Benefits administrator blog from Delta Dental

Tag: dental health

Healthy mouth, healthy mind

Could flossing every day help prevent depression? Does having anxiety increase the risk for developing gum disease?

The relationship between mental health and oral health is a cyclical one. More and more research is revealing that keeping a healthy mouth is an important part of keeping a healthy mind, and vice versa. People with mental health issues are less likely to take proper care of their oral health, and conversely, good oral health can enhance mental and overall well-being.

For Mental Health Awareness Month this May, take some time to remind your employees of the often-overlooked relationship between dental hygiene and mental health. You can use Delta Dental resources to help them understand that caring for their oral health is a central part of caring for their mental health.

The relationship between the mouth and the mind

Oral health and mental health are more closely linked than many people realize. Mental health issues can cause people to brush and floss at irregular intervals, skip dentist visits, maintain unhealthy diets and self-medicate with smoking or drug use, resulting in gum disease and tooth decay.

Some of the mental illnesses that can negatively impact oral health include:

  • Anxiety. Anxiety and dental phobia can stop people from seeing their dentist regularly, which can harm their oral health. In addition, medications prescribed for anxiety can cause dry mouth. Without saliva to rinse away food debris, plaque and bacteria, cavities can form more easily.
  • Depression. Depression is associated with higher abuse of alcohol, coffee and tobacco, all of which can cause tooth erosion and decay. Depression can also lead to self-neglect, which results in poor oral hygiene.
  • Eating disorders. Acids from vomiting make patients with eating disorders more susceptible to tooth decay.
  • Obsessive-compulsive disorder. The condition often causes over-brushing that may damage gums and cause dental abrasion, mucosal lacerations or gingival lacerations.
  • Schizophrenia and psychosis. These serious mental health conditions can cause people to forego dental care, eat poorly and neglect oral hygiene. Side effects of antipsychotic and mood stabilizer drugs may include a higher susceptibility to oral bacterial infections.

Certain mental health conditions can exacerbate poor oral health, and the converse is often also true: Poor oral health can make mental health issues worse. Oral health problems can lead to more frequent pain experience, social isolation and low self-esteem, reducing quality of life and in turn diminishing mental well-being.

A recent study even showed a strong association between chronic gingivitis and subsequent depression. More research is needed to fully understand the connection, but it highlights that maintaining oral health is a crucial part of maintaining a healthy and happy life.

Helping your employees maintain their mental health and oral health

No matter what issues your employees are facing, it’s important to remind them to keep up with routine oral health care and dental visits. Encourage employees to maintain healthy habits like cutting back on sugar, reducing stress, eating a balanced diet and quitting smoking. Staying hydrated, exercising and maintaining a good social support system are also crucial to maintaining mental health through difficult times.

The following resources can help you remind employees to care for their oral health while maintaining their mental well-being. With Delta Dental resources, you can:

Mental health affects the health of the entire body, including oral health. It’s an important link that unfortunately, many people don’t understand. For Mental Health Awareness Month, remind your employees that there is no mental health without oral health.

How stress affects your employees’ oral health

Every day, your employees face challenges that can be stressful and overwhelming, but the pandemic, inflation and war have all helped to push U.S. stress levels to record levels. As stress increases, so do oral health problems. For National Stress Awareness Month this April, learn why your employees may be at risk and what you can do to help.

Pandemic stress and oral health

Unfortunately, due to stress from COVID-19, dentists have seen a sharp rise in stress-related oral health conditions, according to a report from the American Dental Association (ADA). Dentists reported:

  • A 71% increase in the prevalence of teeth grinding and clenching
  • A 63% increase for chipped teeth
  • A 63% increase for cracked teeth

Even as some of the most challenging, isolating and stressful aspects of the pandemic seem to be coming to an end, money problems, inflation and war have pushed stress in the U.S. to alarming levels, according to the American Psychological Association.

Stress-related oral health conditions

It’s crucial to remind your employees to look after their oral health during times of high stress because they may be unaware that they’re developing stress-related oral health conditions.

Teeth grinding

Teeth grinding, or bruxism, occurs when teeth are clenched and ground together, and it’s frequently caused by stress and anxiety. What’s more: teeth grinding often happens at night during sleep, so your employees may be entirely unaware they have the condition.

