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Gupta S, Rangappa KKG, Rani S, Ganesh R, Kukreja P, Kukreja BJ. Periodontal and Dentition Status among Psychiatric Patients in Indore: A Descriptive Cross-sectional Study. J Contemp Dent Pract 2022; 23:1260-1266. [PMID: 37125525 DOI: 10.5005/jp-journals-10024-3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM To assess and record periodontal and dentition status among psychiatric patients using modified WHO Oral Health Assessment form 1997. MATERIALS AND METHODS A descriptive cross-sectional study was conducted at Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore, among the inpatients and outpatients. Ethical approval for the study was obtained from Institutional Review Board of Sri Aurobindo College of Dentistry. Statistical analysis was done using SPSS, IBM version 20.0. Descriptive statistics was used to find the frequencies, mean, and standard deviation of variables considered in the study. RESULTS Among all the disorders, schizophrenia subjects had shallow pockets 28 (25.2%) and deep pockets 55 (49.5%). Only 2 (2.6%) study subjects who had major depressive disorder had more than 12 mm loss of attachment (LOA). The highest mean DMFT score was recorded for schizophrenia patients (13.0 ± 7.09). CONCLUSION The results reveal an unmet need of projecting effective planning and implementation strategies toward the improvement of periodontal and dentition status health of the psychiatric patients. CLINICAL SIGNIFICANCE The study highlights the importance of incorporating dental health education to psychiatric rehabilitation programs.
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Affiliation(s)
- Sonali Gupta
- Department of Public Health Dentistry, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India, Phone: +91 9993043736 e-mail:
| | | | - Shikha Rani
- Department of Orthodontics and Dentofacial Orthopedics, Dr BR Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Rajendran Ganesh
- Faculty of Dentistry, Al Baha University, Al Aqiq Campus, Saudi Arabia
| | - Pankaj Kukreja
- Department of Biomedical and Dental Sciences, Faculty of Dentistry, Al Baha University, Al Aqiq Campus, Saudi Arabia
| | - Bhavna Jha Kukreja
- Department of Preventive Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
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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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Wadhawan A, Reynolds MA, Makkar H, Scott AJ, Potocki E, Hoisington AJ, Brenner LA, Dagdag A, Lowry CA, Dwivedi Y, Postolache TT. Periodontal Pathogens and Neuropsychiatric Health. Curr Top Med Chem 2021; 20:1353-1397. [PMID: 31924157 DOI: 10.2174/1568026620666200110161105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 02/08/2023]
Abstract
Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases, and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature has important pathophysiological consequences. Distant effects via translocation rely on virulence factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its capability to manipulate the immune system via several mechanisms, including its capacity to induce production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development to manage distal consequences of infection with P. gingivalis are also reviewed.
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Affiliation(s)
- Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Department of Psychiatry, Saint Elizabeths Hospital, Washington, D.C. 20032, United States
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore 21201, United States
| | - Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Alison J Scott
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, United States
| | - Eileen Potocki
- VA Maryland Healthcare System, Baltimore VA Medical Center, Baltimore, United States
| | - Andrew J Hoisington
- Air Force Institute of Technology, Wright-Patterson Air Force Base, United States
| | - Lisa A Brenner
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Christopher A Lowry
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Department of Integrative Physiology, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, United States
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Alabama, United States
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, United States
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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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Wang IC, Askar H, Ghassib I, Wang CW, Wang HL. Association between periodontitis and systemic medication intake: A case-control study. J Periodontol 2020; 91:1245-1255. [PMID: 32077489 DOI: 10.1002/jper.19-0593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/19/2020] [Accepted: 01/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND To investigate the frequency of systemic drugs taken by elderly patients with or without periodontitis and the possible association between medication consumption and the severity of periodontitis. METHODS A total of 1221 patients, including 608 with generalized moderate to severe periodontitis (periodontitis group) and 613 age- and gender-matched individuals with healthy periodontium (healthy group) were selected. Systemic conditions, medications and periodontal status were recorded. Medication intake frequency (%) was compared using unconditional logistic regression. RESULTS The top three most common medications were angiotensin-converting enzyme (ACE) inhibitors (17.9%), antidepressants (17.8%), and lipid-lowering medications (16.5%). Both ACE inhibitors and antidepressants showed statistically higher intake frequency in the periodontitis group relative to healthy controls (21.5% versus 14.4%; odds ratio [OR] = 1.64), (21.1% versus 14.5%, OR = 1.57) (P < 0.01). Additionally, intake of oral hypoglycemic agents, calcium channel blockers (CCB), insulin, and diuretics were significantly higher in the periodontitis group with OR = 2.49, 2.32, 2.08 and 1.79, respectively (P < 0.05). Several medications demonstrated a disease severity-dependent association comparing generalized severe periodontitis with moderate periodontitis and healthy group: oral hypoglycemic agents (17.4% versus 16.8% versus 8.0%), CCB (14.8% versus 14.4% versus 8.0%) and anticonvulsants (13.4% versus 7.7% versus 6.4%) with OR of 2.43, 1.99, and 2.28 (severe periodontitis versus healthy group), respectively. CONCLUSION There was a significantly higher frequency of medication intake related to cardiovascular disease and diabetes in patients with periodontitis. A disease severity-dependence with medication intake frequency was also noted. This study provides indirect evidence for the possible relationship between systemic diseases and periodontitis.
