Table 1.

Different symptomatologies and their consequences/manifestations influenced by different risk factors with an accent on the correlation between various psychiatric and dental disorders, highlighting the possible comorbidity between these 2 areas based on several research articles, reviews, clinical trials, and case reports.

Manifestation/symptomatology	Risk factors	Consequences/correlations	Study type	Sample size	Specificity	Other observations
1 Depressive symptomatology	Not under treatment	Favorable environment for caries because of a decreased salivary flow	Double-bind trazodone + imipramine+ placebo, parallel group design [35]	379 patients (142 trazodone, 142 imipramine—positive control, 95 placebo) [35]	Tricyclic and heterocyclic antidepressants [35] Geriatric population [36]	The high incidence of certain side effects even in the placebo groups might have a connection with the neurotic symptomatology [35] Tricyclic and heterocyclic categories of antidepressants target anticholinergic activity by blocking parasympathetic salivary glands [35] The use of hyposalivatory medications increases with age [36] The anticholinergic side effects of classical tricyclic antidepressants are persistent [37]
	Undertreatment (tricyclic and heterocyclic categories)	Influences salivary flow [35–37]—creates xerostomia—> increased calculus and plaque formation, higher levels of dental decay and periodontitis [13]
	High levels of prostaglandins (found in salivary products)	Atypical face pain, odontalgia, burning mouth syndrome, lupus erythematosus, general disorders of taste and salivation [1]				Affected hygiene and tobacco-associated usage Up to 30% more likely to lose all their teeth
	Severe depression acutizations	Atypical face pain and/or facial arthromyalgia [38], burning mouth syndrome [39, 40]	Two centre double blind clinical trial [41] Controlled trial	93 patients at the actual start of the patient [41] 50 patients (25 for BMS∗ group and 25 for control) [39]	No psychotic treatment for two weeks prior to the study [38] Chronic painful oral conditions [39]	Out of the 53 patients considered as “psychiatric cases” due to their symptomatology, only 17 were still classified as such at the end of the nine weeks study (51) 44% of the BMS∗ group presented an associated-psychiatric disorder compared to the control group (16%) (52)
2 Anxiety	Bruxism (tooth grinding)	TMJD∗, recurrent stomatitis or lichen planus [1]
	Phobias	Increased presence of decayed teeth recorded by DMFT∗ and DMFS∗ indexes, increased tooth loss [14]
3 Mildest dental irregularities	Psychological and psychiatric disturbances (anxiety manifestations)	Very disproportionate distress and depressive-social withdrawal, isolation and reduced self-esteem [1]
4 Addiction on drugs and/or alcohol	Excessive bruxism (tooth grinding and toxic habits)	↑ Risk of oral cancers [13] Risk for caries [14, 42, 43]	Clinical trial [42]	28 subjects divided in 3 groups based on the unstimulated saliva flow rate [42]		18 subjects were taking medication knows to provoke xerostomia [42] An unstimulated saliva low rate is a great indicator for increased caries risk [42]
5 Traumatic and stressful events in the dental clinic		PTSD∗ manifestation [44]
6 Bipolar disorder	Excessive tooth brushing and/or flossing	Affected mucosa or deficits at teeth cervical/gingival levels [14]
7 Schizophrenia	Up to 50% reduced attendance to dental professionals >30% brushing frequency [13]	↑ Tendency to develop TMD∗ [41] Considerable throwback in the diagnostic process [41] ↓ Response to prolonged pain as opposed to acute [45] Misdiagnosis of TMD Higher prevalence of bruxism [45]	Clinical trial [45]	77 psychiatric patients under treatment with mostly dopamine antagonists + 50 healthy individuals as control [45] 15 schizophrenic patients with 1 never being admitted to the hospital or receiving neuroleptic treatment [46]	Psychiatric and/or schizophrenic patients + healthy controls	Lack of pain complaints suspected to be an ubiquitous dulling reply to pain connected with blunted replies that they present also to pleasure and basic emotions [41, 47] Tinnitus—being mistaken as possible auditory hallucinations [46] > Altered diagnosis of the patient's mental status [46] Almost 50% of the psychiatric group presented evident abnormal attrition in contrast with 20% in the control group along with significant differences for mean muscle and joint sensitivity to palpation and the range of mouth opening [45]
	Hypoalgesia
	Auditory manifestations of the stomatognathic deficiency (such as ear fulness, hearing loss perception, and tinnitus)
8 Psychiatric patients	Increased consumption of sugary and carbonated drinks [48, 49] Losing interest in performing hygiene activities, oral hygiene included [50, 51]	Creating a favorable environment for caries occurrence A possible accentuation of the symptoms of mental disorder through overconsumption of caffeinated soft drinks [49]	Cross-sectional population-based survey [48] Case report [49] Clinical trial [51]	7305 adolescents [48] 1 40 years old woman [28] 55 patients + 19 healthy individuals as control group [51]		Strong correlation between soft drinks consumption and mental distress [48] The increased consumption of sugary and carbonated drinks might be because of the altered taste perception [50, 51]

∗BMS: burning mouth syndrome; ∗TMJD: temporomandibular joint dysfunction; ∗DMFT: decayed, missing, or filled teeth; ∗DMFS: decayed, missing, or filled surfaces; ∗PTSD: posttraumatic stress disorder; ∗TMD; temporomandibular disorders.