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Matsubara C, Yamaguchi K, Imada R, Yoshizawa A, Bando Y, Kusaka T, Furuya J, Tohara H. Factors associated with the oral health status of patients with schizophrenia: A cross-sectional study. J Oral Rehabil 2024; 51:695-702. [PMID: 38044570 DOI: 10.1111/joor.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Oral function deterioration attributed to ageing and medications is one of the main contributory factors of dysphagia. Therefore, oral health management is essential in older patients with schizophrenia. However, no previous studies have evaluated the oral function in patients with schizophrenia. OBJECTIVE We surveyed patients with schizophrenia to identify factors associated with ageing-related variations in oral function. METHODS This cross-sectional study included 34 male patients diagnosed with schizophrenia who were hospitalised at a psychiatric hospital between July and September 2021 and underwent a screening examination during dental care. The survey items included basic information, oral hygiene information, oral (oral diadochokinesis [ODK] and tongue pressure), physical function, and nutritional status. Thirty-six male community-dwelling older individuals were included as controls, and their outcomes were compared with those of patients with schizophrenia. RESULTS Compared with healthy older adults, patients with schizophrenia demonstrated significantly lower teeth numbers, ODK, and calf circumference (CC) (p < .05). Multiple regression analysis revealed that ODK was associated with age and schizophrenia (p < .05). Conversely, tongue pressure was associated with CC (p < .05), suggesting different factors' association with the parameters indicating decreased oral function. CONCLUSIONS Our study findings suggest that older patients with schizophrenia have decreased tongue pressure and generalised muscle mass, highlighting the need to manage oral function. Interventions for tongue pressure were more strongly associated with muscle mass and could be easier to manage than those with disease-dependent changes in ODK. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, Shizuoka, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Medical Corporation Takanawakai, Tokyo, Japan
| | - Akira Yoshizawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental Oral Surgery, Nasu Chuo Hospital, Tochigi, Japan
| | | | - Teruo Kusaka
- Takatsuki Hospital, Tokyo, Japan
- Welfare Planning Office Minister's Secretariat Ministry of Economy, Trade and Industry, Tokyo, Japan
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Furuya
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Urien L, Jauregizar N, Lertxundi U, Fernández U, Morera-Herreras T. Medication impact on oral health in schizophrenia. Med Oral Patol Oral Cir Bucal 2024; 29:e51-e57. [PMID: 37992139 PMCID: PMC10765325 DOI: 10.4317/medoral.26061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Patients with schizophrenia constitute a particularly vulnerable group for oral diseases. Among the different factors involved, we aimed to examine the evidence of how drugs could contribute to the poorer oral health of this population. MATERIAL AND METHODS An overview of the potential impact of medication on dental/oral health among people with schizophrenia was proposed focusing on selected literature. RESULTS Studies show a higher dental caries and degree of periodontal diseases in this population and point to drug-induced xerostomia as an important risk factor for oral health deterioration. The risk of dry mouth depends on not only antipsychotics, but also drugs with anticholinergic activity. We hypothesize that antipsychotic induced glycaemic alterations might contribute to reduced oral health, and that the antimicrobial activity of certain antipsychotics could have an impact on oral microbiota affecting oral condition. Pharmacovigilance data show that involuntary movements are caused by typical and some atypical antipsychotics. Dry mouth is most frequently reported for quetiapine and olanzapine, while clozapine is more frequently associated with sialorrhea. CONCLUSIONS Literature clearly shows higher caries and periodontal disease in schizophrenic patients. However, overall, there is scarce literature about the potential influence of drugs in these disorders. Health professionals should be aware of this issue in order to implement adequate preventive measures in this vulnerable population.
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Affiliation(s)
- L Urien
- Dept. Pharmacology, Faculty of Medicine and Nursing University of the Basque Country (UPV/EHU) Barrio Sarriena s/n, 48940-Leioa, Spain
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Asami M, Kimura Y, Takenoshita M, Tominaga R, Maeda C, Takao C, Watanabe M, Huyen Tu TT, Nagamine T, Toyofuku A. Dental conditions in patients with medically unexplained oral symptoms. J Dent Sci 2023; 18:1699-1705. [PMID: 37799894 PMCID: PMC10547957 DOI: 10.1016/j.jds.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/04/2023] [Indexed: 01/19/2023] Open
Abstract
Background/purpose: Dentists sometimes struggle with treating patients with unexplained symptoms, known as oral psychosomatic disorders, that do not improve with conventional treatment. Oral psychosomatic disorders do not fit the definition of psychosomatic diseases in internal medicine. To ensure appropriate dental treatment, it is important for general dentists to distinguish between oral psychosomatic disorders and psychosomatic diseases. However, relevant evaluation methods have not yet been developed. The DMFT index is widely used as an indicator of the caries status. The purpose of this study was to compare the DMFT index scores of patients with oral psychosomatic. Materials and methods The DMFT scores of 2202 patients with oral psychosomatic disorders, 145 psychiatric inpatients, and 3940 general dental patients were statistically compared. The DMFT of patients with oral psychosomatic disorders was further compared based on the presence or absence of psychiatric history and disease. Results The median DMFT scores of oral psychosomatic disorder patients, psychiatric inpatients, and general dental patients were 16, 22, and 10, respectively, showing a significant difference. No significant differences were found in the DMFT scores based on the presence or absence of psychiatric history in oral psychosomatic disorder patients. Conclusion The intraoral environment of patients with oral psychosomatic disorders was worse than that of general dental patients but better than that of psychiatric inpatients. General dentists could suspect psychiatric and oral psychosomatic disorders based on the state of patients' oral environment.
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Affiliation(s)
- Mitsuhiro Asami
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuyuki Kimura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Risa Tominaga
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chizuko Maeda
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chihiro Takao
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoko Watanabe
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Trang Thi Huyen Tu
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Basic Dental Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Takahiko Nagamine
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Sunlight Brain Research Center, Hofu, Yamaguchi, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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van der Putten GJ, de Baat C. An Overview of Systemic Health Factors Related to Rapid Oral Health Deterioration among Older People. J Clin Med 2023; 12:4306. [PMID: 37445340 DOI: 10.3390/jcm12134306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration in older individuals, and to explore the implications of these factors for both general healthcare and oral healthcare provision. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal caregivers. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.
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Affiliation(s)
- Gert-Jan van der Putten
- Orpea Dagelijks Leven, 7327 AA Apeldoorn, The Netherlands
- Department of Dentistry, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Cees de Baat
- Fresh Unieke Mondzorg, 2411 NT Bodegraven, The Netherlands
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Guerra LM, Gondinho BVC, Bastos RA, Dos Santos Silva F, Octaviani JV, de Matos Cavalcante J, Turato ER. Perceptions of the oral health of their patients reported by Brazilian medical residents in psychiatry. PLoS One 2023; 18:e0282945. [PMID: 37068082 PMCID: PMC10109482 DOI: 10.1371/journal.pone.0282945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/27/2023] [Indexed: 04/18/2023] Open
Abstract
Persons with severe mental disorders have higher chances of presenting oral health problems than persons in the general population. Mental disorders are considered public-health problems worldwide. Interpreting statements on oral health made by medical students receiving instruction in psychiatry is essential to provide elements for reflection on their difficulties, barriers or limited knowledge in managing their patients' oral health. Based on the presupposition that doctors provide their patients with no instruction or support concerning oral complaints, because these do not symbolize the same challenges as those emerging from severe mental disorders. The aim of this study was to interpret symbolic meanings of statements expressed by medical residents in psychiatry at a specialized university outpatient clinic, about their patients' oral health. Qualitative research using the Qualitative-Clinical method was conducted, adopting the theoretical reference of medical psychology. Data were analyzed by the Clinical-Qualitative Content method and the Seven-Step technique. Based on 06 interviews analyzed, the following categories emerged: "What do I do? Psychiatrists' dilemmas about not understanding their role in patients' oral health; and "Dentists do not participate in Balint' so-called "collusion in anonymity". It was concluded that among others, the paradigm consisted of a sociological composition, therefore it was stronger than personal decisions that might eventually oppose the barriers to interdisciplinary work posed by the institutional model, which were intertwined with paradigmatic barriers. Thus, specialist training should include a dental perspective, so that oral examinations would always be included in the physical examinations, from an interdisciplinary perspective of the integrity of health-care.
