Salivary flow rate and decayed, missing, and filled teeth (DMFT) in female patients with schizophrenia on chlorpromazine therapy

Oral health of people with emotional disorders: A systematic review and meta-analysis

OBJECTIVES

This study aims to determine the association between severe mental disorders and oral health among individuals over 18 years of age.

METHODS

An electronic search was conducted in six electronic databases and gray literature. Qualitative and quantitative analyses were performed on studies that met the inclusion criteria. The methodology of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool. A meta-analysis of proportions with a random effect was carried out. The certainty of evidence was evaluated using the GRADE tool.

RESULTS

After searching the databases, 5,734 references were retrieved, and twenty articles were selected for synthesis. Considering the DMFT index between the groups with mental disorders and the control group, the values of the DMFT index were higher among individuals with schizophrenia [MD = 5.27; 95% CI = 4.13 - 6.42; I2 = 35%] and bipolar disorder [MD = 1.90; 95% CI = 0.87 - 2.93]. Values were lower among individuals with obsessive-compulsive disorder [MD = -0.85; 95% CI = -1.46-0.24]. The risk of bias was considered low for 16 studies, and four were classified with a moderate risk of bias. The certainty of evidence was very low.

CONCLUSION

Patients with schizophrenia and bipolar disorder exhibit increased frequency in the number of decayed, missing, or filled teeth. There was no effect in relation to periodontal probing depth, plaque index, and TMD, but the evidence is still uncertain for this outcome.

CLINICAL RELEVANCE

These findings underscore the need for a comprehensive health approach.

Xerogenic medications may contribute to decreased unstimulated salivary flow in patients with oral burning and/or gastro-esophageal reflux disease

Background

Patients who complain of mucosal burning sensations (i.e., glossodynia and gastro-esophageal reflux disease, GERD) often take multiple medications. However, the relationship between xerogenic medication intake and salivary flow in these patients has not been thoroughly examined.

Methods

A retrospective study of 192 consecutive patients diagnosed with glossodynia (ICD-10-CM) at a regional center over a six-year period was performed. Data from electronic health records were extracted and relationships between medication intake, unstimulated whole salivary flow rate (UWSFR), xerostomia, and GERD were determined by chi-square, t-test, and correlation analysis.

Results

Of 134 records that met inclusion criteria, 87.1% of patients reported daily intake of one or more xerogenic medications. Two or more xerogenic medications were taken significantly more often by patients with glossodynia reporting GERD than those with glossodynia without GERD (p = .02). UWSFR was negatively correlated with number of medications [r(103) = -.277, p = .005] and xerogenic medications [r(103) = -.195, p = .049]. The lowest UWSFR was observed with use of trazodone and cyclobenzaprine.

Conclusions

Daily xerogenic medication intake, hyposalivation, and xerostomia were commonly present and potentially interrelated in patients who suffer from glossodynia and/or GERD.

Practical implications

Clinicians should be aware of the consequences of prescribing multiple and certain xerogenic medications in reducing UWSFR, especially in patients physiologically at risk of hyposalivation such as those suffering from GERD and/or glossodynia.

Oral health, organic and inorganic saliva composition of men with Schizophrenia: Case-control study

BACKGROUND

Schizophrenia (SCZ) presents complex challenges related to diagnosis and clinical monitoring. The study of conditions associated with SCZ can be facilitated by using potential markers and patterns that provide information to support the diagnosis and oral health.

METHODS

The salivary composition of patients diagnosed with SCZ (n = 50) was evaluated and compared to the control (n = 50). Saliva samples from male patients were collected and clinical parameters were evaluated. The concentration of total proteins and amylase were determined and salivary macro- and microelements were quantified by ICP OES and ICP-MS. Exploratory data analysis based on artificial intelligence tools was used in the investigation.

RESULTS

There was a significant increase in the salivary concentrations of Al, Fe, Li, Mg, Na, and V, higher prevalence of caries (p < 0.001), periodontal disease (p < 0.001), and reduced salivary flow rate (p = 0.019) in SCZ patients. Also, samples were grouped into six clusters. As, Co, Cr, Cu, Mn, Mo, Ni, Se, and Sr were correlated with each other, while Fe, K, Li, Ti, and V showed the highest concentrations in the samples distributed in the clusters with the highest association between SZC patients and controls.

CONCLUSIONS

The results obtained indicate changes in salivary flow, organic composition, and levels of macro- and microelements in SCZ patients. Salivary concentrations of Fe, Mg, and Na may be related to oral conditions, higher prevalence of caries, and periodontal disease. The exploratory analysis showed different patterns in the salivary composition of SCZ patients impacted by associations between oral health conditions and the use of medications. Future studies are encouraged to confirm the results investigated in this study.

The oral health of long-term psychiatric inpatients in Singapore

This cross-sectional study aims to describe the dental caries experience, treatment needs, and experience of dry mouth of 191 long-term psychiatric inpatients in Singapore. Medical history, dental caries experience [represented by the Decayed Missing or Filled Teeth index (DMFT)], salivary flow, and treatment needs were recorded. Information on brushing, pain (when eating), and xerostomia was gathered. Bivariate analysis was used to examine the associations of DMFT, saliva flow, the presence of salivary gland hypofunction (SGH), and xerostomia. Simple linear regression was used to examine the association between SGH and DMFT. The sample comprised 143 men (74.9%) and 48 women (25.1%), aged 24 to 80 years old. 169 patients (88.5%) had schizophrenia. DMFT ranged from 0 to 32, with a mean of 21.6 (SD 9.7). Mean DMFT scores were significantly higher among males and older patients. 77 of 176 patients (43.8%) were found to have SGH. SGH was associated with a higher mean DMFT. Those taking classical antipsychotics and anticholinergics had significantly lower mean saliva flow and tended to have SGH. 107 of 165 patients (64.8%) were found to experience xerostomia. Long-term psychiatric inpatients in Singapore have poor oral health, unmet treatment needs, and suffer from dry mouth.