People with poor mental health face many challenges. One that’s perhaps lesser known is that they’re more likely than the overall population to have poor oral health.

Research has shown people with serious mental illness are four times more likely than the general population to have gum disease. They’re nearly three times more likely to have lost all their teeth due to problems such as gum disease and tooth decay.

Serious mental illnesses include major depressive disorder, bipolar disorder and psychotic disorders such as schizophrenia. These conditions affect about 800,000 Australians.

People living with schizophrenia have, on average, eight more teeth that are decayed, missing or filled than the general population.

So why does this link exist? And what can we do to address the problem?

Why is this a problem?

Oral health problems are expensive to fix and can make it hard for people to eat, socialise, work or even just smile.

What’s more, dental issues can land people in hospital. Our research shows dental conditions are the third most common reason for preventable hospital admissions among people with serious mental illness.

Meanwhile, poor oral health is linked with long-term health conditions such as diabetes, heart disease, some cancers, and even cognitive problems. This is because the bacteria associated with gum diseases can cause inflammation throughout the body, which affects other systems in the body.

Why are mental health and oral health linked?

Poor mental and oral health share common risk factors. Social factors such as isolation, unemployment and housing insecurity can worsen both oral and mental health.

For example, unemployment increases the risk of oral disease. This can be due to financial difficulties, reduced access to oral health care, or potential changes to diet and hygiene practices.

At the same time, oral disease can increase barriers to finding employment, due to stigma, discrimination, dental pain and associated long-term health conditions.

It’s clear the relationship between oral health and mental health goes both ways. Dental disease can reduce self-esteem and increase psychological distress. Meanwhile, symptoms of mental health conditions, such as low motivation, can make engaging in good oral health practices, including brushing, flossing, and visiting the dentist, more difficult.

And like many people, those with serious mental illness can experience significant anxiety about going to the dentist. They may also have experienced trauma in the past, which can make visiting a dental clinic a frightening experience.

Separately, poor oral health can be made worse by some medications for mental health conditions. Certain medications can interfere with saliva production, reducing the protective barrier that covers the teeth. Some may also increase sugar cravings, which heightens the risk of tooth decay.

Our research

In a recent study, we interviewed young people with mental illness. Our findings show the significant personal costs of dental disease among people with mental illness, and highlight the relationship between oral and mental health.

Smiling is one of our best ways to communicate, but we found people with serious mental illness were sometimes embarrassed and ashamed to smile due to poor oral health.

One participant told us:

[poor oral health is] not only [about] the physical aspects of restricting how you eat, but it’s also about your mental health in terms of your self-esteem, your self-confidence, and basic wellbeing, which sort of drives me to become more isolated.

Another said:

for me, it was that serious fear of – God my teeth are looking really crap, and in the past they’ve [dental practitioners] asked, “Hey, you’ve missed this spot; what’s happening?”. How do I explain to them, hey, I’ve had some really shitty stuff happening and I have a very serious episode of depression?

What can we do?

Another of our recent studies focused on improving oral health awareness and behaviours among young adults experiencing mental health difficulties. We found a brief online oral health education program improved participants’ oral health knowledge and attitudes.

Improving oral health can result in improved mental wellbeing, self-esteem and quality of life. But achieving this isn’t always easy.

Limited Medicare coverage for dental care means oral diseases are frequently treated late, particularly among people with mental illness. By this time, more invasive treatments, such as removal of teeth, are often required.

It’s crucial the health system takes a holistic approach to caring for people experiencing serious mental illness. That means we have mental health staff who ask questions about oral health, and dental practitioners who are trained to manage the unique oral health needs of people with serious mental illness.

It also means increasing government funding for oral health services – promotion, prevention and improved interdisciplinary care. This includes better collaboration between oral health, mental health, and peer and informal support sectors.

Bonnie Clough, Senior Lecturer, School of Applied Psychology, Griffith University; Amanda Wheeler, Professor of Mental Health, Griffith University; Caroline Victoria Robertson, Research Fellow, Griffith Research Centre for Mental Health, Griffith University; Santosh Tadakamadla, Professor & Head of Dentistry and Oral Health, La Trobe University, and Steve Kisely, Professor, School of Medicine, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The fire at a major oil refinery in the Victorian city of Geelong has now reportedly been extinguished. But with thick smoke from the blaze lingering in the air on Thursday, many residents in Geelong and surrounding areas will understandably be worried.

