There are many complications and symptoms that can arise from bipolar disorder- from medication non-compliance to problems at work and dealing with consequences of behavior during manic episodes. Doctors will discuss symptoms of depression and mania and provide counseling on how to deal with their various aspects. One concern not generally mentioned when discussing bipolar disorder is oral hygiene and how people with mental health problems tend to have higher instances of dental problems.

Dental problems can arise during both depression and mania. During depression, lack of interest sets in. People not only neglect their hobbies and work, they also neglect self-care and personal hygiene. This includes oral hygiene. Any existing problems are exacerbated and new problems arise. The opposite can exist in mania when people will become overzealous regarding brushing and flossing, possibly causing abrasions.

One review of the literature surrounding oral hygiene and bipolar disorder found four types of oral and dental problems that are common in people with bipolar disorder.

Dental cavities
Dental cavities are holes found in the teeth. The acids in plaque buildup can start eroding teeth as soon as 20 minutes after food or drink are ingested. The plaque damages tooth enamel, eventually leading to decay of the tooth itself. They usually do not hurt unless severe or if they cause a tooth fracture.

Xerostomia
Xerostomia is dry mouth or lack of saliva flow. Some symptoms include sore throat, burning sensation, hoarseness and dry nasal passages. Xerostomia can also lead to gum disease and tooth loss. Eating dry foods can become difficult and people with xerostomia often drink more fluids in order to make up for the lack of saliva.

Abnormalities in flavor perception
While not very common, bipolar disorder has been associated with abnormalities in flavor perception. The most common abnormality is phantom taste perception in which there can be an unpleasant lingering taste. Abnormalities in flavor perception also include reduced ability to taste. Most of the time, lack of taste is really caused by a reduced ability to smell.

Bruxism
Bruxism is excessive teeth grinding or jaw clenching. This can happen either while awake or asleep. When it happens during sleep it can be associated with other sleep disorders. It can also be related to stress. Bruxism can result in fractured teeth, locked jaw, jaw or neck pain and headache.

 

Medication for bipolar disorder can be related to or cause these problems, especially xerostomia, which is a common side effect in most medications used to treat bipolar disorder. Lithium especially can increase the likelihood of cavities due to its anticholinergic effects.

It’s important to discuss all medications and medical problems with dentists, orthodontists or oral surgeons. Knowing a patient has bipolar disorder can inform them of potential problems that need to be watched carefully. It is also important that any dental care worker know all medications a patient is taking in case they interact with any dental treatment provided.

 

 

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Image credit: Sherman Geronimo-Tan