PTSD and Oral Health

Matthew Warner

Published by: Psytext

Oral health affects one's emotional state and sense of self worth while being a necessary component for your proper digestion. Stressful events cause physical and psychological changes that can alter our ability to maintain, monitor or manage any negative effects on our teeth and overall health.

There are two strings of thought when considering the negative effects psychiatric disorders can have on one's oral health. One of which is known as periodontal disease. This is caused by the accumulation and dysbiosis of bacterial biofilm. This can lead to different forms of physical issues, including gingivitis, sore throats, bleeding of the gums, malabsorption and what is known as “periodontal pockets”. These conditions can lead to a poor quality of life, and can sometimes go undiagnosed if misunderstood. Your lifestyle, diet, ability to know or understand how to care for your teeth, one's ability to seek out health care and or the desire to do so all play mitigating factors towards oral health, which can affect that physical and mental well-being. Post-traumatic stress disorder is a mental condition that can have a wide range of effects on one's body. Because of this fact, it is sometimes difficult to detect (Kisely, 2023).

-Hormonal -Hygienic -Medical -Addiction

These are the known contributing factors associated with the inadvertent decline to oral 

health for patients suffering with PTSD. The symptoms of post-traumatic stress disorder can range from mild to severe. They include difficulty comprehending reality, depressed feelings coupled with feelings of heightened emotions, fear of people, places and things, difficulty maintaining a sound diet and problems with their social outlook. Because of these combined factors, oral health can disintegrate overtime. 

          Socioeconomic disadvantages such as affordable housing, and access to dental care can not only damage one's oral health, but add more stress to an already difficult situation. Post-traumatic stress disorder not only causes the patient to behave in a fashion that may damage their body, but also changes their body chemically and hormonally which can also create long-lasting negative effects. Stress causes adrenaline glands and neurotransmitters associated with inflammatory mediators to become distorted. These alter your ability to metabolize food and the other necessary chemicals that make up your physiology. Overtime, this will lead to physical changes in your well-being. One of these physical changes is the look and feel of your teeth. You will sometimes notice that individuals who are suffering from some variety of mental conditions have teeth that may not be necessarily damaged, but do not grow or function normally. 

          In order to monitor and understand the effects of post-traumatic stress disorder on the public. Studies have been conducted that involve cases of individuals who have been diagnosed with the condition.  The studies weigh mental health patients against those who have not been diagnosed,  in an attempt to draw a clear comparison in their behavioral traits. One study involved 119 refugee children from Syria, and their own unique oral health cases. 57 of the subjects were diagnosed with post-traumatic stress disorder, or (PTSD). 62 of the  subjects were undiagnosed with any mental health concerns. With ages ranging between 10 and 14, this study was to confirm the hypothesis that post-traumatic stress disorder has caused damage to their oral health. The study showed that children who suffered from post-traumatic stress disorder were more likely to have negative impacts such as; bleeding gums, trouble sleeping, difficulty opening and closing their mouths, difficulty eating hot and cold foods, insecurity about their oral health, in security about their physical appearance, had more problems paying attention and have felt ostracized by their peers. The healthy subjects did not demonstrate these traits (Hamid, 2020).  Generally speaking, one's oral health will affect how you speak, eat and socialize. It may not be a medical emergency, but will affect your quality of life. Making clinical decisions about how to promote positive lifestyle changes in the developing youth is one way of combating these issues. But unfortunately, financial restraints may make it difficult to seek out assistance when necessary. Mental and psychological effects, especially ones related to post-traumatic stress, may also make the subject less willing to look for help when they need it. 

          One of the important things about this study is the discovery of mental health problems. It has become a fact that one's oral health may determine their mental stability, or be proof of other forms of psychological trauma. The manifestation of mental health problems can affect both your mental and physical health. Self neglect, combined with addiction such as tobacco, prescription medication or even poor diet can provide physical proof of post-traumatic stress disorder, or other mental health conditions (Hamid, 2020 paragraph 3). Psychological disorders can create a combined list of physical illnesses. As your mind struggles to deal with the emotional stress, your ability to maintain your sustainable health comes into question. Understanding this has been done through various methods and studies that include depression, anxiety and even syndromes that are related to fear of taking care of one's oral health. In order to ensure that the information is correct, the studies that have been conducted are referenced and related to similar studies in other countries (Solis, 2017).

