The oral implications of mental health disorders part 2: depression

Depression is a common mental health disorder affecting 4−10% of people in England and approximately 300 million people globally.^{1, 2} It is a psychiatric disorder characterized by low mood and can include feelings of sadness, despair or discouragement. It can often involve loss of interest in usual activities, social withdrawal and somatic symptoms, including sleep and appetite disturbance.^{3, 4} In order to arrive at a diagnosis of depression, the altered behaviour must persist for a minimum of two weeks.⁴ Chronic stress is strongly associated with depression, with a possible causal relationship between stressful life events and major depressive episodes. The neurobiology underlying stress and depression is thought to result from molecular and cellular abnormalities that interact with genetic and environmental factors.⁵ It is essential for dental professionals to understand and recognize the possible oral manifestations of depression. This knowledge can help undiagnosed patients receive an appropriate early referral to a medical practitioner, and will also be of benefit in managing the oral manifestations of this disease.