The Link Between Teeth, Mental Health, and Social Barriers

Exploring how oral health impacts mental well-being and self-esteem.

Reviewed by Devon Frye

Key points

• Poor oral health can worsen mental health and quality of life.
• Socioeconomic factors limit access to necessary dental care.
• Shame and fear prevent many from seeking dental treatment.
• Integrated care addresses both oral and mental health together.

Teeth are more than just a cosmetic feature; they can significantly impact mental health.

To be honest—this topic is a bit unusual for me to address because it touches on my own fears and anxieties. I’ve always had a gap in my teeth and used to have more crooked teeth when they first grew in. Over time, they straightened out somewhat, but I’ve considered Invisalign—not because others think I need it, but because I believe it might improve my bite. Additionally, I have a chip in one of my teeth that I’m waiting for my dentist to fix.

Over the years, I’ve received many comments about my teeth. Some of these comments have been kind, while others have been quite mean (for example, I’ve been told that the gap in my teeth looks like “a mountain to floss between”). My own relationship with my teeth has led me to investigate the connection between oral health and mental health.

Research shows that individuals with mental health disorders are more likely to experience poor oral health. A systematic review found a significant association between common mental health disorders and tooth loss. Individuals with these disorders also tend to have higher rates of decayed, missing, and filled teeth compared to those without mental health issues (Tiwari et al., 2022).

Additionally, socioeconomic status plays a major role in oral health. Heaton et al. (2024) noted that mental health conditions and poor health outcomes are bidirectionally linked, and both are tied to socioeconomic factors. Essentially, poorer individuals are more likely to have worse mental health and oral health. This creates a public health issue, as those with fewer financial resources often experience barriers to accessing quality dental care.

Personally, I feel fortunate that my teeth, while not cosmetically perfect, have been strong and healthy overall. I’ve only had cavities filled once in my life, which happened when I was 30.

That said, I do understand how oral health can impact self-esteem and mental health—and research supports this. Tiwari et al. (2022) emphasized that mental health symptoms such as lack of motivation, feelings of worthlessness, and fatigue can negatively impact oral hygiene maintenance. This can lead to a cycle where poor oral health exacerbates mental health issues, and vice versa. Poor oral health can result in more frequent pain, social isolation, low self-esteem, and reduced quality of life.

Heaton et al. (2024) stressed the importance of integrating medical, dental, and behavioral health care to provide comprehensive, person-centered treatment. Such integration can address both oral health and mental health more effectively.

Yet shame can be a significant barrier to seeking dental care. As noted in a TIME article on the connection between depression and oral health, many individuals avoid the dentist out of embarrassment about the state of their teeth. This hesitation often delays necessary treatment and worsens existing dental problems.

The implications of these connections extend beyond the individual. There are systemic issues surrounding access to dental care, particularly for those in lower-income brackets. Poor oral health can lead to physical health complications, such as infections and the need for root canals, which can further impact mental health and financial stability.

Some people seek cosmetic surgery to improve the appearance of their teeth—but this approach is not without its risks. Take veneers, for example: While they can be a helpful solution for some, veneers involve shaving teeth down to stubs and covering them with caps. This procedure, if done improperly, can result in irreversible damage. Unfortunately, some individuals fall victim to unqualified practitioners offering cheap or unsafe services. Such predatory practices can have devastating effects on both physical and mental health.

If you’re considering dental procedures, it’s essential to seek care from licensed professionals. Many clinics offer payment plans, low-cost options, or even free services on certain days. Your oral health and overall well-being are worth investing in.

The connection between oral health, mental health, and socioeconomic status is profound. Addressing this issue requires both individual awareness and systemic change to ensure that everyone has access to the care they need.

The inspiration for this article came from a youtube video I published on the subject.