when our teeth and gums are painful or look bad, we feel worse.
I am no dentist, but I am very interested in keeping our teens feeling as good as they possibly can about themselves, so for once in my life I am going to say, ‘open wide’ and take a good look at how looking after your teeth can boost emotional wellbeing.
We know that “The population with mental illness usually has poorer health than the general population – and that includes oral health” Prof Singhal, Rutgers School of Dental Medicine, New Jersey.
Yet many dentists may not be tuned into asking about mental health or making the connection between oral health and psychological wellbeing. And psychiatrists/ therapists may not naturally focus on dental health either, despite its importance.
Going to the dentist itself is a good habit to get into, though it can make people anxious, and it may be expensive. It is one of the first health habits to fall by the wayside when students start at university for example, and very few universities actively promote dental care sadly.
As parents and carers therefore it falls to us to teach our teens to care for their teeth and gums to create lifelong healthy habits! Even as young adults they might need prompting to book a regular dental check-up.
Here comes the science!
So let’s start, as I always like to do, with the science. Studies have shown a clear link between mental health conditions and oral/ dental health, for example;
1. Students with mild depression are more likely to experience poor oral health such as temporomandibular dysfunction (TMD- jaw pain), gingivitis (inflamed gums), periodontitis (gum disease), and xerostomia (dry mouth).
2. Anxiety has a significant effect on toothache, gum bleeding, and oral ulcers. In other words if you are anxious- these problems will feel worse.
3. Tooth decay, gum diseases, dry mouth (xerostomia), and teeth grinding (bruxism) are all more common in those with mental health issues.
4. The worse you feel emotionally the worse you rate your dental health, which can make you feel even worse about yourself. It’s a vicious circle and undermines self-confidence, a crucial issue in teenagers.
5. Poor dentition can affect eating, speaking and self-esteem, leading to social difficulties and isolation.
6. Poor nutrition (causes may include eating disorders/ anxiety/ poverty/ poor habits) leads to poor dental health, which can then make eating healthily difficult (e.g. biting into an apple).
7. Substance misuse is clearly associated with poor oral health (alcohol, drugs and smoking all have an unhealthy impact). But substances are often used not just for ‘fun’ but for coping with social anxiety, low mood, poor self-esteem and as a form of self-harm, so it becomes clear that there is a link to oral health, not just directly from the substance on the body tissues, but indirectly from the underlying mental health issue too. Dealing with the underlying issue is the key to breaking this cycle of harm.
8. Adolescents who have higher levels of stress, low life-satisfaction and psychological health complaints are less likely to regularly brush their teeth. They may therefore be more at risk of both short and long term dental problems.
9. Research suggests that adolescents with ADHD have worse oral health and need greater attention from dentists and those responsible for their diet and oral hygiene than teens without ADHD. Problems may occur because they forget to brush their teeth, they are more prone to grinding their teeth, or medication can lead to a dry mouth.
10. Perhaps most worryingly, in adolescents with the most severe dental problems there is also a higher risk of self-harmful and suicidal thoughts and behaviours. Clearly dental care is vitally important.
11. Interestingly- whilst wearing braces can be stressful initially, studies have shown it actually improves mental health overall, which is fantastic. Results showed that orthodontic treatment improved mental health, and reduced physical, anxiety, sleep disorder, and depressive symptoms while improving social functioning. In addition, the treatment improved teens’ attitudes towards their body image.
So what can we do to help?
1. The first thing is to recognise the link between dental and mental health and talk about it- with your family, with friends and with your dentist. Underlining the importance of a healthy mouth for a healthy mind and vice versa is key to encouraging great health habits.
2. Practice good toothbrushing as a family and stick to that routine like it’s the army! No skipping out the door without brushing in the morning, and no forgetting because we are tired late at night.
3. Floss, use interdental brushes, use fluoridated toothpaste, brush twice a day minimum, and encourage healthy snacking and a good mixed diet. Use a straw for fizzy drinks, and chew sugar free gum if you’re going to chew any at all!
4. See a dentist regularly (annually is recommended) for check-ups, and impress upon your teens how important it is to keep doing so even when they leave home.
5. Read more about teen dental health here, especially if you need ideas for healthy snacks for between meals, or more info to talk to your teen about dental care. This website also has advice about mouth piercings (these are not recommended and a generally bad idea!), and why wearing a gum shield for sport is vital.
6. Share this TikTok celebrity dentist influencer (who knew?!) with your teen if that might be of interest @drshaadimanouchehri to inspire them!
In summary
Although I am not a dentist, I hope I have managed to share with you a useful explanation of why it is so important that our teenagers look after their teeth, and how dental health equals mental health. Wherever there is an opportunity to boost adolescent emotional wellbeing we should take it, and dental care seems to me to be a reasonably close to home and positive daily healthy habit to build, for now and in the future.
I was never very good at dancing the ‘Floss’ but I reckon this kind of flossing is one I can manage! Good luck!
More NHS info here