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Affiliation(s)
- I-Ching Wang
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Houssam Askar
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Iya Ghassib
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Chin-Wei Wang
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Oral Medicine and Periodontics, University of Michigan, Ann Arbor, MI
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Lam PC, John DA, Galfalvy H, Kunzel C, Lewis-Fernández R. Oral Health-Related Quality of Life Among Publicly Insured Mental Health Service Outpatients With Serious Mental Illness. Psychiatr Serv 2019; 70:1101-1109. [PMID: 31522632 DOI: 10.1176/appi.ps.201900111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study investigated factors associated with unmet need for dental care and oral health-related quality of life (OHQoL) among individuals with serious mental illness receiving outpatient care in a public mental health program serving a largely low-income population, mostly from racial-ethnic minority groups. METHODS Cross-sectional interview data were collected from a convenience sample (N=150) of outpatients. Adjusted risk ratios (ARRs) and adjusted risk differences (ARDs) were estimated by logistic regression models to examine the independent contribution of sociodemographic and clinical factors to low OHQoL and past-year unmet dental need, defined as inability to obtain all needed dental care. RESULTS More than half of participants reported low OHQoL (54%) and a past-year dental visit (61%). Over one-third (39%) had past-year unmet dental need. Financial barriers (ARR=3.16) and nonfinancial barriers (ARR=2.18) were associated with greater risk for past-year unmet dental need after control for age, gender, high dental anxiety, and limited English proficiency. ARDs for financial and nonfinancial barriers indicated absolute differences of 40 and 27 percentage points, respectively. Unmet dental need (ARR=1.31), xerostomia severity (ARR=1.20), and a schizophrenia spectrum diagnosis (ARR=1.33) were associated with low OHQoL, after control for age and current smoking, with ARDs ranging from 11 to 15 percentage points. CONCLUSIONS Improving oral health promotion, oral health service access, and the integration of the mental and oral health systems may help reduce the high prevalence of low OHQoL in this population, given that low OHQoL is partly driven by unmet dental need.
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Affiliation(s)
- Peter C Lam
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Dolly A John
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Hanga Galfalvy
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Carol Kunzel
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Roberto Lewis-Fernández
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
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Periodontal disease and effects of antipsychotic medications in patients newly diagnosed with schizophrenia: a population-based retrospective cohort. Epidemiol Psychiatr Sci 2019; 29:e49. [PMID: 31526409 PMCID: PMC8061124 DOI: 10.1017/s204579601900043x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIM Compared with the general population, individuals with schizophrenia have a higher risk of periodontal disease, which can potentially reduce their life expectancy. However, evidence for the early development of periodontal disease in schizophrenia is scant. The current study investigated risk factors for periodontal disease in patients newly diagnosed with schizophrenia. METHODS We identified a population-based cohort of patients in Taiwan with newly diagnosed schizophrenia who developed periodontal disease within 1 year of their schizophrenia diagnosis. Treatment with antipsychotics and other medications was categorised according to medication type and duration, and the association between medication use and the treated periodontal disease was assessed through logistic regression. RESULTS Among 3610 patients with newly diagnosed schizophrenia, 2373 (65.7%) had an incidence of treated periodontal disease during the 1-year follow-up. Female sex (adjusted odds ratios [OR] 1.40; 95% confidence interval [CI] 1.20-1.63); young age (adjusted OR 0.99; 95% CI 0.98-0.99); a 2-year history of periodontal disease (adjusted OR 2.45; 95% CI 1.84-3.26); high income level (adjusted OR 2.24; 95% CI 1.64-3.06) and exposure to first-generation (adjusted OR 1.89; 95% CI 1.54-2.32) and secondary-generation (adjusted OR 1.33; 95% CI 1.11-1.58) antipsychotics, anticholinergics (adjusted OR 1.24; 95% CI 1.03-1.50) and antihypertensives (adjusted OR 1.91; 95% CI 1.64-2.23) were independent risk factors for periodontal disease. Hyposalivation - an adverse effect of first-generation antipsychotics (FGAs) (adjusted OR 2.00; 95% CI 1.63-2.45), anticholinergics (adjusted OR 1.27; 95% CI 1.05-1.53) and antihypertensives (adjusted OR 1.90; 95% CI 1.63-2.22) - was associated with increased risk of periodontal disease. Therefore, hypersalivation due to FGA use (adjusted OR 0.72; 95% CI 0.59-0.88) was considered a protective factor. CONCLUSIONS The current study highlights that early prevention of periodontal disease in individuals with schizophrenia is crucial. Along with paying more attention to the development of periodontal disease, assessing oral health regularly, helping with oral hygiene, and lowering consumption of sugary drinks and tobacco, emphasis should also be given by physicians to reduce the prescription of antipsychotics to the extent possible under efficacious pharmacotherapy for schizophrenia.
