Mapping the evidence on oral behaviors and mental health: a scoping review with implications for integrated oral healthcare.

OBJECTIVE

To map and characterize the available evidence on the associations between oral behaviors and psychological factors by identifying the psychological constructs investigated and describing the range and patterns of these associations across different oral behaviors.

METHOD: Electronic searches were conducted in PubMed, Web of Science and Scopus (November 2024; updated August 2025), using controlled vocabulary and terms related to oral behaviors and psychological factors. Studies published in the last 10 years assessing oral behaviors and psychological factors were eligible. Study selection followed the PRISMA-ScR guidelines, with two independent reviewers screening titles, abstracts, and full-texts. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria, and findings were synthesized narratively, focusing on methodological characteristics, diagnostic assessment, and reported associations.

RESULTS

Forty-two studies met the eligibility criteria. Most were cross-sectional and showed substantial heterogeneity in terminology, assessment methods, and psychological constructs examined. While five studies reported no significant associations, the majority identified associations between oral behaviors and multiple analytical domains of psychological factors. The analytical domains "anxiety-obsessive/compulsive" and "mood/affective" were the most frequently represented among reported associations, particularly in studies of awake bruxism and nail-biting. Additional associations were reported with somatic symptom disorders, personality traits, emotional processing, and cognitive-executive functioning.

CONCLUSION

Current evidence suggests that oral behaviors are associated with psychological factors spanning multiple analytical domains, particularly "anxiety and obsessive-compulsive symptoms" and "mood and affective symptoms". However, the evidence base remains predominantly cross-sectional and methodologically heterogeneous, limiting causal inference, comparisons across studies, and the certainty with which these associations can be interpreted.