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Posted by: The Probe 9th August 2021
There has been a spotlight on mental health for some time now, but it has shone brighter since the pandemic hit. Social isolation, lack of routine and constant uncertainty are just some of the factors impacting the psychological wellbeing of the global population. Nowhere else is this more apparent than among young people. For dental professionals, it’s important to understand what young patients may be going through, as well as how all of this might influence their oral and general health in order to tailor advice and support accordingly.
A constant concern
Even in the pre-COVID world, 10% of children aged 5 to 16 years had a clinically diagnosable mental health issue, while 20% of adolescents are believed to have experienced mental a health problem every year. Worryingly, 50% of mental health problems are established by the age of 14 and 75% by 24-years-old.[i]
As one would expect, these numbers have likely only gotten worse since the COVID-19 outbreak. Although a Government review[ii] of the available evidence suggested that children and young people in the UK generally coped quite well between March and September 2020, there was still a small reduction in life satisfaction. Unsurprising – though no less of a concern – those from economically disadvantaged backgrounds or with existing health conditions or disabilities suffered most. Other sources have reported a stronger correlation between poorer mental health and behavioural disengagement, self-blame, substance abuse and sleeping problems since lockdown in the young UK population.[iii] Several studies also found a spike in mental health problems in children when schools were closed.[iv]
In fact, it seems that young people aged 12-24 were among the worst affected groups with regards to general social and economic impacts of the pandemic, especially when it came to labour and mental health.[v] All of this means that young people have become an even more vulnerable group in terms of mental and general wellbeing.
Everything is linked
As you’ll know, poor mental health is associated with various physical issues, including those relating to oral health. It is logical that people who are suffering psychologically will be less focused on or motivated to maintain their health, so oral hygiene will slip – among other things. We don’t need to list here the potential problems of infrequent toothbrushing or lack of interdental cleaning.
Mental state can also indirectly impact wellbeing, with some of the possible consequences of mental health struggles leading to dental disease or other issues. For example, life-altering conditions like eating disorders can cause frequent vomiting, which increases the risk of dental erosion and worsening periodontal health.[vi] [vii] [viii] [ix] Bruxism is another common symptom of anxiety and mental distress, which can cause significant tooth wear and TMJ disorders.[x]
Empathy and support
Of course, it is not the role of the dental team to attempt to treat mental health conditions in younger patients. However, it is important that you are aware of the signs and symptoms so that you may tailor oral health advice and offer some of the emotional support that children and their families may need at such a difficult time. Given the regularity you will be seeing children and youths compared to their GP, for instance, you may also be in a stronger position to help identify possible concerns quicker than other healthcare colleagues. This could be particularly important for younger patients who might not realise what they’re experiencing and how to address it.
Approaching any such situation with empathy for both the young patient and their family is crucial. As is being able to signpost them towards the mental health support services available to them in the area. It’s important they don’t feel judged and that they know they are not alone.
Have confidence in your role
Whether looking for signs of mental distress in young patients, safeguarding vulnerable groups or just caring for patients with particular needs, it’s critical that you are confident in your own skills. These relate to both your clinical know-how and your communication skills. To improve both and to gain advice and inspiration from experts across the field, don’t miss the British Dental Conference and Dentistry Show 2022 next May. There will be a comprehensive programme with education tailored to each member of the dental team, enhanced CPD and an industry-leading speaker line-up. A vast array of topics will be explored, with updates provided on how the UK population is recovering from everything the pandemic has caused. It will also be a great opportunity to share your own experiences with colleagues to see how others have helped their young patients through this difficult time.
Once you have confidence in your role, you’ll be able to better help all patients that come through your practice. It’s just one of many ways you can support your patients as they strive for a healthier and happier version of themselves.
The next British Dental Conference and Dentistry Show will be held on Friday 13th and Saturday 14th May 2022, Birmingham NEC, co-located with DTS.
[i] Mental Health Foundation. Statistics. Mental health statistics: children and young people. https://www.mentalhealth.org.uk/statistics/mental-health-statistics-children-and-young-people [Accessed June 2021]
[ii] Public Health England. 7. Children and young people. Research and analysis. Health and wellbeing suring coronavirus. COVID-19: mental health and wellbeing surveillance report. Updated 19 May 2021. https://www.gov.uk/government/publications/covid-19-mental-health-and-wellbeing-surveillance-report/7-children-and-young-people [Accessed June 2021]
[iii] Dewa LH, Crandell C, Choong E, Di Simplicio M, Nicholls D, Aylin P. CCopeY: A mixed-methods coproduced study on the mental health status and coping strategies of young people during COVID-19 UK lockdown. Journal of Adolescent Health. April 2021. 68 (4);P666-675
[iv] Child mental health in England before and during the COVID-19 lockdown. The Lancet. Comment. May 2021. 8; 354-355
[v] Leavey C, Eastaugh A, Kane M. Generation COVID-19. Building the case to protect young people’s future health. The Health Foundation. August 2020.
[vi] Dynesen A., Gehrt C., Klinker S., Christensen L. Eating disorders: experiences of and attitudes toward oral health and oral health behavior. European Journal of Oral Sciences. 2018; 126(6): 500-506. https://doi.org/10.1111/eos.12578 April 12, 2021,
[vii] Pallier A., Karimova A., Boillot A., Colon P., Ringuenet D., Bouchard P., Rangé H. Dental and periodontal health in adults with eating disorders: a case-control study. Journal of Dentistry. 2019; 84: 55-59. https://doi.org/10.1016/j.jdent.2019.03.005 April 12, 2021.
[viii] Radeef A., Faisal G. Assessment of depression, anxiety and stress symptoms among patients with periodontal disease. Journal of International Dental and Medical Research. 2017; 10(2): 260-264. http://www.jidmr.com/journal/wp-content/uploads/2017/05/12_D17_376_Ghassak_Ghazi_Faisal.pdf April 12, 2021.
[ix] Zheng D., Kang X., Wang Y., Huang Y., Pang C., Chen Y., Kuang Z., Peng Y. Periodontal disease and emotional disorders: a meta-analysis. 2021; 48(2): 180-204. https://doi.org/10.1111/jcpe.13395 April 12, 2021.
[x] Bucci C., Amato M., Zingone F., Caggiano M., Iovino P., Ciacci C. Prevalence of sleep bruxism in IBD patients and its correlation to other dental disorders and quality of life. Gastroenterology Research and Practice. 2018; 7274318. https://doi.org/10.1155/2018/7274318 April 12, 2021.
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