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Affiliation(s)
- Luciane Miranda Guerra
- Department of Health Sciences and Children's Dentistry, Piracicaba Dental School, Campinas State University (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
| | | | | | - Felipe Dos Santos Silva
- Department of Medical Psychology and Psychiatry, School of Medical Sciences - State University of Campinas (FCM/ UNICAMP), Campinas, São Paulo, Brazil
| | - Júlia Vitório Octaviani
- Department of Health Sciences and Children's Dentistry, Piracicaba Dental School, Campinas State University (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
| | | | - Egberto Ribeiro Turato
- Department of Psychiatry, School of Medical Sciences, State University of Campinas (FCM/ UNICAMP), Campinas, São Paulo, Brazil
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Karaman E, Yazıcı AR, Doğan BG, Gökalp S, Eni N, Etçi Ş, Yazıcı MK. Oral Health Status of Outpatients with Schizophrenia in Ankara, Türkiye: A Descriptive Study. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2023; 34:262-271. [PMID: 38173327 PMCID: PMC10786350 DOI: 10.5080/u27364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/08/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To evaluate the oral health status and denture treatment needs of a group of outpatients with schizophrenia. METHODS One hundred and eighty-eight patients diagnosed with schizophrenia were evaluated. Socio-demographic characteristics, eating habits, alcohol consumption, smoking status, oral hygiene attitudes, medical status, medications and the data related to dental visit were obtained via structured questionnaire of 45 questions. Medication information were confirmed from hospital records. The DMFT score (the Total of decayed, missing and filled teeth), denture status, Community Periodontal Index of Treatment (CPITN) and attachment loss were recorded in accordance with the criteria defined by the WHO. RESULTS The mean DMFT score was 11.1±8.6. Total number of teeth decreased, while the number of decayed teeth and DMFT scores increased with age (p<0.001). There was no relationship between the anticholinergic effects of antipsychotics and the teeth count, number of decayed, filled and missing teeth, and the DMFT scores. The CPITN assessment revealed that 71.6% of the patients had healthy periodontium, 7.4% exhibited gingival bleeding upon probing, and 21% had dental calculus. Psychotropic medication and tooth brushing habits were associated with CPITN scores. Male sex was associated with higher frequency of denture need (p<0.001), while no association was observed with the education level and antipsychotic use (p>0.001). CONCLUSION Physicians and dentists have to work in coordination to maintain good oral health of patients with schizophrenia. Patients should be encouraged for regular dental check-ups and dentist should take utmost care of the oral hygiene maintenance.
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Affiliation(s)
- Emel Karaman
- Assoc. Prof., Ondokuz Mayıs University School of Dentistry, Department of Restorative Dentistry, Samsun
| | - Ayşe Rüya Yazıcı
- Prof, Hacettepe University Faculty of Medicine, Institute of Public Health, Ankara
| | - Bahar Güçiz Doğan
- Prof., Hacettepe University Faculty of Medicine, Institute of Public Health, Ankara
| | - Saadet Gökalp
- Retired Prof., Hacettepe University School of Dentistry, Department of Restorative Dentistry, Ankara
| | - Nurhayat Eni
- Nurse, Hacettepe University School of Dentistry, Department of Restorative Dentistry, Ankara
| | - Şengül Etçi
- Dentist, DDS, PhD, Burdur Oral and Dental Health Center, Burdur, Turkey
| | - M. Kâzım Yazıcı
- Retired Prof., Hacettepe University Faculty of Medicine, Departmentof Psychiatry, Ankara
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Castrillón E, Castro C, Ojeda A, Caicedo N, Moreno S, Moreno F. Oral health status of hospitalised patients with mental disorders: Systematic review of the literature. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:51-60. [PMID: 35177352 DOI: 10.1016/j.rcpeng.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 02/05/2020] [Indexed: 06/14/2023]
Abstract
According to the literature, hospitalised patients with mental disorders have a higher risk of developing cavities and periodontal disease than the general population, associated with the motor difficulty to perform adequate oral hygiene, to the adverse effects caused by drugs for the control of psychiatric symptoms, as well as the lack of oral care and clinical care. The aim was to carry out a systematic review of the literature on the oral health status of hospitalised patients with mental disorders (MD). A systematic search of the literature was carried out in PubMed, according to the PRISMA statement methodology, through the MeSh health descriptors "Dental Caries" and "Mental Disorders" in February 2017. According to the different filters that were applied, 14 articles describing the oral health status were obtained-through the DMF-T index (teeth with cavities, teeth with restorations, missing teeth and teeth with necessary extraction)-of hospitalised patients with MD. The recognition of the importance of oral health by health professionals, carers and family members should be promoted; the oral cavity should be explored to determine the state of health in addition to instructing patients and support personnel in oral hygiene; mental health institutions should establish an intervention programme to eliminate oral infectious sites and then implement a multidisciplinary preventive programme to maintain oral health according to the MD diagnosis.
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Affiliation(s)
- Eduardo Castrillón
- Médico, Especialista en Psiquiatría, Profesor Departamento de Clínicas Médicas, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia
| | - Camila Castro
- Estudiante de Odontología, Escuela de Odontología, Universidad del Valle, Cali, Colombia
| | - Andrea Ojeda
- Estudiante de Odontología, Escuela de Odontología, Universidad del Valle, Cali, Colombia
| | - Natalia Caicedo
- Médico, Médico Rural Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia
| | - Sandra Moreno
- Odontóloga, Magíster en Ciencias Biomédicas, Profesora Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia
| | - Freddy Moreno
- Odontólogo, Magíster en Ciencias Biomédicas, Profesor Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia.
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Baldo ME, Raffaele RM, Santanna GU, da Silva Santos PS. Accidental aspiration of removable dental prosthesis in a patient with Creutzfeldt-Jacob disease. SPECIAL CARE IN DENTISTRY 2021; 41:756-759. [PMID: 34213018 DOI: 10.1111/scd.12626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
Accidents involving dental prostheses are unusual but relevant, which may result in complications in the upper respiratory airways and esophagus. A 47-year-old male patient with Creutzfeldt-Jacob disease (CJD), completely dependent on care, was reported by his family to have a partial obstruction and intraoral bleeding after swallowing his upper Removable Partial Denture (RPD). After difficulties in the endoscopy procedure, a surgical approach by exploratory cervicotomy to remove the prosthetic device was conducted, without postoperative complications. Considering individual impairments and the patients' advanced age, the removal of dental prostheses during sleep or for patients under intensive care is a preventive strategy to reduce comorbidities in patients with unstable health conditions.
