Mind Over Mouth: Psychological Determinants of Oral Health – A Review
DOI:
https://doi.org/10.12775/JEHS.2025.85.66501Keywords
oral health, mental health, stress, depression, anxiety, bruxism, burning mouth syndrome, eating disorders, psychosomatic disordersAbstract
Background: Mental health conditions such as stress, depression, anxiety, and eating disorders can significantly influence oral health. These psychological factors affect oral function, behavior, and quality of life, yet their role in overall health remains underrecognized.
Aim: To review current literature on the psychological determinants of oral health and examine their broader implications for individual and population well-being.
Methods: A narrative review was conducted using 39 peer-reviewed articles identified through PubMed, Scopus, and Google Scholar. The studies were organized into five thematic categories: stress-related symptoms, depression-associated neglect, dental anxiety, eating disorders, and psychosomatic manifestations.
Results: Psychological disorders were associated with bruxism, xerostomia, dental erosion, chronic oral pain, and decreased oral health-related quality of life. Mental distress often led to harmful behaviors and neglect of self-care. Psychosomatic conditions presented diagnostic challenges. Interdisciplinary strategies, including psychological and physiotherapeutic interventions, were shown to enhance health outcomes. Integrating mental health support into oral and general health frameworks appears essential for effective prevention and intervention. Further research is needed to establish standardized approaches for identifying and managing psychological influences on oral health.
Conclusions: Oral health and mental well-being are closely interconnected and should be considered together in health promotion and disease prevention strategies. A holistic understanding of health requires integration of psychological, behavioral, and somatic dimensions.
References
1. Kuipers S, Boonstra N, Kronenberg L, Keuning-Plantinga A, Castelein S. Oral health interventions in patients with a mental health disorder: A scoping review with critical appraisal of the literature. Int J Environ Res Public Health. 2021;18(15):8113. https://doi.org/10.3390/ijerph18158113
2. Kalaigian A, Chaffee BW. Mental health and oral health in a nationally representative cohort. J Dent Res. 2023;102(9):1007–1014. https://doi.org/10.1177/00220345231171108
3. Tiwari T, Kelly A, Randall CL, Tranby E, Franstve-Hawley J. Association between mental health and oral health status and care utilization. Front. Oral. Health. 2022;2:732882. https://doi.org/10.3389/froh.2021.732882
4. Cao R, Lai J, Fu X, Qiu P, Chen J, Liu W. Association between psychological stress, anxiety and oral health status among college students during the Omicron wave: a cross-sectional study. BMC Oral Health. 2023;23:470. https://doi.org/10.1186/s12903-023-03151-3
5. Matsuda S, Yoshimura H. Impact of oral health management on mental health and psychological disease: a scoping review. J Int Med Res. 2023;51(1):1–7. https://doi.org/10.1177/03000605221147186
6. Saczuk K, Lapinska B, Wilmont P, Pawlak L, Lukomska-Szymanska M. Relationship between sleep bruxism, perceived stress, and coping strategies. Int J Environ Res Public Health. 2019;16(17):3193. https://doi.org/10.3390/ijerph16173193
7. Vasiliou A, Shankardass K, O’Campo P, Quiñonez C. Current stress and poor oral health. BMC Oral Health. 2016;16:88. https://doi.org/10.1186/s12903-016-0284-y
