The dental industry is undergoing significant changes as new research highlights the strong connections between oral health and overall wellness.

Cigna Healthcare’s 2025 Dental Trends Report explores these emerging trends, emphasizing the importance of addressing whole-person health and the social factors that impact access to dental care.

“The connection between oral health and overall well-being is more profound than ever before,” said Dr. Cary Sun, a dentist and the chief dental officer at Cigna Healthcare. “Our latest report underscores the need for new strategies and integrated care approaches to improve health outcomes for all.” 

People living with mental health conditions such as depression and anxiety may also neglect oral hygiene and skip dentist visits, even when they are experiencing dental issues. In addition, a common side effect of many psychiatric medications is dry mouth, caused by the medication affecting saliva production. Antidepressant medication has also been linked to bruxism, which can damage teeth and gums.

Additionally, factors affecting mental and oral health share common attributes, suggesting that integrated medical, dental, and behavioral health treatment can lead to better overall health outcomes.

Some mental health conditions directly impact oral health

Traditionally, oral health issues like tooth decay, dental pain, gum disease, and tooth loss were seen as side effects of mental health problems. People with depression, anxiety, or other mental health disorders often had more dental issues, likely due to decreased self-care.

However, newer research shows a more direct connection between oral and mental health. For example, periodontitis and its associated chronic inflammation can cause oral bacteria to enter the bloodstream, raising stress hormones that affect mental health. Similarly, bacteria from gum disease can lead to neuroinflammation. One study found a link between early childhood neglect and poor oral care, which led to more mental health issues compared to a control group.

Additionally, some psychiatric conditions directly impact oral health. For example, people with eating disorders may experience dental problems like tooth erosion. Studies also show that people with anxiety and depression are more likely to grind their teeth, causing serious jaw pain.

“A more integrated care approach involving dentists, medical doctors, and mental health professionals is key,” said Jason Youngblood, director of behavioral clinical account management at Cigna Healthcare, and a licensed behavioral health clinician. “One study indicates that including oral care resources in behavioral health settings could improve oral health and health care utilization among people with behavioral health challenges. The idea is gaining support as a way to address whole-person health.”

Social determinants of health: Barriers to oral care

While evidence shows that oral health is crucial for overall health, our research shows that many barriers to obtaining dental care remain. Social determinants of health (SDOH) are non-medical factors that influence a person’s health and well-being, such as geographic location, income, and race.

In rural areas, a significant challenge is simply finding a dentist. About 67% of rural areas are considered Dental Health Professional Shortage Areas. The U.S. Department of Health and Human Services states that over 10,000 dentists are needed to address this shortage.

Rural areas also have higher tobacco use rates, but fewer rural businesses offer health insurance. As a result, people in rural areas are more likely to be missing five or more teeth and less likely to have seen a dentist in the past year.

Urban areas face similar issues, but for different reasons. Poverty is a key factor. People who rent their homes are 13% less likely to have seen a dentist in the past year, and those in public housing are 26% less likely. Patients with a household income of less than $30,000 are twice as likely to go to the emergency room (ER) for an oral health issue than any other income group. Adults with a 12th-grade education or less are nine times more likely to seek dental care in an emergency room than those with higher education levels.

Addressing the challenges: Actions by dentists, insurers and employers

With the growing evidence of the importance of oral health and the barriers many Americans face in accessing it, how are dentists, insurers, and employers tackling these challenges?

For dentists, increasing the number of providers in rural areas is crucial. Dental schools are offering specific tracks with financial incentives for students to practice in underserved areas. All 50 states provide loan-repayment incentives for those working in underserved areas. Additionally, making patients feel comfortable in dental offices involves recruiting providers, hygienists, and staff who have ties to the local community, either by race or ethnicity. Patients in areas where English is not the primary language are being welcomed by staff who speak their language.

For dental insurance carriers, new tools are extending care to patients in rural or underserved areas. Almost all carriers now offer teledentistry to help triage oral health issues, recommend next steps in care, and, if necessary, provide prescriptions. This helps patients determine whether they need to see a dentist and can divert them from expensive and time-consuming ER visits.

Mobile dentistry brings dentists to rural worksites or urban care deserts, making primary oral care convenient for patients without missing work. Issues that can’t be addressed with mobile dentistry are referred to the nearest in-network dentist for further care.

Employers are uniquely positioned to use available programs to improve employees’ oral and overall health. Incentives for medical health screenings are common, and many employers are now offering similar incentives for preventive dental visits. Employers can also partner with insurers to offer employees access to home oral care tools, such as electric toothbrushes and flossers, at discounted rates.

Additionally, employers can work with insurers to educate employees about the connections between oral care and medical/mental health, encourage regular preventive dental visits, and improve home oral care routines. Highlighting insurer tools, such as lists of multilingual providers and interpreter services, can help non-English speakers access care.

“By recognizing the link between oral health and overall health and removing barriers to care, dentists, insurers and employers can make progress in improving health outcomes,” Dr. Sun said.