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Affiliation(s)
| | - Regina Maria Raffaele
- Hospital Dental Care, ICU Dentistry Service, Associação Beneficente de Campo Grande, MS Santa Casa Hospital, Campo Grande, Brazil
| | | | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry - University of São Paulo, Bauru, Brazil
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Zigmundo GCDO, Schmidt TR, Silveira FM, Neves M, Martins MAT, Carrard VC, Martins MD. Analysis of referrals to the stomatology service in a Southern Brazilian hospital: a retrospective study. Braz Oral Res 2021; 35:e072. [PMID: 34161411 DOI: 10.1590/1807-3107bor-2021.vol35.0072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/22/2020] [Indexed: 01/24/2023] Open
Abstract
This paper intends to describe the demand for referrals to the stomatology service requested by the medical teams for inpatients in a reference hospital in the south of Brazil. This research is a retrospective cross-sectional descriptive study focusing on data collection and assessment of information about referrals to the stomatology unit carried out from January 2008 to December 2018. All information was obtained from the hospital management software database, then transferred and analyzed individually for descriptive statistics. A total of 4433 cases were referred to the stomatology team, with an average of 403 cases by year. Hematology/hemato-oncology (37.3%) was the specialty asking for the majority of the referrals, followed by Oncology (20.4%) and Pneumology (8.2%). The mean patients' profile was males (55.5%), receiving a diagnosis of oral mucositis (43.5%), and with the first and second decades of life being the most prevalent ones (34.9%), with a mean age of 34.8±22.3 years. The most common treatment performed by the stomatology team was the photobiomodulation therapy (44.8%). This retrospective study demonstrated the important profile of the stomatological care in hospitalized patients from a specific hospital, especially referred by the hematology/hemato-oncology team. These results evidenced the importance of the stomatology specialty in the hospital environment.
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Affiliation(s)
| | - Tuany Rafaeli Schmidt
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Felipe Martins Silveira
- Universidade Estadual de Campinas, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Matheus Neves
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Preventive Dentistry, Porto Alegre, RS, Brazil
| | | | - Vinicius Coelho Carrard
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
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Yang M, Li Q, Deng C, Yao G, Bai X, Tan X, Zhang X. Prevalence and Clinical Correlation of Decayed, Missing, and Filled Teeth in Elderly Inpatients With Schizophrenia. Front Psychiatry 2021; 12:728971. [PMID: 34594252 PMCID: PMC8476810 DOI: 10.3389/fpsyt.2021.728971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Schizophrenia is a mental disease with a profound impact on human health. Patients with schizophrenia have poor oral hygiene, increasing their risk of systemic diseases, such as respiratory infections, and declining their quality of life. Therefore, this study aims to assess the oral health status of inpatients with schizophrenia, analyze its related factors, and thus provide scientific evidence for further exploration of corresponding control strategies. Methods: A total of 425 inpatients older than 50 years with a diagnosis of schizophrenia from two psychiatric hospitals (mean age 58.49 ± 5.72 years) were enrolled. The demographic data of the patients were checked on admission. Two independent dentists examined caries, missing teeth, and fillings. Mini-Mental State Examination (MMSE) and Global Deterioration Scale were performed as cognitive tests. Positive and Negative Syndrome Scale and Repeatable Battery for the Assessment of Neuropsychological Status rating scale were used to determine their mental status. Results: The average decayed, missing, and filled teeth index was 12.99 ± 8.86. Linear regression analysis showed that the decayed, missing, and filled teeth index had a significantly positive relationship with age (p < 0.001) and smoking (p < 0.001) and a negative relationship with MMSE (p = 0.029). The missing teeth index had a positive relationship with age (p < 0.001), smoking (p < 0.001), and Global Deterioration Scale (p = 0.014) and a negative relationship with MMSE (p = 0.004). Conclusion: The oral health of elderly patients with schizophrenia is poor, which may be related to the cognitive level of patients and affect their quality of life. The focus should be provided to the oral care of patients with schizophrenia, and investment in their specialized oral treatment should be increased.
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Affiliation(s)
- Mi Yang
- The Fourth People's Hospital of Chengdu, Chengdu, China.,MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China.,MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiwen Li
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Chijun Deng
- MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan, University of Electronic Science and Technology of China, Chengdu, China
| | - Gang Yao
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xue Bai
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xi Tan
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Haresaku S, Nakashima F, Hara Y, Kuroki M, Aoki H, Kubota K, Naito T. Associations of Oral Health-Related Quality of Life with age, oral status, and oral function among psychiatric inpatients in Japan: a cross-sectional study. BMC Oral Health 2020; 20:361. [PMID: 33317511 PMCID: PMC7737280 DOI: 10.1186/s12903-020-01355-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND As the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients. METHODS The subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥ 3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level. RESULTS A total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means ± SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6 ± 6 and 49.7 ± 7.9, respectively. The GOHAI score in the older age group (≥ 65 years) was significantly lower than that in the younger age group (< 65 years). The mean ODK scores were less than 3 times/s for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β = - 0.725, 95% CI - 0.97, - 0.64). CONCLUSIONS In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan.
| | - Fuyuko Nakashima
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Yayoi Hara
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Madoka Kuroki
- Department of Dental Hygiene, Fukuoka College of Health Sciences, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
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Agarwal D, Kumar A, B C M, Kumar V, Sethi S. Oral health perception and plight of patients of schizophrenia. Int J Dent Hyg 2020; 19:121-126. [PMID: 32969176 DOI: 10.1111/idh.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/28/2020] [Accepted: 09/13/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the oral health status, perception and dental treatment needs in patients of schizophrenia in the hospital set-up in Rohtak district, Haryana. METHODS AND RESULT A cross-sectional study was conducted to assess the oral health in patients of schizophrenia at Postgraduate Institute of Medical Sciences, Rohtak, Haryana amongst patients with ≤48 score on BPRS. A modified Dental Coping Belief Scale along with a structured questionnaire and clinical examination were recorded. Descriptive and inferential statistics were used in relation to demographic variables. Amongst 111 subjects, 74.4% were males and the mean age was 34.73 ± 9.9 years. Around 77.5% had habit of regular mouth rinsing, 72% and 3% brushed their teeth once and twice daily, respectively. Subjects had high negative oral health beliefs and external locus of control for oral health. Compared to the general population, mean OHI (8.4 ± 2.5) and DMFT (3.09 ± 2.9) scores were higher. Nearly, 66% patients had gingival pockets and around 7% showed attachment loss above 3 mm or gingival recession. CONCLUSION Patients with schizophrenia have much poorer oral health as compared to general population. They are aware of their poor oral hygiene but are not motivated enough to take care of their oral health. A multifaceted approach is required to plan and undertake effective oral health preventive and rehabilitative measures for this special group.
