Introduction
The connection between mental health and overall well-being is significant, yet the role of dental visits in this context is often overlooked. Dental hygienists, who spend considerable time with patients, are uniquely positioned to observe changes in behavior, mood, and physical symptoms that could indicate mental health concerns. By incorporating routine mental health screenings into dental care, hygienists can initiate important conversations that address not just oral health but overall wellness.
The Unique Role of Dental Hygienists
Dental hygienists, through their ongoing relationships with patients, can easily detect subtle changes in behavior or mood that might signal a mental health issue. Research suggests that patients typically confide in their hygienists, presenting an opportunity for early identification of mental health concerns. This positions the hygienist as a key player in recognizing potential problems, making routine dental visits a chance to care for the whole person4.
The Importance of Early Mental Health Intervention
Early detection of mental health issues is crucial. Screening and support at the initial stages can alleviate symptoms and improve quality of life. Sadly, nearly 800,000 people globally, including over 45,000 in the U.S., die by suicide annually5,3. Depression, a leading cause of suicide, can often be identified early through screenings during dental visits. Tools like the PHQ-2 depression screening questionnaire enable dental hygienists to identify at-risk patients and refer them for further support, potentially preventing tragic outcomes2.
Incorporating Mental Health Screenings in Dental Practice
Integrating mental health screenings into dental visits can be straightforward with the right tools. The PHQ-2 is an effective starting point, asking two key questions about interest in activities and feelings of depression over the past two weeks. A score of 3 or higher may warrant further assessment with tools like the PHQ-9. These screenings can be incorporated into patient paperwork or conducted during appointments, allowing hygienists to identify patients who may need additional support2. Proper training is essential to ensure hygienists are comfortable conducting these screenings and can approach patients with sensitivity. By normalizing these conversations, such as saying, “We’re including some basic questions about your well-being as part of our overall health check,” hygienists can reduce stigma and encourage openness1.
Building Confidence in Addressing Mental Health
Discussing mental health can be challenging, but with practice and training, hygienists can become more confident in these conversations. They should be able to recognize signs of common mental health issues and know how to initiate sensitive discussions. Practising different scenarios can prepare them for various patient reactions, making these interactions more manageable. Regularly bringing up mental health in the dental setting is key to making these discussions feel less daunting. When mental health is visibly addressed, such as through pamphlets or posters in the waiting room, patients are more likely to see its importance4.
It’s essential to respect the patient’s response to these conversations. Some may be more open, while others might find the topic uncomfortable. Establishing boundaries while letting patients know that mental health can be discussed whenever they’re ready is crucial. Ongoing education and collaboration with colleagues can help dental hygienists enhance their knowledge and skills in this area.
Establishing a Referral Network for Mental Health Professionals
While dental hygienists can identify potential mental health issues, treatment typically requires specialized care. Referring patients to mental health professionals, similar to referring them to an oral surgeon, ensures they receive the appropriate support. Collaboration between dental care and mental health services can significantly benefit patients1.
To implement a referral system, dental practices should establish a network of trusted mental health providers, such as psychologists, counselors, and social workers. Building relationships with these providers ensures that patients receive the necessary care. A well-defined referral process is crucial, including identifying the need based on screening results, discussing the referral with the patient, providing resources, documenting the referral, and following up at subsequent visits – much like a referral to a dental specialist. Effective communication with mental health providers, with patient consent, facilitates coordinated care and better outcomes. By offering a clear path to appropriate resources, dental hygienists can help patients improve their overall health and well-being.
Conclusion
As awareness of mental health grows, dental hygienists have a unique opportunity to make a significant impact. By integrating mental health screenings like the PHQ-2 into routine care, building confidence in addressing mental health, and establishing a solid referral process, dental hygienists can provide comprehensive care that addresses both oral and mental health. Early intervention in the dental setting can lead to life-saving measures, highlighting the profound influence hygienists can have on their patients’ overall well-being.
References
- American Dental Association (ADA). (2019). Addressing mental health in dental practice. Retrieved from https://www.ada.org/publications/ada-news/viewpoint/addressing-mental-health
- Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003). The PHQ-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284-1292.
- National Institute of Mental Health. (2021). Suicide statistics. Retrieved from https://www.nimh.nih.gov/health/statistics/suicide
- Simonsen, C. E., & Martin, S. B. (2016). The role of dental hygienists in recognizing and addressing mental health issues in patients. Journal of Dental Hygiene, 90(1), 14-19.
- World Health Organization (WHO). (2019). Mental health and suicide prevention. Retrieved from https://www.who.int/health-topics/suicide#tab=tab_1
About the Author
Leah Hargrove has a decade of experience working as a dental hygienist in both DSO and private practice settings. Her personal experiences with loss have deeply motivated her to promote mental health awareness within the dental community. Leah is committed to advocating for routine mental health screenings during dental visits to ensure comprehensive patient care. If you’re interested in learning more about Leah’s work or connecting with her, you can reach out via email at ldhtherdh@gmail.com or follow her on Instagram @ldhtherdh.