It’s important for employees to know the signs and to seek treatment if they suspect they may be grinding their teeth. Signs include:

  • Tips of the teeth appear flat
  • Tooth sensitivity caused by worn enamel
  • Indentations in the tongue

Dentists can examine your employees’ teeth to determine whether they may be grinding their teeth at night and, if so, how best to treat it.

Gum disease

Stress can deplete the immune system, the body’s natural defense mechanism against disease and infection. And when the immune system is weakened by stress, harmful bacteria in the mouth seize the opportunity to wreak havoc on the gums. Furthermore, research shows that the systemic diseases associated with gum disease such as diabetes and cardiovascular disease may share stress as a common risk factor.

When your employees are stressed, they should take extra care of their gums by flossing and maintaining a solid dental hygiene routine. If their gums bleed when they floss or brush, they should visit the dentist right away.

Tooth decay

Stress and tooth decay often go hand in hand. People tend to make poor choices regarding their health during times of stress, eating comforting but unhealthy foods full of starch and sugar. They pay less attention to their normal hygiene routines, forgoing regular brushing and flossing if they feel stressed or depressed. Your employees who take medications for chronic stress may be at an even greater risk due to dry mouth, which is often a side effect of such medications. Altogether, these issues can shape the perfect storm leading to more cavities during times of stress.

How to help your employees

The best way to reduce stress is to remove its source. Of course, in many cases, that’s simply not possible. Counseling, exercise, relaxation, physical therapy or meditation may all help your employees manage stress during difficult times. If your company makes these resources available, use National Stress Awareness Month to remind your employees to use them.

But during times of stress, it’s equally important to remind your employees to take care of their oral health, to watch for stress-related oral health problems and to keep up with regular dentist visits.

The following resources from Delta Dental can help you raise awareness about stress-related oral conditions and keep your employees informed. With Delta Dental, you can:

Managing stress in the post-pandemic era

Many of your employees may be unaware of the crucial relationship between stress and oral health. During Stress Awareness Month, you can serve the crucial role of reminding employees to manage their stress, to watch for the signs of stress-related oral health conditions and to visit their dentist to help treat any stress-related oral health problems.

Are foster children at higher risk of oral disease?

More than 400,000 children in the United States are in foster care. While almost all of them get state-mandated dental insurance through Medicaid, children in foster care reported more oral health problems than children who aren’t in foster care, according to a recent study.

And it’s not just dental care. Foster children’s overall health outcomes are worse than the outcomes of children from more economically secure backgrounds. What’s causing this rift?

Oral health problems may begin before foster care placement

Children who enter the foster care system are there for a variety of reasons, but a leading cause is neglect. In 2019, about 656,000 American children were the victims of reported neglect or abuse.

When children are neglected, they may not be taught about the importance oral hygiene or given the tools they need to maintain their oral health, like toothbrushes and floss. Instead, these children often develop chronic conditions, such as gum disease, and rarely see a dentist. If those children are taken in to foster care, their history of chronic oral health problems may contribute to more frequent dental issues.

Even worse, children in the foster system suffer from high rates of emotional abuse, with children of Native American, Black and Hispanic descent particularly vulnerable to reoccurring maltreatment. That means that foster children may not receive care for chronic oral health problems that can lead to more severe oral care outcomes.

Struggles in getting access to care

The current nature of the foster care system means that the average foster kid moves home three times during their time in care, with some children moving more than 15 times a year.

The instability of life in the system makes it difficult for healthcare professionals to care for these kids, since they could move suddenly. Coordinating care can contribute to delays, since state agencies, birth parents and foster parents all have different responsibilities and levels of control.

Finding a dentist who accepts Medicaid can be difficult and can lead to delays in care that could result in worse diagnoses. Options like teledentistry may help for families with consistent access to the internet, but not all dentists provide telemedicine services.

How you can help

While kids fostered by your employees are covered by Medicaid, there are still ways you can help. You can regularly remind your employees of the importance of oral health care for all children. Consider putting together a small package of helpful materials for any employee who decides to foster. Delta Dental has a variety of wellness materials that may help:

You can also modify your current benefits packages to support children’s health with effective preventive tools like sealants or important orthodontic devices like braces.