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Affiliation(s)
- Deepali Agarwal
- Department of Public Health Dentistry, Postgraduate Institute of Dental Sciences, Pt. B.D Sharma University of Health Sciences, Rohtak, India
| | - Adarsh Kumar
- Department of Public Health Dentistry, Postgraduate Institute of Dental Sciences, Pt. B.D Sharma University of Health Sciences, Rohtak, India
| | - Manjunath B C
- Department of Public Health Dentistry, Postgraduate Institute of Dental Sciences, Pt. B.D Sharma University of Health Sciences, Rohtak, India
| | - Vijay Kumar
- Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sujata Sethi
- Department of Psychiatry, Postgraduate Institute of Medical Sciences, Pt. B.D Sharma University of Health Sciences, Rohtak, India
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Sogi GM, Khan SA, Bathla M, Sudan J. Oral health status, self-perceived dental needs, and barriers to utilization of dental services among people with psychiatric disorders reporting to a tertiary care center in Haryana. Dent Res J (Isfahan) 2020; 17:360-365. [PMID: 33343844 PMCID: PMC7737828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Patients with psychiatric disorders can be vulnerable to oral diseases due to the adverse effects of medications and disease per se. The aim of this study is to assess oral health status, self-perceived dental needs, and barriers to utilization of dental services along with evaluation of intervention urgency among psychiatric patients. MATERIALS AND METHODS In this cross-sectional study, 165 individuals were examined at the psychiatric outpatient department of a tertiary care center. Clinical examination [dentition status and community periodontal index (CPI) modified] was done according to the World Health Organization Basic Oral Health Surveys, 2013. Other information was collected by direct interview and all the data were recorded on a prestructured, validated pro forma. Data were analyzed using SPSS Software. The statistical significance was determined by analysis of variance (ANOVA) and level of significance was set at P < 0.05. RESULTS Although decayed, missing, and filled teeth (DMFT) and CPI-modified scores increased with increase in duration of illness, the difference was not statistically significant. Evaluation of self-reported attributes revealed that the majority of the individuals had reported dental pain (34.6%) as their dental problem, 39.6% visit dentist only when there is a dental problem, and 41.7% did not felt any need to visit dentist. The ANOVA of DMFT in relation to duration of illness (P > 0.062) and CPI-modified scores (P > 0.078) were not statistically significant. Although when intervention urgency was evaluated, 70.3% needed prompt treatment depending on their oral health assessment. CONCLUSION The findings of this study suggest that oral health concerns of this marginalized section of the population are unrecognized and should be given prominence by psychiatrists.
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Affiliation(s)
- Girish M. Sogi
- Department of Public Health Dentistry, MM College of Dental Sciences and Research, MM Institute of Medical Sciences and Research, Ambala, Haryana, India,Address for correspondence: Dr. Girish M. Sogi, Department of Public Health Dentistry, MM College of Dental Sciences and Research, Ambala, Haryana, India. E-mail:
| | - Sami Ahmed Khan
- Department of Public Health Dentistry, MM College of Dental Sciences and Research, MM Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Manish Bathla
- Department of Psychaitry, MM College of Dental Sciences and Research, MM Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Jasneet Sudan
- Department of Public Health Dentistry, MM College of Dental Sciences and Research, MM Institute of Medical Sciences and Research, Ambala, Haryana, India
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Castrillón E, Castro C, Ojeda A, Caicedo N, Moreno S, Moreno F. Oral Health Status of Hospitalised Patients with Mental Disorders: Systematic Review of the Literature. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30026-3. [PMID: 33735005 DOI: 10.1016/j.rcp.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 12/22/2019] [Accepted: 02/05/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND According to the literature, hospitalised patients with mental disorders have a higher risk of developing cavities and periodontal disease than the general population, associated with the motor difficulty to perform adequate oral hygiene, to the adverse effects caused by drugs for the control of psychiatric symptoms, as well as the lack of oral care and clinical care. AIM To carry out a systematic review of the literature on the oral health status of hospitalised patients with mental disorders (MD). MATERIALS AND METHODS A systematic search of the literature was carried out in PubMed, according to the PRISMA statement methodology, through the MeSh health descriptors "Dental Caries" and "Mental Disorders" in February 2017 RESULTS: According to the different filters that were applied, 14 articles describing the oral health status were obtained - through the DMF-T index (teeth with cavities, teeth with restorations, missing teeth and teeth with necessary extraction)- of hospitalised patients with MD. CONCLUSIONS The recognition of the importance of oral health by health professionals, carers and family members should be promoted; the oral cavity should be explored to determine the state of health in addition to instructing patients and support personnel in oral hygiene; mental health institutions should establish an intervention programme to eliminate oral infectious sites and then implement a multidisciplinary preventive programme to maintain oral health according to the MD diagnosis.
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Affiliation(s)
- Eduardo Castrillón
- Médico, Especialista en Psiquiatría. Profesor Departamento de Clínicas Médicas, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia
| | - Camila Castro
- Estudiante de Odontología. Escuela de Odontología, Universidad del Valle, Cali, Colombia
| | - Andrea Ojeda
- Estudiante de Odontología. Escuela de Odontología, Universidad del Valle, Cali, Colombia
| | - Natalia Caicedo
- Médico, Médico Rural Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia
| | - Sandra Moreno
- Odontóloga, Magíster en Ciencias Biomédicas. Profesora Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia
| | - Freddy Moreno
- Odontólogo, Magíster en Ciencias Biomédicas. Profesor Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana, Cali, Colombia.
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Couatarmanach A, Sherlaw W, Prigent PM, Harpet C, Bertaud V. Dentists' perspectives on barriers to providing oral health care in French psychiatric hospitals with on-site dental clinics. Community Dent Oral Epidemiol 2020; 48:296-301. [PMID: 32212269 DOI: 10.1111/cdoe.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Psychiatric inpatients suffer from poorer oral health than the general population, and difficulties in accessing necessary dental treatment remain even when a dedicated dental service is available within the psychiatric hospital. The aim of this study was to identify barriers to access dental care from the point of view of dentists working within French psychiatric hospitals. METHODS The relatively small number of dentists working in psychiatric hospitals necessitated a qualitative approach. Semi-structured interviews were conducted, recorded, transcribed and coded in a conventional content analysis approach. RESULTS Eight interviews were conducted. Six of the dentists interviewed were men, and two were women. Three of them worked full-time in a psychiatric facility, while the other five worked partly in the hospital and partly in private practice. The average duration for interviews was 54 minutes (minimum 24 min, maximum 89 min). The interviews highlighted three dimensions of barriers to access to dental care. The first dimension was directly related to the patient. This may be linked to the patient's psychiatric disorder but not necessarily. This also encompasses refusal of care. A second dimension regrouped events related to the organization of the hospital (locally), such as communication issues between staff members within the dental office, and with other staff members from the psychiatric ward. A third dimension included difficulties related to the overall organization of the healthcare system, including financial issues and deinstitutionalization. CONCLUSIONS In-site dental consultations appear as an interesting tool to enhance access to oral care for psychiatric inpatients. However, difficulties remain from the dentists' perspective.
