Improving Dental and Mental Health Through Case Management

We’ve all seen and felt the growing mental health crisis in our country, with particular attention drawn to it this May as we mark Mental Health Awareness Month. From pandemic stress to economic stress, to a stressed health care system, there’s no doubt that many people are struggling with mental health issues right now. It’s an extremely troubling trend, as we know that stress has a significant impact on a person’s health — and oral health is no exception.

New research published in Frontiers in Oral Health studied the associations between mental health and oral health, and the impact of COVID-19 on mental health. It showed that rates of dental decay and tooth loss were higher for patients with common mental disorders as compared to the general population, and that COVID-19 exacerbated these issues. The negative impacts were not distributed equally. For example, the 2022 CareQuest Institute State of Oral Health Equity survey showed that dental anxiety was particularly associated with lower household income and having Medicaid insurance coverage.

At DentaQuest, our case management team has a unique and up-close role helping those who are most vulnerable overcome barriers to care. The team of nine works one-on-one with high-risk members to get them the care they need, directly reaching out to as many as 400 to 500 members per month. For those members, many of whom have intellectual or developmental disabilities and already experience difficulty accessing dental care, COVID fear and anxiety have produced even greater obstacles.

“These are people who already have significant challenges dealing with the world in normal times and now they have to deal with the stress of possibly coming into contact with a serious illness,” says Gonzalo Perez, manager of case management at DentaQuest.

According to Perez, the team has seen an increase in referrals for members who are dealing with mental health conditions including anxiety, depression or psychiatric illness. When these referrals come in, the team then connects with the providers managing the member’s mental health to help prepare the member for dental care.

“Imagine a patient who is autistic and has a hard time wearing a mask,” explains Perez. “How do we help manage that so the member can go into a dental office and both the staff and the patient feel safe? We work together, with our members and with the providers, to make sure caregivers prioritize not only the patient’s needs but also the dental team and staff.”

It hasn’t been an easy task. The systemic issue of lack of access to oral care, combined with COVID factors, have made it more difficult than ever to help people get the oral care they need.

“We have seen a very serious reduction in access to care for our regular members, never mind those with severe issues and barriers to getting dental appointments,” says Perez. He attributes this to more dental offices closing, staffing issues and COVID anxiety, all of which contribute to delays in care.