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Schnabl D, Guarda A, Guarda M, von Spreckelsen LMI, Riedmann M, Steiner R, Dumfahrt H. Dental treatment under general anesthesia in adults with special needs at the University Hospital of Dental Prosthetics and Restorative Dentistry of Innsbruck, Austria: a retrospective study of 12 years. Clin Oral Investig 2019; 23:4157-4162. [PMID: 30830265 DOI: 10.1007/s00784-019-02854-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 02/13/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Special needs patients are prone to insufficient oral care and subsequent caries or periodontitis. The aim of this retrospective study was the assessment of demand for restorative therapy and tooth extractions under general anesthesia in adults with intellectual and/or physical disablement (IPD) or psychiatric disorders (PDs) with inherent dentist phobia at the University Hospital of Innsbruck with regard to demographic factors. MATERIALS AND METHODS A total of 444 consecutive cases of scheduled dental general anesthesia (DGA) in adults from 2003 to 2014 were included. From patient files, demographic data, the presence of either IPD or a PD, attested by a mandatory certificate, and restorative therapy and tooth extractions performed under DGA were obtained. Data analysis was carried out by means of descriptive and comparative statistics. RESULTS Four hundred two cases (mean age 37.5 ± 13.87 years) assigned to 283 individuals with IPD and 42 cases (mean age 36.09 ± 13.03 years) assigned to 39 individuals with PDs arose in the observed period. Patients with PDs required significantly more restorations (in 7.98 ± 5.4 versus 5.34 ± 4.41 teeth; p = 0.002; Mann-Whitney U test) and extractions (of 4.86 ± 4.51 versus 2.6 ± 3.96 teeth; p < 0.001; Mann-Whitney U test) than patients with IPD. CONCLUSIONS Demand for dental treatment was high in the collective of special needs patients. Oral health status was worse in patients with PDs than in patients suffering IPD. CLINICAL RELEVANCE While in patients with severe disablement, DGA presents the only treatment option, specific preventive programs should be implemented for patients with minor disablement or dentist phobia. In these patients, alternative approaches should be promoted.
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Affiliation(s)
- Dagmar Schnabl
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria.
| | - Annachiara Guarda
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Maria Guarda
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | | | - Marina Riedmann
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Rene Steiner
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Herbert Dumfahrt
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, 6020, Innsbruck, Austria
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Oral health status of the disabled compared with that of the non-disabled in Korea: A propensity score matching analysis. PLoS One 2019; 14:e0208246. [PMID: 30640962 PMCID: PMC6331121 DOI: 10.1371/journal.pone.0208246] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 11/14/2018] [Indexed: 11/28/2022] Open
Abstract
Background There are many types of disabilities, and each type has a variety related to socioeconomic factors. Such factors affect to many health problems of the disabled. However, surveys of the oral health status of the disabled in Korea are rare. Objective The purpose of this study was to estimate oral health disparity through comparing oral health status of the disabled to the non-disabled, adjusted for the net effect of the disability on oral health status. Methods A cross-sectional study was conducted among the disabled in urban and suburban areas in Korea from June to September 2016. People with physical, mental, and multiple disabilities took part in this survey. The clinical examinations were carried out by trained dentists. Statistical analysis was performed to quantify the association between oral health and socioeconomic status after restricting the analysis using a propensity score matching method. Results The disabled had more DMFT, DT, and MT, fewer FT, and fewer teeth than the non-disabled based on entire groups (P<0.01). No difference in the ratio of periodontitis was observed. The subjects with mental disabilities (MD) scored 3.09 (95% CI, 1.07–8.97), and those with multiple disabilities scored 4.37 (95% CI, 1.16–16.37) for edentulous status. The MD had an odds ratio of 1.34 (95% CI, 1.03–1.74), and those with multiple disabilities had an odds ratio of 1.75 (95% CI, 1.11–2.76) for the DMFT index. Conclusions These results represent poor oral health status of the disabled compared to the non-disabled. Consequentially, we can verify that not only the existence of disability but also the type of disability has a decisive effect on oral health condition. This comparison is necessary to widen our approach to evaluate the actual status condition of the disabled.
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Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
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Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
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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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Stevens T, Spoors J, Hale R, Bembridge H. Perceived oral health needs in psychiatric in-patients: impact of a dedicated dental clinic. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/pb.bp.109.029157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodWe have audited the impact of a dedicated dental clinic on the oral health needs of an inner-city in-patient psychiatric population. A questionnaire assessing patient perception of oral health was undertaken on in-patient wards before opening a dental clinic on the hospital site and 5 months after.ResultsThe audit suggested improvements in patients' perception of oral health, behaviour directed at oral hygiene and knowledge of accessing services after initiation of a dedicated in-patient dental clinic.Clinical implicationsPsychiatric in-patient settings may provide important opportunities for oral health promotion and intervention. This is a neglected component of in-patient care.