8. Vlăduțu D, Popescu SM, Mercuț R, Ionescu M, Scrieciu M, Glodeanu AD, et al. Associations between bruxism, stress, and manifestations of temporomandibular disorder in young students. Int J Environ Res Public Health. 2022;19(9):5415. https://doi.org/10.3390/ijerph19095415
9. Pinheiro LS, Ritzel IF, Hugo FN, Hilgert JB, Bastos JL, Celeste RK. Associations between psychological stress, discrimination, and oral health-related quality of life: the buffering effects of social support networks. Cad Saude Publica. 2024;40(2):e00123123. https://doi.org/10.1590/0102-311xen123123
10. Stoy S, McMillan A, Ericsson AC, Brooks AE. The effect of physical and psychological stress on the oral microbiome. Front Psychol. 2023;14:1166168. https://doi.org/10.3389/fpsyg.2023.1166168
11. Paudel D, Kuramitsu Y, Uehara O, Morikawa T, Yoshida K, Giri S, et al. Proteomic and microbiota analyses of the oral cavity during psychological stress. PLoS One. 2022;17(5):e0268155. https://doi.org/10.1371/journal.pone.0268155
12. Stankeviciene I, Stangvaltaite-Mouhat L, Aleksejuniene J, Mieliauskaite D, Talijuniene I, Butrimiene I, et al. Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren’s syndromes patients – a cross-sectional study. BMC Oral Health. 2024;24:454. https://doi.org/10.1186/s12903-024-04224-7
13. Dagli N, Haque M, Kumar S. Bibliometric analysis and visualization of clinical trials on psychological stress and oral health (1967–2024). Cureus. 2024;16(4):e57865. https://doi.org/10.7759/cureus.57865
14. Chaudhary S. Psychosocial stressors in oral lichen planus. Aust Dent J. 2004;49(4):192–5. https://doi.org/10.1111/j.1834-7819.2004.tb00072.x
15. Alcázar-Hernández JM, Pecci-Lloret MR, Guerrero-Gironés J. Oral manifestations in patients in treatment with antidepressants: a systematic review. J Clin Med. 2024;13(22):6945. https://doi.org/10.3390/jcm13226945
16. Bafageeh F, Loux T. Depression symptoms linked to multiple oral health outcomes in US adults. JDR Clin Transl Res. 2025;10(1). https://doi.org/10.1177/23800844241246225
17. Skoskiewicz-Malinowska K, Malicka B, Ziętek M, Kaczmarek U. Oral health condition and occurrence of depression in the elderly. Medicine (Baltimore). 2018;97(41):e12490. https://doi.org/10.1097/md.0000000000012490
18. Palomer T, Ramírez V, Ortuño D. Relationship between oral health and depression: data from the National Health Survey 2016–2017. BMC Oral Health. 2024;24:188. https://doi.org/10.1186/s12903-024-03950-2
19. Nerobkova N, Park EC, Jang SI. Depression and oral health-related quality of life: a longitudinal study. Front Public Health. 2023;11:1072115. https://doi.org/10.3389/fpubh.2023.1072115
20. Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The relationship between dental fear and anxiety, general anxiety/fear, sensory over-responsivity, and oral health behaviors and outcomes: a conceptual model. Int J Environ Res Public Health. 2022;19(4):2380. https://doi.org/10.3390/ijerph19042380
21. Hassan BH, Abd El Moniem MM, Dawood SS, Alsultan AA, Abdelhafez AI, Elsakhy NM. Dental anxiety and oral-health-related quality of life among rural community-dwelling older adults. Int J Environ Res Public Health. 2022;19(13):7643. https://doi.org/10.3390/ijerph19137643
22. Nangle MR, Adams AG, Henry JD. Dental anxiety and oral health following stroke: a pilot study. BMC Oral Health. 2022;22(1):568. https://doi.org/10.1186/s12903-022-02618-z
23. Ludovichetti FS, Zuccon A, Zambon G, Signoriello AG, Zerman N, Stellini E, et al. Maternal mental health and children oral health: a literature review. Eur J Paediatr Dent. 2023;24(2):99-103. https://doi.org/10.23804/ejpd.2023.1833