          In order to fully understand some of the causes of oral deterioration in relation to post traumatic stress disorder (PTSD); determining the link between psychiatric problems, substance abuse and the lack of oral care education is important. Although depression and anxiety may play a contributing factor to the lack of taking care of one's oral health, there is also a clear link between periodontal disease and anxiety. Hormonal changes can alter the human body's ability to process nutrients while causing diet deviations that may not be in their favor. One of the strongest and more prominent factors that have been known to affect one's health is that of substance abuse. Drugs, alcohol and tobacco or other forms of smoking cause detrimental effects to your teeth, and because one who is using these as a coping mechanism may not be as cautious to how it is affecting themselves. They may also be introverted, or have other social anxiety issues that are causing them to not feel concerned with their oral appearance, or how it is affecting them.

          Post-traumatic stress syndrome diagnosis can be done by a doctor, or by someone who is close to the individual. There may be other physical changes, or abnormalities that would suggest one is suffering from psychological trauma. After being Thai girls, taking the necessary steps to make the required lifestyle changes for the recovery of the patient is necessary so further damage is not incurred. Education, pre planning, and overall sense of social responsibility will help prevent this from becoming more of a systemic issue.  

     Treatment for this condition comes with understanding. Understanding that your oral health is important, and taking the steps to rectify any circumstances that may be causing your body harm. In some cases, this may not be an easy task for everyone. It is also important to diagnose any form of psychological this order that may affect your health. In most cases, any form of negative impact to one's psychosis will ultimately cause trouble to themselves and those around them. Diagnosis of post-traumatic stress disorder at an early stage will help prevent the sufferer from any prolonged exposure to the negative effects. Having a system of individuals who are willing to provide support, and the necessary tools for the patient to thrive, is crucial for their success (Hamid, 2020).  Because periodontal health concerns have become a growing issue, there have been a number of studies that have been related to determining its ultimate cause. One of the more clear results would be from lack of oral hygiene, or use of substances, but one of the mitigating factors that goes overlooked is that of use of medication that is directed towards the treatment of said conditions. In some cases, prescription medication may lead to poor oral health, because of the other side effects, or how it interacts with the subject's physiology. A prime example would be that of having a dry mouth, chewing, or craving sweet substances because someone who has post-traumatic stress disorder may be on medication that causes them to do so furthermore, the use of psychotropic drugs, antidepressant and  and sweet foods which will damage their teeth. (Kisely, 2023 Figure 19). The classified drugs labeled in the stereotan class, have also been known to exhibit more of an urge to eat carbohydrates and sugars.  Regardless of whether it is caused by physical changes, hormonal or chemical changes, or a simple lack of hygiene, feeling unwell will create a dialogue that leaves you physically and looking exactly the same way. There is little you can do to get around these changes, other than monitoring your mental and physical state and taking steps to rectify any negative differentials.

References

          Kisely, S. (2023). Periodontal health and psychiatric disorders. Current Oral Health Reports, 10(3), 111–116. https://doi.org/10.1007/s40496-023-00339-y

         Hamid, S. H. (2020). Oral Health-Related Quality of Life and Self-Esteem of Children with Post Traumatic Stress Disorder Living in War Zones: A case-control study. Research Square (Research Square). https://doi.org/10.21203/rs.2.20107/v1

          De Oliveira Solis, A. C., Araújo, Á. C., Corchs, F., Bernik, M., Duran, É. P., Silva, C., & Lotufo-Neto, F. (2017). Impact of post-traumatic stress disorder on oral health. Journal of Affective Disorders, 219, 126–132. https://doi.org/10.1016/j.jad.2017.05.033

          Kisely, S., Sawyer, E., Siskind, D., & Lalloo, R. (2016b). The oral health of people with anxiety and depressive disorders – a systematic review and meta-analysis. Journal of Affective Disorders, 200, 119–132. https://doi.org/10.1016/j.jad.2016.04.040

          Pinto, G. D. S., De Ávila Quevedo, L., Corrêa, M. B., Azevedo, M. S., Goettems, M. L., Pinheiro, R. T., & Demarco, F. F. (2016). Maternal depression increases childhood dental caries: a cohort study in Brazil. Caries Research, 51(1), 17–25. https://doi.org/10.1159/000449040