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Affiliation(s)
| | - William Sherlaw
- Ecole des Hautes Etudes en Santé Publique (EHESP), UMR 6051, Rennes, France
| | | | - Cyrille Harpet
- Ecole des Hautes Etudes en Santé Publique (EHESP), UMR 6051, Rennes, France
| | - Valérie Bertaud
- Faculty of Dentistry, University of Rennes, LTSI, CHU Rennes, Rennes, France
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Denis F, Goueslard K, Siu-Paredes F, Amador G, Rusch E, Bertaud V, Quantin C. Oral health treatment habits of people with schizophrenia in France: A retrospective cohort study. PLoS One 2020; 15:e0229946. [PMID: 32150582 PMCID: PMC7062238 DOI: 10.1371/journal.pone.0229946] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 02/18/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To identify the differences between persons with schizophrenia (PWS) and general population in France in terms of oral health treatment (tooth scaling, dental treatment and tooth extraction) and the factors associated with these differences. METHODS This retrospective cohort study included PWS identified from a representative sample of 1/97th of the French population (general sample of beneficiaries). PWS were identified from 2014 data by an algorithm that included: F2 diagnostic codes in the register of long-term diseases in 2014 AND {(at least three deliveries of antipsychotics in 2014) OR (F20 diagnostic codes as a main or associated diagnosis in hospital discharge abstracts in 2012 or 2013 (hospital data for medicine, surgery and obstetrics)}. Follow-up dental care was explored for all people over a period of 3 years (2014 to 2017). RESULTS In 2014, 580,219 persons older than 15 years were identified from the 96 metropolitan departments in France; 2,213 were PWS (0.4%). Fewer PWS were found along a diagonal line from north-east to south-west France, and the highest numbers were located in urban departments. PWS were more often male (58.6% vs 48.7%, p<0.001). They were less likely to have had tooth scaling but more likely to have undergone a dental extraction. In one third of departments, more than 50% of PWS had at least one tooth scaling over a three-year period; the rate of dental extraction in these departments ranged from 6 to 23%. Then, a quarter of the departments in which 40 to 100% of PWS had had at least one dental extraction (2/8) presented a rate of tooth scaling ranging from 0 to 28% over the study period. CONCLUSIONS Compared with the general population, PWS were less likely to have had tooth scaling and dental treatment but more likely to have undergone dental extraction.
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Affiliation(s)
- Frédéric Denis
- Faculté de Médecine, EA 75–05 Education, Ethique, Santé, Université François-Rabelais, Tours, France
- Université de Nantes, Faculté d’odontologie, Nantes, France
- Odontology Department, Tours University Hospital, Tours, France
| | - Karine Goueslard
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
- Bourgogne Franche-Comté University, Dijon, France
| | - Francesca Siu-Paredes
- Faculté d’Odontologie de Reims, Université Champagne Ardenne, Reims, France
- EA 481 Integrative Neurosciences and Clinical, University Hospital of Besançon, Besançon, France
| | - Gilles Amador
- Université de Nantes, Faculté d’odontologie, Nantes, France
| | - Emmanuel Rusch
- Faculté de Médecine, EA 75–05 Education, Ethique, Santé, Université François-Rabelais, Tours, France
| | - Valérie Bertaud
- Health Big Data, LTSI—INSERM U 1099, University of Rennes 1, Rennes, France
- Rennes University Hospital and Guillaume Regnier Hospital, Rennes, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
- Bourgogne Franche-Comté University, Dijon, France
- INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, clinical epidemiology/ clinical trials unit, Dijon, France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
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Sogi G, Khan S, Bathla M, Sudan J. Oral health status, self-perceived dental needs, and barriers to utilization of dental services among people with psychiatric disorders reporting to a tertiary care center in Haryana. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.294324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rat C, Peteuil A, Reynaud M, Millot I, Carpentier M, Soudry-Faure A, Denis F. [A caregiver-person with schizophrenia partnership to improve oral health education]. SANTE PUBLIQUE 2019; Vol. 31:405-415. [PMID: 31640328 DOI: 10.3917/spub.193.0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Poor oral health in persons with schizophrenia is a major public health issue affecting 600,000 people in France. The aim of this article was to present the different stages in the development of a specific oral health educational program for persons with schizophrenia. It takes into account experimental knowledge of these persons and presents the results of the feasibility study. PATIENTS AND METHOD The focus group method was applied to a group of health professionals and users to highlight an exploratory corpus in order to develop an oral health educational program. An expert group including persons with schizophrenia among others validated the fields and tools of this program. A feasibility study was then conducted in a control group of 7 persons with schizophrenia. RESULTS Altogether, 26 persons participated in this feasibility study. The main fields investigated by the expert group aimed to promote personal responsibility for one’s health, to improve access to the healthcare system and to promote the global management of health. The feasibility study showed the ability of this program to change persons with schizophrenia representations and knowledge of this health problem. Most educational tools were considered relevant. CONCLUSION An oral health educational program was built as part of a caregiver-persons with schizophrenia partnership and showed its feasibility. A multicentric randomized trial is currently ongoing to assess the efficacy of this program with a high level of proof.
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20
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Singh A, Purohit BM, Mittal P. Periodontal predicaments and associated risk factors among patients with schizophrenia. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.npbr.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Oral health in schizophrenia patients: A French Multicenter Cross-Sectional Study. Presse Med 2019; 48:e89-e99. [DOI: 10.1016/j.lpm.2018.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/12/2018] [Accepted: 06/21/2018] [Indexed: 11/18/2022] Open
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Poor oral health in patients with schizophrenia: A systematic review and meta-analysis. Schizophr Res 2018; 201:3-9. [PMID: 29759350 DOI: 10.1016/j.schres.2018.04.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/14/2018] [Accepted: 04/19/2018] [Indexed: 11/21/2022]
Abstract
Increased rates of comorbid physical illness have been commonly reported in patients with schizophrenia. However, there are fewer data on dental disease in these patients. We systematically evaluated existing data on the oral health survey of schizophrenia patients through meta-analysis. Using the available databases, we performed a systematic search to identify the studies examining the oral health in schizophrenia patients from January 1997 to June 2017, based on the inclusion and exclusion criteria. Two investigators extracted the related data independently. The meta-analysis was performed by using the RevMan 5.3 software after data extraction and quality assessment. We compared the oral health results between the schizophrenia patients and the general population, including the following measures: the mean number of decayed, missing and filled teeth (DMFT). Eight studies comprising 2640 patients with schizophrenia and 19,698 healthy controls were included in the meta-analysis. The patients with schizophrenia had significantly higher scores of dental caries (mean difference [MD] = 7.77, 95% confidence interval [CI] = 3.27 to 12.27), missing teeth (MD = 7.61, 95% CI = 3.44 to 11.77), and decayed teeth (MD = 3.44, 95% CI = 2.06 to 4.82) compared to controls (all p < 0.01). By contrast, the schizophrenia patients had fewer score of filled teeth (MD = -3.06, 95% CI, -4.82 to -1.30) than the controls (p < 0.01), indicating decreased access to dental care. Our systematic review suggests that patients with schizophrenia have worse oral health than the general population, but have received less dental care services. Hence, the oral health services should be taken into account in the patients with schizophrenia.