Glaucoma and the oral health connection

January is National Glaucoma Awareness Month. While you might be aware that the disease is a leading cause of permanent blindness, it might surprise you to know that it may also be linked to oral health.

What is glaucoma?

Glaucoma occurs when a buildup of fluid causes pressure in the eyes to increase to abnormal levels, damaging the optic nerve. The resulting nerve damage causes partial or total blindness in the affected eye. After it occurs, this vision loss can’t be reversed, but early treatment to reduce eye pressure may reduce or halt the damage.

More than 3 million people in the United States have glaucoma, and the number of people who have the disease is expected to more than double by 2050, according to the National Eye Institute. While anyone, including children, can develop glaucoma, the condition is most common in:

  • People over age 60
  • African Americans over age 40
  • People who have a family history of the disease

OK, but how is glaucoma connected to oral health?

Various studies suggest a connection between poor oral health and glaucoma. A 26-year study of more than 40,000 men over the age of 40 found a correlation between tooth loss and primary open-angle glaucoma.

The study found that the risk for glaucoma was 43% greater in men who had lost at least one tooth than those who didn’t lose any teeth. When periodontal disease was also factored in, the glaucoma risk for men with tooth loss increased to 86% higher than men with no tooth loss.

While the specific cause isn’t certain, researchers speculate that bacteria at the site of the tooth loss can cause inflammation, which triggers reactions in the body that can affect the eyes.

What can I do for my employees with glaucoma?

If you have employees with glaucoma, here are few steps you can take to help them:

  • Encourage your employees to schedule dental cleanings. Preventive care not only helps improve the health of teeth and gums, it can also help improve employees’ overall health and help prevent conditions that lead to inflammation, a condition that can contribute to glaucoma.
  • Urge employees with gum disease to follow their dentist’s recommended periodontal treatment. Along with tooth loss, periodontitis has been linked to other health problems, including inflammation. If you don’t already, consider offering periodontal benefits, including our SmileWay® Wellness Benefits.
  • Take advantage of Delta Dental’s materials. You can take advantage of a variety of materials to support your employees during Glaucoma Awareness Month, including emails, posters, articles and videos.
  • Make our materials accessible for your employees. Delta Dental can also translate written materials, such as plan information, to Braille or audio for blind and low-vision employees. Contact Customer Service to make a request.

HIV/AIDS resources for employees

More than a million people in the United States live with human immunodeficiency virus (HIV), according to the Centers for Disease Control and Prevention (CDC) and the mouth is one of the first areas of the body that can be affected by an HIV infection. In honor of World AIDS Day on December 1, here are some tips for supporting your employees’ health.

Oral manifestations of HIV

As many as 80% of people infected with HIV experience oral manifestations. People with HIV may experience the following dental health-related issues, according to the American Dental Association (ADA):

  • Dry mouth
  • Thrush
  • White lesions on the tongue
  • Red band gingivitis
  • Ulcerative periodontitis
  • Karposi’s Sarcoma
  • Oral herpes outbreaks
  • Mouth ulcers
  • Canker sores
  • Susceptibility to infections and tooth loss

It’s important to note that symptoms alone are not a diagnosis.

Support for employees

Thanks to advances in science and technology, people living with HIV have a better outlook than ever, but proper care and maintenance is still critical.

  • Encourage your employees to keep up with their regular dental appointments and brush twice daily and flossing. Most HIV-related mouth issues are treatable, yet at least 58% of people living with HIV and AIDS don’t receive regular dental care.
  • Talk to your employees about SmileWay Wellness Benefits. If a person who’s HIV positive has an eligible Delta Dental PPO™ plan and opts in, he or she may be eligible for added benefits, including 100% coverage for one scaling and root planing procedure per quadrant and 100% coverage for four of the following in any combination: prophylaxis, periodontal maintenance or scaling in the presence of moderate or severe gingival inflammation. If your groups don’t offer this benefit, consider adding it your group’s plan
  • Share dental resources with your clients. Delta Dental offers monthly wellness campaigns for benefits administrators that include informative articles, emails, flyers and more, including content for World AIDS Day.

Learn more about World AIDS Day and HIV resources.

