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ABSTRACTAimsThere are many factors that play into the success or failure of dental treatments, and mental health has been hypothesized to increase failure rates in treatment such as resin‐based restorations. The goal of this work was to evaluate if composite resin dental restorations perform the same in individuals with depression in comparison to matched individuals without depression.Methods and resultsA total of 6,026 individuals from the University of Pittsburgh Dental Registry and DNA Repository project were evaluated and 326 patients with depression were selected for this study. They were matched by age, sex, ethnicity, and smoking history with 326 subjects without depression. Rates of failure of resin‐based restorations were determined in both groups. Chi‐square was used for all comparisons with alpha set at 0.05. We found significantly higher failure rates of resin‐based restorations in patients diagnosed with clinical depression (p < 0.00001, OR = 1.89, 95% C.I. 1.6 to 2.23).DiscussionThe significantly higher failure rates in patients with clinical depression suggests that clinical depression has an effect on the success of resin‐based restorations. The results of this study suggest a need for more personalized dental care for patients, which includes taking into account their mental health and its subsequent effects on oral health and hygiene, and customized definitions of follow‐up time intervals.