Counties aim to provide comprehensive care to residents. It is critical to ensure that this care incorporates primary, behavioral and chronic disease management and oral health care. Approaches such as accountable care organizations, service integration and the implementation of parity for behavioral health services and treatment offer opportunities to treat the whole person rather than provide fragmented services and treatment. Both oral health and mental health are integral components of an individual’s health and well-being and can impact an individual’s economic productivity and ability to work.1 Poor oral health has been shown to:
- lead to malnutrition, which in turn influences physical health
- cause serious or fatal infections
- be linked to heart disease, stroke and diabetes, and
- be associated with respiratory diseases such as pneumonia.
When treating individuals with mental illness, particularly those with serious mental illnesses, paying attention to oral health is important because it is often neglected and deteriorates.7 This population has an average of 6 or more decayed, missing or filled teeth than the general population and is 3.4 times more likely to have lost teeth. Individuals living with mental illness are susceptible to certain oral health conditions, including enamel erosion, gingivitis, tooth abrasion, oral pain disorder, dry mouth and jaw and muscle pain.9 For example, depression and stress increase the level of the hormone cortisol, which can contribute to periodontal disease. Furthermore, medications, lack of motivation for maintaining good dental hygiene, dental phobia, dental care costs, geography and access to care have all been shown to contribute to oral diseases.