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Hartwig AD, Stüermer VM, da Silva-Júnior IF, Schardosim LR, Azevedo MS. Effectiveness of an oral health educational intervention for individuals with special health care needs from a southern Brazilian city. SPECIAL CARE IN DENTISTRY 2017; 37:246-252. [DOI: 10.1111/scd.12246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andreia Drawanz Hartwig
- Graduate Program in Dentistry; Federal University of Pelotas; Rua Gonçalves Chaves 457 96015-560 Pelotas RS Brazil
| | - Vanessa Müller Stüermer
- Graduate Program in Dentistry; Federal University of Pelotas; Rua Gonçalves Chaves 457 96015-560 Pelotas RS Brazil
| | - Ivam Freire da Silva-Júnior
- Graduate Program in Dentistry; Federal University of Pelotas; Rua Gonçalves Chaves 457 96015-560 Pelotas RS Brazil
| | - Lisandrea Rocha Schardosim
- Graduate Program in Dentistry; Federal University of Pelotas; Rua Gonçalves Chaves 457 96015-560 Pelotas RS Brazil
| | - Marina Sousa Azevedo
- Graduate Program in Dentistry; Federal University of Pelotas; Rua Gonçalves Chaves 457 96015-560 Pelotas RS Brazil
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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: 25] [Impact Index Per Article: 3.6] [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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15
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Velasco-Ortega E, Monsalve-Guil L, Ortiz-Garcia I, Jimenez-Guerra A, Lopez-Lopez J, Segura-Egea JJ. Dental caries status of patients with schizophrenia in Seville, Spain: a case-control study. BMC Res Notes 2017; 10:50. [PMID: 28100262 PMCID: PMC5241932 DOI: 10.1186/s13104-016-2368-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/29/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the dental status (DMFT) in patients with schizophrenia compared with a control group. MATERIAL In this case-control study, 50 patients with schizophrenia attended in the Psychiatric Unit at the Virgen Macarena University Hospital of Seville were compared with 50 people (without systemic diseases and not taking psychotropic drugs) in a control group attended in the School of Dentistry of Seville. Decayed, missing and filled teeth (DMFT) were assessed according to the World Health Organization WHO criteria. RESULTS Patients with schizophrenia showed a decayed teeth (DT) score of 7.26 ± 5.69 compared with 6.50 ± 4.37 for patients the control group. These differences were significant and suggest that dental caries are most prevalent in patients with schizophrenia. People who smoked showed significantly higher DT scores in both groups. Among patients with schizophrenia, smokers scored 9.34 ± 5.42 compared with 4.38 ± 4.82 for non-smokers. Among the healthy controls, smokers scored 6.88 ± 4.85 compared with 6.12 ± 3.85 for non-smokers (p < 0.05). Patients with schizophrenia showed a missing teeth (MT) score of 9.10 ± 8.56 compared with 5.38 ± 5.14 in control patients. MT scores increased significantly with age and with smoking in both groups of patients (p < 0.05). Patients with schizophrenia showed a filled teeth (FT) score of 1.38 ± 2.70 compared with 2.34 ± 3.48 in control patients. FT differences in gender and smoking habits between patients with schizophrenia and healthy control subjects were statistically significant (p < 0.05). This data, along with the DT scores, suggests that patients with schizophrenia have extensive untreated dental disease. CONCLUSIONS Patients with schizophrenia constitute a high risk population for dental health. This group showed a greater prevalence of decayed and missing teeth and more extensive treatment needs.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Faculty of Dentistry, Dpto. de Estomatología, University of Sevilla, C/Avicena s/n, 41009 Seville, Spain
| | | | | | | | - J. Lopez-Lopez
- Faculty of Dentistry, University of Barcelona, Barcelona, Spain
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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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Kisely S. No Mental Health without Oral Health. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:277-82. [PMID: 27254802 PMCID: PMC4841282 DOI: 10.1177/0706743716632523] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The poor physical health faced by people with mental illness has been the subject of growing attention, but there has been less focus on the issue of oral health even though it is an important part of physical health. This article discusses the two-way association between oral and mental health. In one direction, the prospect of dental treatment can lead to anxiety and phobia. In the other, many psychiatric disorders, such as severe mental illness, affective disorders, and eating disorders, are associated with dental disease: These include erosion, caries, and periodontitis. Left untreated, dental diseases can lead to teeth loss such that people with severe mental illness have 2.7 times the likelihood of losing all their teeth, compared with the general population. Possible interventions include oral health assessments using standard checklists that can be completed by nondental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral.
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Affiliation(s)
- Steve Kisely
- School of Medicine, University of Queensland, Woolloongabba, Australia
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George B, John J, Saravanan S, Arumugham IM, Johny MK. Dental caries status of inmates in central prison, Chennai, Tamil Nadu, India. J Nat Sci Biol Med 2015; 6:S110-2. [PMID: 26604596 PMCID: PMC4630740 DOI: 10.4103/0976-9668.166103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: To understand the dental health among prison inmates, we assessed the dental caries status of central prison inmates in Chennai, India. Materials and Methods: A total of 1060 inmates from three divisions of the central prison in Chennai were assessed by a single investigator for dental caries status based on World Health Organization specifications. Results: Among the inmates, 58.2% of males and 54.2% of females had decayed teeth. About 4.1% of males and 2.9% of females had filled teeth. The mean decayed, missing, filled teeth index was 5.1 and 3.9 for female and male prisoners, respectively. The prevalence of dental caries was highest among inmates younger than 24 years age. Conclusion: Our study suggests that a high proportion of prison inmates was affected by dental caries, which necessitates the need for initiating oral health promotion activities among prison inmates.
