IIn June, Elina Howard posted a TikTok of her brushing her teeth, writing in the caption that she “knew [her depression] It was getting bad again when even the simplest tasks felt like too much.”
A homemaker of three children, Howard, 30, lives in Greenville, SC, and often talks about her experiences with mental health on social media. Howard says she’s lucky to have her husband’s support, but for years she’s struggled to brush her teeth regularly while dealing with anxiety and depression. For her, brushing your teeth tends to be “one of the first things to go.”
“I’m like, ‘I know I haven’t brushed my teeth in a few days, but I also haven’t eaten anything today — and I know I need to do that, so I’m going to eat a meal instead of brushing my teeth,’” Howard tells TIME. “Because I can’t do both.”
How mental health affects oral health
Research over the years has established a link between mental and oral health, with several studies finding that people suffering from depression and anxiety are more likely to suffer tooth loss.
Mental health can affect oral health in a few ways, according to experts. Some antidepressants or anxiolytic medications may have the effect side effect of dry mouthwhich can increase your risk of cavities, says Zainab Mackie, a dentist in Grosse Pointe, Michigan. clench or grind your teeth, which can cause teeth to chip or break. And people who suffer from depression or anxiety sometimes simply don’t have the energy or motivation to take care of their teeth every day.
Oral health professionals to recommend brush your teeth twice a day, floss at least once a day and visiting a dentist semiannually for oral exam and professional cleaning. But for someone going through depression, this can feel like a challenge.
“When people are depressed, whether it’s a major depressive episode or just a little downtime, everything becomes difficult to do,” says Kojo Sarfo, a psychotherapist based in Los Angeles. “The things we call ‘routine tasks’ or ‘activities of daily living’ – like brushing your teeth, putting on your shoes, taking a shower – become much more difficult to do.”
see more information: How much do you really need to shower?
And it’s not uncommon, he says Suhail Mohiuddin, a dentist based in Chicago and co-founder of the Dentologie practice. He estimates that almost 15-20% of patients in his practice have had a mental health issue that has affected their oral health at some point in their lives.
Grace Mills, 25, has had difficulty brushing her teeth regularly since she was little, and this continued when her mental health worsened, such as when her mother passed away and when she was in a toxic relationship.
“Brushing my teeth is the last thing I want to do right now,” Mills remembers thinking.
Now that Mills is in a healthier relationship and undergoing therapy, she says she feels more motivated to start taking better care of herself. But she still finds it difficult to brush her teeth consistently – although it’s best to brush them in the morning, she finds it harder to do so in the evening when she’s tired from the day. She posts videos of her brushing her teeth TikTok to hold herself accountable and she says she hopes the videos help destigmatize the effects of fighting on mental health.
Barriers to dental care
Mackie and Mohiuddin say not brushing your teeth regularly can lead to problems like cavities and gum disease. And the longer the problem persists, the more it can snowball.
Some people may be afraid of going to the dentist and postpone or avoid making an appointment, either because they worry about how much it will cost (the longer someone puts off dental care, the more expensive it can be, says Mohiuddin) or because they are worried that their dentist might judge them by the state of their teeth. Studies show that about 36% of people in the U.S. are afraid of dental treatment.
“Now they’re in this position of, ‘Oh my God, now I have a bunch of cavities or a bunch of problems, and I’m really stressed and anxious.’ [about] going to the dentist,’” says Mohiuddin.
It’s been years since Howard has been to the dentist, even though he knows he needs to go to one. Howard says the guilt and shame she feels about her oral health has held her back.
“It’s something I’m embarrassed about, because I think, ‘What’s the dentist going to say when they look at my teeth?’” says Howard.
Mills, who lives in New Jersey, also hasn’t been to the dentist in years, except for an emergency visit when he had to have a tooth pulled. Mills currently works as a pet sitter and has been between jobs and moving a lot, so it’s been difficult for her to find and pay for dental care.
Mackie and Mohiuddin emphasize that dentists are not there to judge – they just want to care for their patients.
“We are their quarterback and we guide them through this process,” says Mohiuddin. “If you really struggle for a certain period of time and don’t take care of your teeth, it’s not something you can’t recover from.”
How to take care of your teeth if you are struggling
People can take several small steps to make brushing easier. Mackie suggests rinsing your mouth with a fluoride mouthwash and using baby wipes to remove plaque from your teeth. She adds that chewing gum with xylitol, which can starve bacteria in the mouth, can help prevent cavities from forming. Mohiuddin says using mini disposable toothbrushes that come pre-glued and keeping them in easily accessible places – like in the car or kitchen – can also help make brushing more convenient.
Sarfo says people who have difficulty brushing their teeth should “eliminate the shame” they feel. He encourages people to say affirmations –I am worthy, I am loved, I am respected-and remind them that many people around the world struggle with their mental health.
“Whether you brush your teeth or not, shower or not, be around people or not, you are still a human being worthy of love, attention and respect,” says Sarfo.
This story originally appeared on Time.com read the full story