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Frederic D, Corinne R, Matthieu R, Francesca SP, Stephanie TJ, Nathalie R. The Schizophrenia Oral Health Profile: Development and Feasibility. Transl Neurosci 2018; 9:123-131. [PMID: 30263228 PMCID: PMC6153450 DOI: 10.1515/tnsci-2018-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/29/2018] [Indexed: 12/26/2022] Open
Abstract
Background The aim of this study was to present the different stages of development of the Schizophrenia Oral Health Profile (SOHP) questionnaire, aimed at assessing oral disorders and their impacts on functioning and psychosocial wellbeing for patients with schizophrenia (PWS) and to give the results of a feasibility study conducted in France Materials and methods The first step of this qualitative study was semi-structured interviews were conducted with 20 PWS and 6 health professionals (HP). A focus group integrating 4 PWS and 4 HP was also organised to identify the items of the SOHP. The data were analysed using a thematic analysis. Second, a feasibility study was conducted in a sample of 30 PWS who answered the SOHP questionnaire. The acceptability and understanding of the SOHP were evaluated, using a specific questionnaire. Results The semi-structured interviews and focus groups included 34 individuals in total. Items’ selection was done with several stages and led to a SOHP scale with 53 final items related to oral disorders and their impacts on functioning and psychosocial well-being. These items were classified in 13 preselected dimensions including one additional module related to the side effects of medications (11 items). The feasibility study showed good acceptability and understanding of the items of the SOHP scale. Conclusions The psychometric validation of the SOHP scale, involving a large sample of PWS, is currently in progress. The SOHP is important to evaluate PWS oral health needs and to offer appropriate strategies to improve oral health of this persons. Trial registration Clinical Trials Gov NCT02730832. Date registered: 21 March, 2016.
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Affiliation(s)
- Denis Frederic
- Clinical Research Unit, La Chartreuse Psychiatric Centre, 21033 Dijon, France.,EA 75-05 Education, Ethique, Santé, Université François-Rabelais Tours, Faculté de Médecine, 37032 Tours, France
| | - Rat Corinne
- Clinical Research Unit, La Chartreuse Psychiatric Centre, 21033 Dijon, France
| | - Reynaud Matthieu
- Clinical Research Unit, La Chartreuse Psychiatric Centre, 21033 Dijon, France
| | - Siu-Paredes Francesca
- EA 481 Integrative and Clinical Neurosciences, University Hospital of Besançon, F-25000 Besançon, France.,Université Champagne Ardenne. Faculté d'Odontologie de Reims, 51100 Reims, France
| | - Tubert-Jeannin Stephanie
- Université Clermont Auvergne, EA4847 CROC Centre for Clinical Research in Dentistry, Clermont-Ferrand, France
| | - Rude Nathalie
- EA 481 Integrative and Clinical Neurosciences, University Hospital of Besançon, F-25000 Besançon, France
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Scrine C, Durey A, Slack-Smith L. Enhancing oral health for better mental health: Exploring the views of mental health professionals. Int J Ment Health Nurs 2018; 27:178-186. [PMID: 28345285 DOI: 10.1111/inm.12307] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2016] [Indexed: 11/26/2022]
Abstract
The association between oral health, self-esteem and quality of life is well established yet there is limited research on the impact of addressing the poor oral health of people living with mental health disorders. Greater consideration is warranted on how enhancing oral health in the course of mental healthcare might reduce the burden of a person's ill health. The role of mental health professionals is important in this regard yet uncertainty persists about the role these providers can and should play in promoting oral health care for people with mental health disorders. This qualitative study explored the issue of oral health and mental health with community based mental health professionals in Perth, Western Australia. It examined their views on the oral health status and experiences of their clients, and the different and alternative ways to improve access to care, knowledge and preventative regimens. Findings indicated participants' ambivalence, reluctance and lack of training in raising oral health issues, despite its acknowledged importance, indicating a siloed approach to care. Findings offer an opportunity to reflect on whether a more integrated approach to oral health care for people with mental health disorders would improve health outcomes.
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Affiliation(s)
- Clair Scrine
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia
| | - Angela Durey
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia
| | - Linda Slack-Smith
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia
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Oral Health Is a Challenging Problem for Patients with Schizophrenia: A Narrative Review. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.8062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Hamuro A, Honda M, Tanaka R. Oral care and prevention of pneumonia after withdrawal of nasogastric tube feeding in three elderly patients with psychiatric disorders. Clin Case Rep 2018; 6:68-70. [PMID: 29375840 PMCID: PMC5771932 DOI: 10.1002/ccr3.1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/30/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
We investigated the effect of oral care on the prevention of pneumonia using a clinical scoring scale in elderly patients with psychiatric disorders after the withdrawal of nasogastric feeding tubes. Notably, oral care was effective in preventing pneumonia relapse in these patients.
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Affiliation(s)
- Atsushi Hamuro
- Department of Psychiatry; Yuzuriha Hospital; Nagasaki Japan
| | - Minoru Honda
- Department of Nursing; Yuzuriha Hospital; Nagasaki Japan
| | - Ryuichi Tanaka
- Department of Dentistry; Yuzuriha Hospital; Nagasaki Japan
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Status and perception of oral health in 6-17-year-old psychiatric inpatients-randomized controlled trial. Clin Oral Investig 2017; 21:2749-2759. [PMID: 28210811 DOI: 10.1007/s00784-017-2077-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
AIM The following are the aims of the study: assessment of oral health status, oral health-related quality of life (OHRQoL) and the effect of oral health care training over OHRQoL in children and adolescents hospitalized with mental disorders. METHODOLOGY This randomized case controlled prospective interventional study involved 81 child and adolescent psychiatric inpatients (CAP) aged between 6 and 17 years (mean age 10.6 ± 2.4 years), compared to 81 mentally healthy patients attending routine dental examinations (DC group) matched according to age and sex of the CAP group. Oral examinations were performed by two calibrated dentists. OHRQoL was assessed with the German version of the Child Perceptions Questionnaire. CAP inpatients were randomly divided in two equal subgroups, an intervention (IG) and a non-intervention group (non-IG). The IG received oral health care training at admission to the hospital. RESULTS CAP inpatients, especially those with stress-related disorders, revealed significantly higher caries prevalence and experience than DC patients. Although OHRQoL did not differ from the German reference values, CAP inpatients compensated higher impairment due to oral symptoms and functional limitations with lower impairment due to emotional and social well-being. OHRQoL increased in all CAP patients during hospitalization, regardless of receiving oral health care training. CONCLUSION Poorer oral health of CAP inpatients was not accompanied by higher impairment of OHRQoL. Oral problems seem to be overshined by better self-perceived emotional and social well-being. OHRQoL was not improved by individualized oral health care training. CLINICAL RELEVANCE Children and adolescents with mental disorders are at risk for oral diseases and need referral to dental services.
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Villadsen DB, Sørensen MT. Oral Hygiene - A Challenge in Everyday Life for People with Schizophrenia. Issues Ment Health Nurs 2017; 38:643-649. [PMID: 28481666 DOI: 10.1080/01612840.2017.1316328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the study is to explore how adults with schizophrenia describe their lived experiences with oral hygiene. 23 adults with schizophrenia were interviewed within a period of four months in late 2015. Transcriptions of the interviews were analysed using the Reflective Lifeworld Research phenomenological approach of Dahlberg, Dahlberg, and Nyström. The essence of the phenomenon, oral hygiene, is described as a challenge: a mixture of ability and assigning priority; a challenge in which significant others, for better or worse, play an important role. We recommend a systematic cooperation between health care professionals and adults with schizophrenia in order to improve oral health, well-being and recovery.