How COVID-19 brought challenges and solutions in dentistry for seniors

Times of crisis call for creative solutions, and that’s never been more evident than during the COVID-19 pandemic. Innovative dentists have sought to adapt many aspects of their practices, but especially those involving the most vulnerable segment of our population: older adults.

New challenges for seniors’ oral health

For many seniors, even before the advent of COVID-19, physical limitations, systemic disease, cognitive decline and dependence on caregivers could all lead to an overall decline in oral health. What’s more, the pandemic worsened many of these same problems while presenting new ones.

“COVID-19 laid bare weaknesses in our elder care system,” said moderator Stephen K. Shuman, DDS, MS, in a webinar on pandemic-related disruptions in oral health care hosted by the Gerontological Society of America.

Some of the challenges in oral health care for seniors during the pandemic have included:

  • Reduced access. Early in the pandemic, many dentists’ offices shuttered, and even when they reopened, fear of COVID-19 led many older adults to delay or entirely forego visits to the dentist’s office. Nearly half of U.S. adults reported delaying dental care due to the COVID-19 pandemic during the spring of 2020, and the increased risk posed by COVID-19 to seniors likely exacerbated the problem among older adults.
  • Reduced care. In long-term care facilities, daily brushing, flossing and other routine care tasks were sometimes put on the back burner as COVID-19 diverted staff members to provide more urgent care to those affected or at risk. Proper oral care could also be challenged by staff members’ fears about the potential for oral transmission of COVID-19. Staffing shortages in facilities and on oral care teams made the situation worse. Georgia and Minnesota reported staffing shortages in long-term care facilities of more than 25% during the pandemic, and a recent poll from the ADA Health Policy Institute found that more than 80% of owner dentists who are currently hiring consider recruitment of dental hygienists and assistants to be extremely or very challenging at this time.
  • Psychosocial problems. The loneliness, anxiety and depression caused by shelter-at-home orders could themselves worsen oral health among older Americans.

Solutions in oral health care for seniors during the pandemic

Just as the COVID-19 presented new problems, it also created potential for positive long-term change.

Teledentistry and teletriage

Through necessity, many dentists began refining techniques for the use of teledentistry and teletriage, using telecommunications technology to deliver health services and information.

Some companies began implementing or built up their existing “pandemic teledentistry.” Teams used cloud-based electronic health records and taught long-term care facility staff how to take useful images of patient mouths and send them to centrally located dentists.

At the height of the pandemic, 24.8% of responding dentists reported they were conducting remote problem-focused evaluations through virtual technology or telecommunications, according to polling from the American Dental Association’s Health Policy Institute.

Some innovative dentists used what they referred to as assisted, or guided, oral hygiene during the pandemic. They used the latest audio and video technology to guide a patient or caregiver as they carried out oral hygiene on a regularly scheduled basis.

Mobile dentistry

While the pandemic restricted mobile care in some cases, its primary advantage of reducing the need to transport at-risk seniors also caused it to emerge as another possible solution.

Many dentists were already accustomed to setting up mobile units in long-term care facilities even before the pandemic. Mobile dentistry helps reduce the potential for stress and confusion caused by moving older patients or those with dementia.  With the latest mobile equipment deployed to long-term care facilities, dentists are able to perform simple extractions, restorative work and more in a timely manner. As in many dental offices, mobile units often add an external dental suction that uses ultraviolet light and filters to remove pathogens from the air.

How to support your senior employees and relatives through the pandemic

COVID-19 presented extraordinary challenges to your senior employees, retirees and those caring for elderly relatives. The new solutions that helped maintain health care for older adults during the pandemic are likely here to stay.

To support your senior employees throughout the pandemic:

  • Communicate. Oral health care should never be placed on the back burner, and maintaining good communication with your employees is crucial to emphasize the importance of oral health. As always, keep in mind the systemic relationship between oral health and overall well-being. Use email campaigns, social media and other reminders to encourage the maintenance of oral hygiene routines among your senior employees throughout the pandemic.
  • Discuss new approaches. Teledentistry can now connect older adults with oral health care providers when they can’t visit a dental clinic or if there are restrictions on dental providers visiting residential facilities. The option is available at no added cost under Delta Dental PPO™ and Delta Dental Premier® plans, so discuss teledentistry with your employees if you think it might be right for them.

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