Dentists Play Key Role in Addressing Mental Health Issues

When self-care is lacking, or a change in self-care is noticed, including patients missing appointments, it opens the door for dentists to begin a conversation.

The latest Vital Signs report by the Centers for Disease Control and Prevention indicates that in 2016, nearly 45,000 Americans age 10 or older died by suicide. Not only is suicide the 10^th leading cause of death, it is one of just three leading causes that are on the rise.

And dentists are uniquely positioned to play an important role in reversing this trend.

“Patients come to us and they stay with us because they develop a level of trust,” says Edmond Hewlett, D.D.S., professor of restorative dentistry and associate dean for outreach and diversity at the UCLA School of Dentistry. “When they trust you, they’re going to talk to you. And if we’re listening, we can gain an enormous amount of insight into our patients.”

FREQUENT INTERACTION

Hewlett points out that dentists review their patients’ health histories, including prescription medications they’re taking, on a regular basis. That information alone provides insight into a patient’s health status.

“We’re in a special position here because of the nature of the relationship dentists develop with their patients,” Hewlett says. “It’s inherent in our dental care delivery model that we spend time with our patients. That interaction during an individual visit tends to be pretty substantial.”

Patients, however, don’t only interact with the dentist. They could be interacting with the dental assistant, hygienist, or practice manager. As such, Hewlett stresses, staff should be made aware of the important role they play as well.

“There’s no such thing as a throwaway comment when our patients are talking to us,” he says. “Tell staff, ‘I want you to listen very carefully, and let me know what you’re hearing from them.’ That’s easy to do, and it empowers your staff to be an important part of this very important role we can play.”

Hewlett also has no hesitancy, when he senses an opportunity, to share with patients his personal experience with depression. When he does so, and says, “I understand,” patients are likely to open up even more, or at the very least, listen more to his advice.

“There’s an opportunity for the message to resonate.”

COMMUNICATION SKILLS

Patient communication skills and best practices are part of the curriculum leading to a degree in dentistry. Dental students are taught how to pose questions and how to frame a conversation so that patients are more forthcoming with their concerns. That said, Hewlett believes dentists could do a better job with specificity around discussing mental health.

“We expose our students to tools for having difficult conversation with patients or staff,” he says. “But I would argue that more specifically … we would do well to focus on heightened awareness of the mood, and the mental and emotional wellbeing of a patient.”

Part of that, Hewlett says, is overcoming the stigma that still exists with mental health. He says that, if nothing else, dentists can play a role in tearing down that stigma by helping people understand that mental health is no different than diabetes or heart disease.

“I understand we’re made to feel that we’re defective,” he says. “That there’s something wrong with me, and somehow it’s my fault. But it’s not something to be ashamed of. And there are ways to treat it.”

KNOW THE SIGNS

There is data indicating a link between depression and oral health. According to an information sheet developed by the University of Washington School of Dentistry, neglect of oral hygiene, poor nutrition, and avoidance of necessary dental care are some of the key impacts depression has on oral health.

When self-care is lacking, or a change in self-care is noticed, including patients missing appointments, it opens the door for dentists to begin a conversation.

“I know there’s a lot of pressure to be very efficient with time in a dental practice,” Hewlett says. “But I stress with our students, you have to take time to listen to your patients. You have to build that in to your workflow, because it’s so important.”

And to be perfectly pragmatic, Hewlett adds, that attentiveness to patients will pay off as a practice builder. You become the doctor patients love because you listen to them.

“I’ve been a dentist for 38 years,” Hewlett says, “and I’ve heard everything because we talk about it.”