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Affiliation(s)
- Benley George
- Department of Public Health Dentistry, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India
| | - Joseph John
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India
| | - S Saravanan
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India
| | - I Meignana Arumugham
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, India
| | - Minimol K Johny
- Department of Conservative Dentistry and Endodontics, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India
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Rosedale M, Strauss SM, Knight C, Malaspina D. Awareness of Prediabetes and Diabetes among Persons with Clinical Depression. Int J Endocrinol 2015; 2015:839152. [PMID: 26060495 PMCID: PMC4427826 DOI: 10.1155/2015/839152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/03/2015] [Indexed: 01/30/2023] Open
Abstract
Background. Major depressive disorder (MDD) is highly comorbid with diabetes, a relationship underappreciated by clinicians. Purpose. Examine the proportion of nonpregnant individuals ≥20 years with MDD and elevated glucose and the demographic and clinical characteristics associated with unrecognized elevated glucose. Methods. 14,373 subjects who participated in the National Health and Nutrition Examination Survey (2007-2012) completed the PHQ-9 depression screen and had hemoglobin A1C (HbA1c) measured. PHQ-9 scores ≥10 and HbA1c scores ≥5.7% were defined as MDD and elevated HbA1c, respectively. Data were analyzed using complex survey sampling software. Results. 38.4% of the sample with MDD had elevated HbA1c readings. Compared with nondepressed subjects, they were significantly more likely to have elevated glucose readings (P = 0.003) and to be aware of their elevated glucose levels if they had a higher body mass index, family history of diabetes, more doctor visits in the past year, a usual care source, health insurance, or were taking hypertension or hypercholesterolemia medications. Conclusions. Many adults with MDD have elevated HbA1c levels, have never been advised of elevated HbA1c, have not received diabetes screening, and have minimal contact with a healthcare provider. Additional opportunities for diabetes risk screening in people with MDD are needed.
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Affiliation(s)
- Mary Rosedale
- New York University College of Nursing, New York, NY 10010, USA
- NYU Langone Medical Center, New York, NY 10016, USA
| | | | - Candice Knight
- New York University College of Nursing, New York, NY 10010, USA
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Ilić S, Knežević R. Oral health in children with intellectual disabilities in Banja Luka municipality. SCRIPTA MEDICA 2015. [DOI: 10.5937/scrimed1501012i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Abstract
BACKGROUND Psychiatric patients have increased comorbid physical illness. There is less information, however, on dental disease, especially tooth decay, despite life-style risk factors or psychotropic-induced dry mouth in this population. Importantly, poor oral health can predispose people to chronic physical disease leading to avoidable admissions to hospital for medical causes. METHODS Using MEDLINE, PsycInfo, EMBASE, and article bibliographies, we undertook a systematic search for studies from the last 25 years regarding the oral health of people with severe mental illness (SMI). Results were compared with the general population. The two outcomes were total tooth loss (edentulism) and dental decay measured through the following standardized measures: the mean number of decayed, missing, and filled teeth or surfaces. RESULTS We identified 25 studies that had sufficient data for a random-effects meta-analysis. These covered 5076 psychiatric patients and 39,545 controls, the latter from either the same study or community surveys. People with SMI had 2.8 the odds of having lost all their teeth compared with the general community (95% confidence interval [CI] = 1.7-4.6). They also had significantly higher decayed, missing, and filled teeth (mean difference = 5.0, 95% CI = 2.5-7.4) and surfaces scores (mean difference = 14.6, 95% CI = 4.1-25.1). CONCLUSION The increased focus on the physical health of people with SMI should encompass oral health. Possible interventions could include oral health assessment conducted using standard checklists that can be completed by non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral.
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Farhadmollashahi L, Lashkaripour K, Bakhshani NM, Faghihinia M. Dental Health Status in Hospitalized Psychiatric Patients in Sistan and Baluchestan Province, Iran. HEALTH SCOPE 2014. [DOI: 10.17795/jhealthscope-21626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mago A, Thyvalikakath TP. Impact of mood disorders on oral health-care utilization among middle-aged and older adults. Community Dent Oral Epidemiol 2014; 42:451-9. [PMID: 24684143 DOI: 10.1111/cdoe.12102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 01/18/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Good oral health improves quality of life and is an integral part of active aging. Similar to some other systemic diseases, mood disorders are more prevalent in middle to older ages and have an associated risk of developing poor oral health. Consequently, people with mood disorders need to have regular dental care. There is scarce evidence in Canada linking mood disorders to the use of professional oral care services. The purpose of this study was to investigate the association between mood disorders and utilization of oral health-care services in a population-based sample of middle aged and older adults in Canada. METHODS Data were extracted from Canadian Community Health Survey - Healthy Aging, 2008. Multinomial logistic regression was used to investigate the association between mood disorders and oral care utilization, adjusted for the confounders. RESULTS Among 30,354 respondents included in our sample, 2162 (6.9%) reported having mood disorders. After adjusting for age, sex, education, marital status, and dental insurance status, the respondents who had mood disorders had a significant increased odds of not visiting a dental professional in the past year (OR:1.21, 95% CI: 1.08-1.35). The association of never visiting a dental professional and mood disorders was even stronger (OR: 1.49, 95% CI: 0.91-2.46). CONCLUSION Mood disorders were found to have a strong association with underutilization of oral care services among aging adults of Canada. Given the associated poor oral health risks for elderly with mood disorders, oral health planners should strengthen the implementation of surveillance programs directed toward better oral health for this disadvantaged subpopulation.