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Hamuro A, Kawaguchi H, Yamazoe K, Honda M, Tanaka R. Oral Care and Prevention of Pneumonia in Hospitalized Patients With Psychiatric Disorders in Japan. JAPANESE CLINICAL MEDICINE 2017; 8:1179670717720407. [PMID: 28811746 PMCID: PMC5528949 DOI: 10.1177/1179670717720407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 06/09/2017] [Indexed: 11/17/2022]
Abstract
Purpose: Oral care in hospitalized patients with psychiatric disorders is important. However, some patients with psychiatric disorders cannot undergo oral care because of psychiatric symptoms and cognitive decline. The effect of a standardized oral hygiene intervention on the prevention of pneumonia in hospitalized patients with psychiatric disorders was investigated. Method: Patients were divided into 2 groups: control group (N = 259), patients without standardized intervention who were enrolled on April 2014 as the time point of baseline, and intervention group (N = 263), patients with standardized intervention who were enrolled on April 2015 as the time point of baseline. Two end points were evaluated: (1) pneumonia onset within 1 year after the enrollment and (2) no pneumonia for 1 year after the enrollment. The following parameters were compared between the groups: sex, age, psychiatric disorders, past history of diseases of the respiratory system, hypertension, diabetes, hyperlipidemia, heart impairment, and pneumonia. Results: No statistically significant differences were found between the 2 groups in the distributions of characteristics except pneumonia by univariate analysis. The presence of pneumonia was significantly associated with age and the absence of the standardized oral hygiene intervention by multivariate logistic regression analysis. Conclusions: The standardized oral hygiene intervention appears to be effective for preventing pneumonia in patients with psychiatric disorders.
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Affiliation(s)
- Atsushi Hamuro
- Department of Psychiatry, Yuzuriha Hospital, Nagasaki, Japan
| | | | | | - Minoru Honda
- Department of Nursing, Yuzuriha Hospital, Nagasaki, Japan
| | - Ryuichi Tanaka
- Department of Dentistry, Yuzuriha Hospital, Nagasaki, Japan
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Denis F, Hamad M, Trojak B, Tubert-Jeannin S, Rat C, Pelletier JF, Rude N. Psychometric characteristics of the "General Oral Health Assessment Index (GOHAI) » in a French representative sample of patients with schizophrenia. BMC Oral Health 2017; 17:75. [PMID: 28399850 PMCID: PMC5387256 DOI: 10.1186/s12903-017-0368-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 04/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The "General Oral Health Assessment Index" (GOHAI) was widely used in clinical or epidemiological studies worldwide, as it was available for use in different languages. Therefore, the aim of this study was to evaluate the psychometric characteristics of the GOHAI in a representative sample of patients with schizophrenia. METHODS A total of 90 schizophrenic patients (in-patients and out-patients) were recruited from the participants of the "buccodor study" (NCT02167724) between March and September 2015. They were selected using a random stratified sampling method according to their age, sex, or residential area (urban/rural area). GOHAI validity (construct, predictive, concurrent and known group validity) and internal consistency (reliability) were tested. Test-retest reliability was evaluated in 32 subjects. RESULTS The mean age was 47.34 (SD = 12.17). Internal consistency indicated excellent agreement, with a Cronbach's α value of 0.82 and average inter-item correlation of 0.65. Intraclass correlation coefficients for test-retest reliability with 95% confidence intervals were not significantly different (p > 0.05). Construct validity was supported by three factor that accounted for 60.94% of the variance observed. Predictive validity was corroborated as statistically significant differences were observed between a high GOHAI score, which was associated with self-perceived satisfaction with oral health, lower age and high frequency of toothbrushing. Concurrent validity was corroborated as statistically significant relationships were observed between the GOHAI scores and most objective measures of dental status. For known group validity, they was no significant difference of the mean GOHAI score between out or in-patients (p > 0.05). CONCLUSION Acceptable psychometric characteristics of the GOHAI could help caregivers to develop ways to improve the Oral Health related Quality Of Life of schizophrenic patients. TRIAL REGISTRATION Clinical Trials Gov NCT02167724 . Date registered 17 June, 2014.
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Affiliation(s)
- Frederic Denis
- La Chartreuse Psychiatric Centre, 1, boulevard Chanoine Kir, BP 23314, 21033, Dijon, Cedex, France. .,EA 481 Integrative Neurosciences and Clinical, University Hospital of Besançon, F-25000, Besançon, France. .,Department of Dentistry, University Hospital of Dijon, 21079, Dijon, France.
| | - Mohamad Hamad
- EA 481 Integrative Neurosciences and Clinical, University Hospital of Besançon, F-25000, Besançon, France
| | - Benoit Trojak
- Department of Psychiatry and Addiction, University Hospital of Dijon, 21079, Dijon, France
| | - Stéphanie Tubert-Jeannin
- Université Clermont Auvergne, EA4847 CROC Centre for Clinical Research in Dentistry, BP10448, 63000, Clermont-Ferrand, France
| | - Corinne Rat
- La Chartreuse Psychiatric Centre, 1, boulevard Chanoine Kir, BP 23314, 21033, Dijon, Cedex, France
| | - Jean-François Pelletier
- Department of Psychiatry, Montreal University, Yale Program for Recovery & Community Health, Montreal, Canada
| | - Nathalie Rude
- EA 481 Integrative Neurosciences and Clinical, University Hospital of Besançon, F-25000, Besançon, France
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Singh A, Mittal P, Goel P, Purohit BM, Thukral R. Severity of illness and extra pyramidal symptoms as predictors for oral diseases among patients with schizophrenia. Acta Odontol Scand 2017; 75:220-226. [PMID: 28116993 DOI: 10.1080/00016357.2017.1278789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The study explores the association between severity of illness (positive, negative, depressive and cognitive symptoms) and extra pyramidal symptoms (EPS) with dental caries, periodontal disease and prosthetic needs among patients with schizophrenia. MATERIAL AND METHODS A total of 71 schizophrenic patients diagnosed based on ICD-10 criteria participated in the study. Clinical Global Impression - Schizophrenia (CGI-SCH) scale was used to evaluate positive, negative, depressive, cognitive symptoms and overall severity of schizophrenia. Simpson-Angus Scale (SAS) was used for assessment of EPS. Dental examinations were conducted as per WHO (1997) criterion. RESULTS Mean DMFT and CPI scores with periodontal pockets were 5.57 ± 2.12 and 2.37 ± 0.74; significant differences being noted among those with and without EPS (p < 0.001). Positive and EPS associated with dental caries with odds ratio of 5.26 (1.05, 26.2) and 8.52 (2.31, 31.4) (p < 0.001). Depressive and EPS were associated with periodontal disease with odds ratio of 4.19 (1.53, 32.5) and 5.27 (1.29, 21.5), respectively (p < 0.001). Cognitive and EPS were associated with dental prosthetic needs with odds ratio of 4.33 (1.47, 31.2) (p < 0.001) and 7.78 (1.43, 42.2), respectively (p < 0.001). CONCLUSIONS Patients with schizophrenia had high dental caries, periodontal disease and unmet dental prosthetic needs. Severity of the schizophrenic and EPS was associated with poor oral health. Efforts need to be focused on strengthening the evidence of its association with oral health indicators through further studies including cohort investigations.
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Affiliation(s)
- Abhinav Singh
- Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India
| | - Pankaj Mittal
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India
| | - Pankaj Goel
- Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India
| | - Bharathi M. Purohit
- Department of Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Bhopal, India
| | - Rishi Thukral
- Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India
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Slack-Smith L, Hearn L, Scrine C, Durey A. Barriers and enablers for oral health care for people affected by mental health disorders. Aust Dent J 2017; 62:6-13. [PMID: 27164018 DOI: 10.1111/adj.12429] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with mental health disorders are reported to have poorer access to dental services and poorer oral health outcomes. The aim of this paper is to analyze current published work regarding barriers and enablers for oral health outcomes and access to dental care for adults with mental health disorders which will be addressed from individual, organizational and systemic perspectives METHODS: A narrative review based on a search of the relevant published work regarding oral health for people with mental health disorders was undertaken using Medline, Web of Science, ERIC and Psychlit. Any relevant systematic reviews were highlighted in this process along with primary studies. RESULTS The published work repeatedly verified poorer oral health and inadequate access to dental services in people with mental health disorders. The published work identified barriers at individual, organizational and systemic levels. Much of the published work focused on barriers with less focus on enablers and interventions. CONCLUSIONS Considerable investigation of barriers had not elucidated options to improve care or outcomes.
