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Older Americans Agree Smiling Could Make Them Feel Happier, But Many Are Held Back by a Self-Perpetuating Cycle of Poor Oral and Mental Health



Delta Dental’s first Senior Mental and Oral Health Survey reveals a harmful feedback loop between poor oral health and mouth pain, and depression, anxiety, and low self-image for Americans 50 and up.

SAN FRANCISCO, May 15, 2023 /PRNewswire/ — Mental health challenges contribute to the neglect of oral health care for many Americans 50 years of age and older, and mouth pain intensifies their feelings of depression or hopelessness, according to Delta Dental’s 2023 Senior Mental and Oral Health Report.

The survey asked more than 1,000 Americans 50 and older about their oral health habits and stratified their self-reported indications of mental wellbeing.

Of older Americans who said they have experienced any feelings of depression or hopelessness frequently or on occasion in the last six months (N=503), the survey found that:

  • More than 1 in 3 (35%) are likely to neglect brushing and flossing their teeth.
  • 37% say oral tooth pain intensifies feelings of depression or hopelessness. That connection is more prominent among Hispanics (45%, N=179) than Caucasians (35%, N=144) and African Americans (33%, N=146) who report experiencing occasional or frequent feelings of depression or hopelessness within the past 6 months.

Of those surveyed who indicate a higher incidence of feelings of anxiety or depression (N=176):

  • Delay in care: Over one-fourth of respondents (27%) indicate the last time they went to their dentist for a routine check-up/cleaning was more than 3 years ago.
  • Judgement: Sixty percent worry about being negatively judged based on the appearance of their teeth, compared to only 22% of those who less frequently or never experience feelings associated with depression or anxiety within the past 6 months (N=514).
  • Shame: Over half (57%) feel shame about their oral health and appearance of their teeth, compared to only 18% of those who indicate less frequent or not experiencing feelings associated with depression in the past 6 months.

Oral Health and Mental Health’s Inextricable Link

The survey indicates several possible relationships between oral health and how we feel emotionally: 45% of all respondents regardless of mental health status say they are more likely to notice changes in their mood/mental health when experiencing dental pain or discomfort. And 1 in 4 (25%) Americans 50 and over feel negatively about themselves when brushing and flossing because they don’t like the way their teeth look. In addition, more than 1 in 3 (36%) of all respondents smile less than they did when they were young due to deteriorating oral health or teeth.

And yet, 80% of all respondents say the simple act of smiling can make them feel happier – and among those who indicate they frequently experience feelings of depression or hopelessness, 78% still share that view.

“The link between mental health and oral health is really powerful,” says Sarah Chavarria, President of Delta Dental. “These results show us that addressing mental health is critical, especially as it relates to its impact on our oral and overall health. Everyone, regardless of age, ethnicity or gender, should feel uninhibited to smile and take care of their whole selves.”

Dentist to Patients: ‘Talk To Us About Your Mental and Physical Health’

If you’re experiencing oral pain, Dr. Daniel Croley, Delta Dental’s Chief Dental Officer, recommends visiting your dentist as soon as possible. “Beyond causing discomfort and impeding our day-to-day lives, oral pain can be an indication that something more serious is going on,” he says. “Our mouth and our body are not separate entities – the pain you’re feeling may be caused by inflammation of the gums, for example, which can be linked to diabetes, heart disease and even an increased risk of Alzheimer’s disease. Regular visits to your dentist can help you keep those conditions and diseases in check.”

For improving your mental health, Delta Dental recommends you seek care from your physician or a licensed therapist. If your mental health is impacting your oral health habits, Delta Dental encourages you to have open conversations with your dentist about how you’re feeling and the impact it may have on your oral care. “If you’re feeling overwhelmed, don’t let that lead you to ignore your oral health,” Dr. Croley says. Your dentist can give you tips on smaller, manageable steps, like proper daily flossing and brushing. For Dr. Croley, these small habits can give you a sense of accomplishment and are victories that should not be overlooked: “Small wins may be small, but they are steps in the right direction, and they count for a lot.”

Delta Dental is committed to providing older adults with consistent, quality access to oral health care, improving education and driving lasting policy changes to address systemic issues. To learn more about the survey, view Delta Dental’s report


Dental Dental’s Senior Mental and Oral Health Survey reflects feedback from Americans aged 50 and older and provides a look into how older Americans think about their mental and oral health, the connection between the two and the ways in which this impacts how they perceive themselves. Delta Dental commissioned Atomik Research, an independent market research agency, to conduct an online survey from a national sample size of 1,016 Americans 50 years of age or older that was representative of the race/ethnicity and gender composition of the senior population across the United States. The margin of error is +/- 3 percentage points with a confidence level of 95 percent. Fieldwork took place between April 1 and April 7 of 2023.

About Delta Dental:

Since 1955, Delta Dental of California has offered comprehensive, high-quality oral health care coverage to millions of enrollees and built the strongest network of dental providers in the country. The Delta Dental of California enterprise includes its affiliates Delta Dental Insurance Company, Delta Dental of Pennsylvania, Delta Dental of New York, Inc., as well as the national DeltaCare USA network, and provides dental benefits to more than 44 million people across 15 states and the District of Columbia.* All are members of the Delta Dental Plans Association based in Oak Brook, Illinois, the not-for-profit national association that through a national network of Delta Dental companies collectively covers millions of people nationwide. For more information about Delta Dental of California and Affiliates, please visit

*Delta Dental of California’s operating areas encompass Alabama, California, Delaware, Florida, Georgia, Louisiana, Maryland, Mississippi, Montana, Nevada, New York, Pennsylvania, Texas, Utah, West Virginia and the District of Columbia.

For Media Inquiries, Contact:

Kinga Skowronek

Public Relations Manager


[email protected]

SOURCE Delta Dental of California

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