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Affiliation(s)
- Anjali Mago
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Bertaud-Gounot V, Kovess-Masfety V, Perrus C, Trohel G, Richard F. Oral health status and treatment needs among psychiatric inpatients in Rennes, France: a cross-sectional study. BMC Psychiatry 2013; 13:227. [PMID: 24053587 PMCID: PMC3856526 DOI: 10.1186/1471-244x-13-227] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 09/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality and oral health is critical for overall systemic health. But general health care needs in this population are often neglected. Some studies have aimed at determining the oral health status of psychiatric in-patients but to date, no emphasis has been placed on oral health of psychiatric patients in France. The goal of this study was to assess the oral health and treatment needs of institutionalized patients in a large psychiatric hospital, where a dental service was available and free, to compare it with the average population, with psychiatric in-patients in other countries and to provide recommendations for psychiatrists and care-giving staff. METHODS The dental status (DMFT), the oral hygiene (OHIS: Simplified Oral Hygiene Index), the saliva flow rate were recorded on a randomized patient sample. Demographic and medical data were retrieved from the institutional clinical files. RESULTS Among the 161 examined patients, 95 (59.0%) were men and 66 (41.0%) were women. The mean age was 46.9 ± 17.5 years. The majority was diagnosed schizophrenia (36.6%) or mood disorders (21.1%). The mean OHIS was 1.7 ± 1.1. Among the 147 patients who agreed to carry out the salivary examination, the average saliva flow rate was 0.3 g ± 0.3 g/min. Saliva flow under the average rest saliva flow (0.52 mg/min) was found for 80.3% of the patient. The mean DMFT was 15.8 ± 8.8 (D = 3.7 ± 4.4, M = 7.3 ± 9.4, F = 4.7 ± 4.9) and significantly increased with age (p < 0.001) and degree of disability (p = 0.003) (stepwise linear regression). Eighteen patients (11.2%) were edentulous. CONCLUSIONS The DMFT was similar to low income French population but psychiatric patients had almost 4 times more decayed teeth, slightly less missing teeth and 1.5 times less filled teeth. Oral health appeared to be better than in most other countries. But compared to general population, the still unmet dental and prosthetic needs indicated the major need of enhanced access to dental care and specific preventive programs.
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Affiliation(s)
- Valerie Bertaud-Gounot
- EHESP School of Public Health, Epidemiology and Biostatistics Department, Avenue Professor Leon Bernard, CS 74312, 35043 Rennes, France.
| | - Viviane Kovess-Masfety
- EHESP School of Public Health, Epidemiology and Biostatistics Department, Avenue Professor Leon Bernard, CS 74312, 35043 Rennes, France
| | - Catherine Perrus
- Guillaume Régnier Psychiatric Center, 108, av. du Général Leclerc, BP 60321-35703 Rennes, France
| | - Gilda Trohel
- University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex, France,University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9, France
| | - Frederique Richard
- University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex, France,University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9, France
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Kossioni A, Kossionis GE, Polychronopoulou A. Variation in oral health parameters between older people with and without mental disorders. SPECIAL CARE IN DENTISTRY 2013; 33:232-8. [DOI: 10.1111/scd.12004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Anastasia Kossioni
- Assistant Professor, Department of Prosthodontics, Dental School; University of Athens; Greece
| | | | - Argy Polychronopoulou
- Associate Professor, Department of Preventive and Community Dentistry, Dental School; University of Athens; Greece
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An oral health intervention for people with serious mental illness (Three Shires Early Intervention Dental Trial): study protocol for a randomised controlled trial. Trials 2013; 14:158. [PMID: 23714397 PMCID: PMC3669616 DOI: 10.1186/1745-6215-14-158] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 05/13/2013] [Indexed: 11/21/2022] Open
Abstract
Background Oral health is an important part of general physical health and is essential for self-esteem, self-confidence and overall quality of life. There is a well-established link between mental illness and poor oral health. Oral health problems are not generally well recognized by mental health professionals and many patients experience barriers to treatment. Methods/Design This is the protocol for a pragmatic cluster randomised trial that has been designed to fit within standard care. Dental awareness training for care co-ordinators plus a dental checklist for service users in addition to standard care will be compared with standard care alone for people with mental illness. The checklist consists of questions about service users’ current oral health routine and condition. Ten Early Intervention in Psychosis (EIP) teams in Nottinghamshire, Derbyshire and Lincolnshire will be cluster randomised (five to intervention and five to standard care) in blocks accounting for location and size of caseload. The oral health of the service users will be monitored for one year after randomisation. Trial registration Current Controlled Trials ISRCTN63382258.