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Affiliation(s)
- L Slack-Smith
- School of Dentistry, University of Western Australia, Perth, Australia
| | - L Hearn
- School of Dentistry, University of Western Australia, Perth, Australia
| | - C Scrine
- School of Dentistry, University of Western Australia, Perth, Australia
| | - A Durey
- School of Dentistry, University of Western Australia, Perth, Australia
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Nayak SU, Singh R, Kota KP. Periodontal Health among Non-Hospitalized Chronic Psychiatric Patients in Mangaluru City-India. J Clin Diagn Res 2016; 10:ZC40-3. [PMID: 27656561 DOI: 10.7860/jcdr/2016/19501.8248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION A substantial section of society constituting the mentally ill and psychiatric patients deserve special attention. Evidence has suggested that psychological factors have contributed to an increase in the susceptibility to periodontal disease. AIM The aim of the study was to evaluate the gingival and periodontal health of chronically non-hospitalized psychiatric patients in Mangaluru city, India. MATERIALS AND METHODS Forty one psychiatric patients having chronic psychiatric illness and on neuroleptic medications for a minimum of 2 years were included in the study. The control group consisted of 41 healthy dental patients who were selected to match the study group by age and gender, and for both groups 20 teeth excluding the third molars should be present. Demographic characteristics, dental examination including gingival index and periodontal health according to the community periodontal index were recorded for each patient in both the groups. RESULTS In the psychiatric patient group (Group A) 47.1% subjects were suffering from schizophrenia and 17.6% subjects were having mood disorder. Gingivitis varied from mild to severe among the patients of both the groups. Bleeding on probing (CPI 1) was recorded in 23.5% in Group A and 14.6% in Group B. Dental calculus (CPI 2) in 38.2% in Group A and 58.5% in Group B of the subjects, 20.6% with at least one 4mm to 5mm pocket (CPI 3), and 17.6% with at least one 6mm pocket (CPI 4). CONCLUSION The present study underlines a considerable need for prevention and treatment of periodontal disease among chronic psychiatric patients in Mangaluru city. Every effort should be made to increase the awareness of this cohort regarding the importance of oral hygiene practices and on the early diagnosis of periodontal problems.
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Affiliation(s)
- Sangeeta Umesh Nayak
- Reader, Department of Periodontics, Manipal College of Dental Scienes, Manipal University , Mangaluru, Karnataka, India
| | - Rashmi Singh
- Intern, Manipal College of Dental Sciences , Mangaluru, Karnataka, India
| | - Keshava Pai Kota
- Professor and Head, Department of Psychiatry, Kasturba Medical College, Manipal University , Mangaluru, Karnataka, India
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Teng PR, Lin MJ, Yeh LL. Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database. BMC Oral Health 2016; 16:87. [PMID: 27585979 PMCID: PMC5009687 DOI: 10.1186/s12903-016-0280-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/15/2016] [Indexed: 11/10/2022] Open
Abstract
Background The oral health of patients with severe mental illness is poor, in general, and this may be attributed, in part, to inadequate dental care. This study investigated dental care utilization among patients with severe mental illness using a national representative sample. Methods This study used Taiwan’s National Health Insurance Research Dataset for 2009. Patients with the diagnosis of severe mental illness (ICD-9-CM: 290–298) were recruited as the study sample, and others comprised the control. Any visit to a dentist was defined as positive in terms of dental care utilization. Regression analyses were applied to determine the odds of dental care utilization for each diagnostic entity of severe mental illness, compared with the general population and controlling for potential covariates. Results Only 40 % of 19,609 patients with severe mental illness visited the dentist within 12 months. This was significantly lower than the dental visit rate of 48.3 % for the control population (odds ratio [OR] = .72, 95 % confidence interval [CI] = .69–.74; P <0.0001). The odds of dental care utilization differed among the severe mental illness diagnostic categories; e.g., the odds were lowest among those with alcohol psychoses (OR = .54, CI = .43–.68), senile dementia (OR = .55, CI = .52–.59) and other organic psychoses (OR = .58, CI = .52–.65), and highest among those with mood disorder (OR = .89, CI = .85–.94), with schizophrenic patients occupying a mid-level position (OR = .63, CI = .59–.67). Conclusions Patients with severe mental illness received less dental care than the general population. Health care providers and caregivers of patients with severe mental illness should encourage them to visit the dentist regularly, in order to improve the oral health of these vulnerable patient groups.
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Affiliation(s)
- Po-Ren Teng
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, No. 6, Lu-Gong Road, Lu-Gang Township, Changhwa County, Taiwan
| | - Miao-Jean Lin
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, No. 6, Lu-Gong Road, Lu-Gang Township, Changhwa County, Taiwan
| | - Ling-Ling Yeh
- Department of Healthcare Administration, Asia University, No. 500, Lioufong Rd, Wufeng, Taichung, 41354, Taiwan.
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Wey MC, Loh S, Doss JG, Abu Bakar AK, Kisely S. The oral health of people with chronic schizophrenia: A neglected public health burden. Aust N Z J Psychiatry 2016; 50:685-94. [PMID: 26560842 DOI: 10.1177/0004867415615947] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE People with chronic schizophrenia have high rates of physical ill-health such as heart disease. However, there has been less attention to the issue of poor oral health including dental caries (tooth decay) and periodontal (gum) disease, although both have consequences for quality of life and systemic physical health. We therefore measured tooth decay and gum disease in Malaysians with schizophrenia. METHODS We recruited long-stay inpatients with schizophrenia from June to October 2014. Four dental specialists assessed oral health using the decayed-missing-filled teeth index, the Community Periodontal Index of Treatment Needs and the Debris Index of the Simplified Oral Hygiene Index. Results were compared with the 2010 Oral Health survey of the general Malaysian population. RESULTS A total of 543 patients participated (66.7% males, 33.3% females; mean age = 54.8 years [standard deviation = 16.0]) with a mean illness duration of 18.4 years (standard deviation = 17.1). The mean decayed-missing-filled teeth was 20.5 (standard deviation = 9.9), almost double that of the general population (11.7). Higher decayed-missing-filled teeth scores were associated with both older age (p < 0.001) and longer illness duration (p = 0.048). Only 1% (n = 6) had healthy gums. Levels of decay and periodontal disease were greatest in those aged between 45 and 64 years, coinciding with the onset of tooth loss. CONCLUSION Dental disease in people with schizophrenia deserves the same attention as other comorbid physical illness. The disparity in oral health is most marked for dental decay. Possible interventions include oral health assessments using standard checklists designed for non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth and early dental referral.
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Affiliation(s)
- Mang Chek Wey
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - SiewYim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jennifer Geraldine Doss
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Steve Kisely
- School of Medicine, The University of Queensland, Australia, Woolloongabba, QLD, Australia
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