24. Presskreischer R, Prado MA, Kuraner SE, Arusilor IM, Pike K. Eating disorders and oral health: a scoping review. J Eat Disord. 2023;11:55. https://doi.org/10.1186/s40337-023-00778-z
25. Kavitha PR, Vivek P, Hegde AM. Eating disorders and their implications on oral health – role of dentists. J Clin Pediatr Dent. 2011;36(2):155–160 https://doi.org/10.17796/jcpd.36.2.3785414p682843wj
26. Frydrych AM, Davies GR, McDermott BM. Eating disorders and oral health: a review of the literature. Aust Dent J. 2005;50(1):6–15 https://doi.org/10.1111/j.1834-7819.2005.tb00079.x
27. Valeriani L, Frigerio F, Piciocchi C, Piana G, Montevecchi M, Donini LM, et al. Oro-dental manifestations of eating disorders: a systematic review. J Eat Disord. 2024;12:87. https://doi.org/10.1186/s40337-024-01050-8
28. Frigaard J, Hynne H, Randsborg K, Mellin-Olsen T, Young A, Rykke M, et al. Exploring oral health indicators, oral health-related quality of life and nutritional aspects in 23 medicated patients from a short-term psychiatric ward. Front Public Health. 2023;11:1083256. https://doi.org/10.3389/fpubh.2023.1083256
29. DeBate RD, Tedesco LA, Kerschbaum WE. Knowledge of oral and physical manifestations of anorexia and bulimia nervosa among dentists and dental hygienists. J Dent Educ. 2005;69(3):346–354 https://doi.org/10.1002/j.0022-0337.2005.69.3.tb03921.x
30. Chiba FY, Chiba EK, Moimaz SAS, Matsushita DH, Garbin AJI, Garbin CAS. Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders. Dental Press J Orthod. 2022;27(2):e2220305. https://doi.org/10.1590/2177-6709.27.2.e2220305.oar
31. Silverstein LS, Haggerty C, Sams L, Phillips C, Roberts MW. Impact of an oral health education intervention among a group of patients with eating disorders (anorexia nervosa and bulimia nervosa). J Eat Disord. 2019;7:29. https://doi.org/10.1186/s40337-019-0259-x
32. Hamon B, Orliaguet M, Misery L, Boisramé S. Burning mouth syndrome and pelvodynia: a literature review. Medicine. 2023;102(3):e32648. https://doi.org/10.1097/md.0000000000032648
33. Gurvits GE, Tan A. Burning mouth syndrome. World J Gastroenterol. 2013;19(5):665–72. https://doi.org/10.3748/wjg.v19.i5.665
34. Priyadharshini G, Ramalingam K, Ramani P. Unveiling the unspoken: exploring oral manifestations of psychological disorders. Cureus. 2024;16(1):e52967. https://doi.org/10.7759/cureus.52967
35. Toyofuku A. Psychosomatic problems in dentistry. BioPsychoSocial Med. 2016;10:14. https://doi.org/10.1186/s13030-016-0068-2
36. Pop-Jordanova N, Loleska S. On psychosomatic problems in dentistry. Prilozi. 2020;41(1):57–63. https://doi.org/10.2478/prilozi-2020-0023
37. Madland G, Feinmann C. Factors Chronic facial pain: a multidisciplinary problem. J Neurol Neurosurg Psychiatry 2001;71:716–719 https://doi.org/10.1136/jnnp.71.6.716
38. Westad YAS, Flemmen GL, Solem S, Monsen T, Hollingen H, Feuerherm A, Havnen A, Hagen K. Interdisciplinary CBT treatment for patients with odontophobia and dental anxiety related to psychological trauma experiences: a case series. BMC Psychiatry. 2024;24:606. https://doi.org/10.1186/s12888-024-06055-w
39. Sauvageon L, Savard G, Moussa C, Rochefort GY, Denis F, Fossat C, Renaud M. Dentists and physiotherapists level of collaboration in the treatment of temporomandibular disorders in France. BMC OralHealth. 2024;24:979. https://doi.org/10.1186/s12903-024-04768-8
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Copyright (c) 2025 Martyna Woźniak, Marcela Słomianny, Karolina Kutnik, Karolina Kusibab, Gabriela Sikora, Michał Czechowski, Gabriela Skórska, Karolina Koguc, Karolina Kolada, Małgorzata Sajda
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