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Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 2000 2013; 60:15-39. [PMID: 22909104 DOI: 10.1111/j.1600-0757.2011.00425.x] [Citation(s) in RCA: 424] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper middle-income countries, whereas the tooth-loss rates, at the time of writing, are modest for low-income countries. In high-income countries somewhat lower rates for edentulism are found when compared with upper middle-income countries. Around the world, social inequality in tooth loss is profound within countries. The Community Periodontal Index was introduced by the WHO in 1987 for countries to produce periodontal health profiles and to assist countries in the planning and evaluation of intervention programs. Globally, gingival bleeding is the most prevalent sign of disease, whereas the presence of deep periodontal pockets (≥6 mm) varies from 10% to 15% in adult populations. Intercountry and intracountry variations are found in the prevalence of periodontal disease, and these variations relate to socio-environmental conditions, behavioral risk factors, general health status of people (e.g. diabetes and HIV status) and oral health systems. National public health initiatives for the control and prevention of periodontal disease should include oral health promotion and integrated disease-prevention strategies based on common risk-factor approaches. Capacity building of oral health systems must consider the establishment of a financially fair service in periodontal care. Health systems research is needed for the evaluation of population-oriented oral health programs.
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Chu KY, Yang NP, Chou P, Chi LY, Chiu HJ. Dental prosthetic treatment needs of inpatients with schizophrenia in Taiwan: a cross-sectional study. BMC Oral Health 2013; 13:8. [PMID: 23331491 PMCID: PMC3554600 DOI: 10.1186/1472-6831-13-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 01/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need to obtain information on the dental prosthetic treatment needs (DPTNs) of inpatients with schizophrenia is unrecognized. This study aims to assess the DPTNs of this population and investigate the association between these needs and related factors. METHODS The results of an oral health survey involving 1,103 schizophrenic adult inpatients in a long-term care institution in Taiwan were used. Chi-square tests and multiple logistic analyses were used to measure the independent effects of the characteristics of each subject on their DPTNs. RESULTS Of the subjects, 805 (73.0%) were men and 298 (27.0%) were women. The mean age was 50.8 years. A total of 414 (37.5%) required fixed prosthesis, whereas 700 (63.5%) needed removable prosthesis. Multivariate analyses show that fixed prosthesis is associated with age only after adjusting for other potential independent variables. Older subjects who had a lower educational attainment or a longer length of stay required removable prosthesis. CONCLUSIONS The findings of this study show that the DPTNs of schizophrenic inpatients are not being met. Therefore, a special approach to the dental prosthetic treatment of these patients should be developed.
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Affiliation(s)
- Kuan-Yu Chu
- Department of Dentistry, Tao-Yuan General Hospital, DOH, Tao-Yuan, Taiwan.
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Velasco-Ortega E, Segura-Egea JJ, Córdoba-Arenas S, Jiménez-Guerra A, Monsalve-Guil L, López-López J. A comparison of the dental status and treatment needs of older adults with and without chronic mental illness in Sevilla, Spain. Med Oral Patol Oral Cir Bucal 2013; 18:e71-5. [PMID: 23229258 PMCID: PMC3548649 DOI: 10.4317/medoral.18332] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 06/06/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To study the dental status and treatment needs of institutionalized older adults with chronic mental illness compared to a non-psychiatric control sample. STUDY DESIGN The sample size was 100, in which 50 were psychogeriatric patients (study group; SG) classified according to DSM-IV, with a mean age of 69.6 ± 6.7 years, and 50 non-psychiatric patients (control group; CG), with a mean age of 68.3 ± 6.9 years. Clinical oral health examinations were conducted and caries were recorded clinically using the Decayed, Missing and Filled Teeth Index (DMFT). Results were analyzed statistically using the Student's t-test or analysis of variance. RESULTS Caries prevalence was 58% and 62% in SG and CG, respectively. DMFT index was 28.3 ± 6.6 in SG and 21.4 ± 6.07 in CG (p < 0.01). Mean number of decayed teeth was higher in SG (3.1) compared to CG (1.8) (p=0.047). Mean number of missing teeth were 25.2 and 16.4 in SG and CG respectively (p<0.05). DMFT scores were higher in SG in all the age groups (p < 0.01). Mean number of teeth per person needing treatment was 3.4 in SG and 1.9 in CG (p= 0.037). The need for restorative dental care was significantly lower in the SG (0.8 teeth per person) than in the CG (1.7 teeth per person) (p = 0.043). CONCLUSIONS Institutionalized psychiatric patients have significantly worse dental status and more dental treatment needs than non-psychiatric patients.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Department of Stomatology, (section of Gerodontology), School of Dentistry, University of Sevilla, Spain.
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Prosthetic Status and Treatment Needs of Prisoners in Central Prison, Chennai. J Indian Prosthodont Soc 2012; 13:265-8. [DOI: 10.1007/s13191-012-0206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/18/2012] [Indexed: 11/25/2022] Open
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Shah VR, Jain P, Patel N. Oral health of psychiatric patients: A cross-sectional comparision study. Dent Res J (Isfahan) 2012; 9:209-14. [PMID: 22623940 PMCID: PMC3353700 DOI: 10.4103/1735-3327.95238] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Mental illness is associated with physical health. Oral health affects people physically and psychologically and influences how they grow, enjoy life, look, speak, chew, taste food and socialize. Oral health may have lower priority in the context of mental illness and these diverse and changing client group experiences similar oral and dental problems. Objective: To assess oral health problems in psychiatric patients. Materials and Methods: This cross-sectional study included 133 patients attending the psychiatric outpatient department (OPD) as the study group and 133 patients attending the general OPD of the same hospital as the control group. Both groups were examined for oral health status. Results: Mean age of the study group was 40.2 years, 66.17% were males, 66.17% were married and 83.67% belonged to middle or lower class. 39.8% of patients had mental illness for 1-5 years, 88% were self sufficient and 34.6% had healthy oral practices. These results are very much comparable with the control group. Mean decayed missed filled teeth (DMFT) score (2.10) and mean oral hygiene index-simplex (OHI-S) score (3.6) increased with age. Difference in DMFT score with age was not statistically significant (P>0.5) while it was highly significant for OHI-S score (P<0.0001). Periodontal condition worsened as age increased, suggested by community periodontal index. Only 26.7% of patients had healthy gingiva in the age group 20-50 years while it was zero for 50 years and above. This difference is statistically significant (P<0.001).