What is released into the air when a refinery burns? And is the smoke bad for your health?

For most people, serious long-term health effects are unlikely. However, there can be short-term risks, and some groups are more vulnerable than others. So here’s what to look out for and how to stay safe.

What is in the air when an oil refinery burns?

Smoke from an oil refinery fire is made up of many different pollutants. The exact mix depends on what material is burning, how hot the fire is, and how long it lasts.

Typically, these fires release fine particles, known as PM2.5 and PM10, which are small enough to travel deep into the lungs.

They can also release toxic gases such as sulfur dioxide, nitrogen oxides and carbon monoxide, along with volatile organic compounds including benzene.

For people living further from the fire, fine particles are typically the main concern because they can travel long distances and linger in the air.

What are the health risks?

For most healthy adults living in the area, short-term exposure to these pollutants will cause irritation rather than lasting harm.

You may notice sore or watery eyes, a scratchy throat, coughing, headaches or a feeling of chest tightness. These symptoms are unpleasant but usually settle once air quality improves and exposure is reduced.

This kind of exposure is very different from the long-term occupational exposure experienced by refinery workers or emergency responders, for whom risks of cancer and lung diseases are much higher and better studied.

Who is most at risk?

When air quality worsens, people with existing lung conditions such as asthma or chronic obstructive pulmonary disease are more likely to experience symptom flare-ups.

Smoke particles can irritate already inflamed airways, leading to increased breathlessness and coughing. For those with existing respiratory conditions, this may mean needing to use reliever medications more frequently than normal.

Those with heart disease are also at greater risk as air pollution can place extra strain on the cardiovascular system, increasing the risk of chest pain, irregular heartbeat and heart failure.

Older people are also generally more sensitive to poor air quality because they are more likely to have chronic diseases and their heart and lungs might not work as well as they did when they were young.

Children have the greatest risk of developing health issues in the longer term, as their lungs are still developing. But the risks from an isolated exposure, such as the Geelong fire, are relatively low.

Some studies suggest repeated or prolonged exposure to air pollution during pregnancy may increase the likelihood of adverse outcomes for babies, such as low birth weight. But again, the risk for pregnant people from an isolated incident such as this is low.

These kind of events often make people worry about cancer risk. But based on what we know, being exposed in the short term, from a single fire, does not meaningfully increase your risk of developing cancer – though these kinds of events are difficult to study, so evidence remains limited.

Cancers associated with oil refinery emissions are linked to years or decades of exposure, usually among workers and those in heavily polluted environments.

So while monitoring the air pollution and for any health issues is still necessary, it’s important to keep the risk in perspective.

Continued follow-up of workers directly involved in firefighting or cleanup will be essential, as their exposure levels are likely to be much higher than those in the surrounding community.

How to protect yourself from smoke

There are practical steps people can take to reduce their exposure if smoke or poor air quality persists.

It sounds obvious, but the less time you spend outside in smoke, the lower your risk of health issues cause by smoke inhalation.

Staying indoors with windows and doors closed can significantly reduce your exposure to particles, especially if air conditioning is set to recirculate indoor air.

If you have asthma or other chronic lung diseases, it’s important to keep your reliever close at hand, follow your existing written action plan, and seek medical advice early if symptoms worsen. This can prevent more serious flare-ups.

Well-fitting P2 or N95 masks can reduce inhalation of fine particles when worn correctly. Loose-fitting surgical or cloth masks provide much less protection against smoke.

Residents in and around Geelong concerned about air quality can check real-time monitoring data for the area at the Victorian Environment Protection Authority website.

If your symptoms worsen or persist, you should speak to a health-care professional, and in emergency always call triple 0.

Brian Oliver, Professor, School of Life Sciences, University of Technology Sydney and Peter J. Irga, Assistant Professor (Senior Lecturer) in Air and Noise Pollution, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.