WOHD 2025: Strategic partnership to achieve a healthy mouth with a healthy mind

BY DAVID ADETULA AND MARY FUNMILAYO ONI

Globally, every age group has some peculiar oral health challenges; studies have shown that nearly all adults and 60-70 percent of school children have dental cavities. In Africa, more than 40 percent of the region’s population suffers oral diseases such as dental caries, gum disease, and tooth loss. Ordinarily, it would take pain, facial disfigurement, or anything that makes the smile look awkward for many people to remember their dentists. Even though the scarcity of dentists and paucity of insurance coverage contribute to poor access to oral health care, the oral health-seeking behaviour of many Nigerians remains a bothersome health crisis.

These health challenges leave considerable deficits in the quest for overall well-being. With these gaps felt in health policy programs, where oral health policies are missing, there is a need for partnership between dentists and dental health professionals, pharmacists, other healthcare professionals, policymakers, governments, and private stakeholders toward reviewing existing oral health plans, develop more impactful interventions, improve on oral health advocacy and follow through with implementation of oral health strategies.

A happy mouth is a happy mind

Since 2024, dentists, dental health professionals, and stakeholders worldwide have been celebrating World Oral Health Day with a special focus on having a happy mouth. The emphasis of the day has been on what happens to the mouth and how that affects the general human and vice versa. For the next two years, the focus will remain on achieving a happy mouth, but with greater attention on the nexus between a happy mouth and a happy mind.

This year’s theme, “A happy mouth, a happy mind” takes a deeper consideration of how the mouth connects to the other parts of humans, even up to the soul level. The mouth serves as a gateway to overall health, and poor oral health can have a profound ugly impact on mental well-being. The mind, a set of cognitive abilities governing self-awareness and rational thought, encompasses mental states such as emotions, beliefs, and desires, shaping personality and overall wellness. It plays a crucial role in responding to dental health, while oral conditions, in turn, significantly influence mental well-being. This understanding underscores the intricate relationship between mental health and oral health, where issues in one area often affect the other.

According to the World Health Organization, mental health is not merely the absence of mental disorders but involves actively maintaining wellness and promoting happiness.

Focusing on two key aspects, the psychological impact of oral health and the influence of mental well-being on oral health, one could factually identify oral health problems such as tooth loss, bad breath (halitosis), and stained teeth, significantly impacting self-esteem, social confidence, and emotional stability. Individuals who feel self-conscious about their oral health sometimes experience anxiety, social withdrawal, and even depression.

Conversely, poor mental health can negatively influence oral hygiene habits. Individuals struggling with depression, anxiety, or other mental health disorders may engage in behaviours such as neglecting oral hygiene, consuming unhealthy diets, and substance abuse, all of which contribute to deteriorating oral health (Nono et al., 2024).

Understanding the Vicious Cycle

Chronic stress, often triggered by poor oral health, can elevate cortisol levels, weakening the immune system and increasing susceptibility to bruxism (teeth grinding), temporomandibular joint disorders, and mouth ulcers. Cortisol, often called the “stress hormone,” is a steroid hormone produced by the body to regulate the body’s response to stress, blood sugar, and inflammation.

Additionally, the use of psychopharmacologic drugs to manage mental health conditions can create a cycle where poor oral health exacerbates psychological struggles. Many medications prescribed for anxiety, depression, and other mental disorders cause dry mouth (xerostomia), increased cavities, and gum disease, further worsening oral health.

First Cycle: Poor oral health leads to low self-esteem, which in turn causes psychological stress that often progresses to depression. A depressive mental health state left unattended would worsen to become chronic, which would then lead to the use of some psychopharmacologic drugs, with peculiar side effects such as dry mouth and gum disease, and deteriorating oral health.

The second cycle is positive. Good oral health boosts confidence and self-image, which causes the release of the “D.O.S.E” also known as the feel-good hormones (Dopamine, Oxytocin, Serotonin, and Endorphins). These hormones cause an effortless bright smile, an enhanced mood, and well-being, ultimately improving humans’ overall mental health.

The sequential progressive analogies above highlight the urgent need to bridge the gap between oral and mental health to enhance the quality of life for individuals affected by these interconnected conditions.

Recommendations

Fostering awareness and promoting holistic healthcare approaches could help people achieve both a healthy mouth and a happy mind.

Dentists must improve on oral health and hygiene advocacy, especially in rural areas with limited access to oral healthcare. Oral health promotion should target those in these underserved communities, utilizing innovative delivery methods that are well-relatable to them. For example, dentists should explain the cycles above to rural dwellers in their local languages through songs, stories, drama, and other conventional means of communication in the community for easy understanding.

Pharmacists could play a crucial role in connecting patients to dental care services, particularly those with limited oral healthcare access. Community pharmacists are often more accessible than dentists in the hospital, and they can bridge the gap by referring patients to affordable dental clinics, especially when specialized care is needed. This approach would reduce the abuse of antibiotics and other drugs, which could lead to a destructive cycle of unhappiness.

A collaboration between dentists and pharmacists would prove strategically effective in educating patients about medication-induced oral side effects and how to minimize them. Both prescription and over-the-counter medications can contribute to oral health issues, including dry mouth (Xerostomia) caused by antidepressants, antihistamines, diuretics, and antipsychotics, increasing the risk of cavities, gum disease, and infections. Another example is oral thrush (Candidiasis), which has been linked to prolonged use of antibiotics, corticosteroids, and immunosuppressants, disrupting oral microbiota. Again, studies have also connected gum overgrowth (gingival hyperplasia) with anti-seizure medications such as Phenytoin and calcium channel blockers, which are antihypertensive.

In conclusion, this year’s WOHD theme subtly calls for a collaborative approach to addressing patients’ health challenges. Dentists and pharmacists can achieve so much in promoting oral healthcare when they work together; the dentist-pharmacist collaboration is integral to promoting oral health, managing medication side effects, and improving access to dental care. By fostering collaboration, they contribute to a holistic approach to dental care, prioritizing oral and mental well-being.

Dr. David Adetula is a dentist and public health professional with a special interest in achieving innovative health systems for equitable, accessible, and universal healthcare delivery. He is the Executive Director of the Public Health Interest Group Africa (PHIGA) and serves as a co-lead for the health policy and management subgroup of PHIGA. David interns with the American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH – “Clinical Group”), ASTMH.

Mary Funmilayo Oni is a Doctor of Pharmacy candidate and a dedicated public health advocate with robust passionate for bridging the gap between pharmaceutical science and public health. She is committed to advancing preventive healthcare through education, research, community engagement, and innovative and sustainable solutions. Mary is also a member of the American Society of Tropical Medicine and Hygiene, reflecting her dedication to global health initiatives.