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Affiliation(s)
- Viral R Shah
- Department of Community Medicine, Shri M. P. Shah Medical College, Jamnagar, Gujarat, India
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Gopalakrishnapillai AC, Iyer RR, Kalantharakath T. Prevalence of periodontal disease among inpatients in a psychiatric hospital in India. SPECIAL CARE IN DENTISTRY 2012; 32:196-204. [DOI: 10.1111/j.1754-4505.2012.00271.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Eltas A, Kartalcı S, Eltas SD, Dündar S, Uslu MO. An assessment of periodontal health in patients with schizophrenia and taking antipsychotic medication. Int J Dent Hyg 2012; 11:78-83. [PMID: 22583707 DOI: 10.1111/j.1601-5037.2012.00558.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Severe periodontal disease is prevalent among patients with schizophrenia and is caused by the side effect of their medication, poor dental hygiene and smoking. The objective of this study was to evaluate whether the rate of periodontal disease could be modulated by changing the salivary flow rate (SFR) because of the use of antipsychotic medications in patients with schizophrenia. METHODS Group A (n=33) included patients who used medications that may cause xerostomia, or dry mouth and Group B (n=20) included patients who used medications that may cause sialorrhea, an excessive secretion of saliva. The participants' periodontal status was assessed using the plaque index (PI), assessing bleeding on probing (BoP), probing pocket depth (PPD) and clinical attachment levels (CAL). RESULTS The mean of PI and BoP was significantly higher in Group A than in Group B (P<0.001), but the PPD, CAL and decayed, missing and filled teeth (DMFT) scores were not significantly different in the two groups according to the statistical results (P>0.05). CONCLUSIONS The researcher concluded that there is a high risk of periodontal disease among patients with schizophrenia, and there is an even higher risk of periodontal disease induced by medication that increased SFR. Preventive dental protocol should be increased during the dental health care of this disadvantaged patient group.
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Affiliation(s)
- A Eltas
- Department of Periodontology, Faculty of Dentistry, Inonu University, Malatya, Turkey
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Comparison of oral health between inpatients with schizophrenia and disabled people or the general population. J Formos Med Assoc 2012; 111:214-9. [DOI: 10.1016/j.jfma.2011.02.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 02/12/2011] [Accepted: 02/19/2011] [Indexed: 11/22/2022] Open
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Kossioni AE, Kossionis GE, Polychronopoulou A. Oral health status of elderly hospitalised psychiatric patients. Gerodontology 2012; 29:272-83. [DOI: 10.1111/j.1741-2358.2012.00633.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Azodo CC, Ezeja EB, Omoaregba JO, James BO. Oral health of psychiatric patients: the nurse's perspective. Int J Dent Hyg 2011; 10:245-9. [PMID: 22192470 DOI: 10.1111/j.1601-5037.2011.00537.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess nurses' perspectives on character, prevalence and cause of oral diseases among psychiatric patients and also their approach and suggestions in relation to the care of oral problems. MATERIALS AND METHODS A questionnaire-based cross-sectional survey of all cadres of nurses (n = 136) at the Federal Psychiatric Hospital, Benin City, Nigeria, was conducted between December 2010 and January 2011. RESULTS Two-thirds (67.6%) of the respondents reported that psychiatric in-patients in comparison with the general population have a higher occurrence of oral and dental problems. Commonly cited reasons for the poor oral health of patients included as follows: sedation for long periods, lack of care by family, psychopathological symptoms, poor access to dentists and lack of oral hygiene advice. The common oral health complaints received by the respondents included toothache, pain from the gums and inability to open the mouth. Majority (91.4%) of respondents claimed to be presently involved with oral care of psychiatric in-patients but oral care delivery is however bedevilled with lot of barriers like uncooperativeness of patients and lack of oral care materials. CONCLUSION Oral complaints received are frequent and numerate with limited palliative action rendered. Attaching dentists to psychiatric hospitals and regular training of psychiatric nurses on oral care delivery are recommended to comprehensively cater for the oral health problems of psychiatric in-patients.
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Affiliation(s)
- C C Azodo
- Department of Periodontics, University of Benin, Benin City, Edo State, Nigeria.
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Adeniyi AA, Ola BA, Edeh CE, Ogunbanjo BO, Adewuya AO. Dental status of patients with mental disorders in a Nigerian teaching hospital: a preliminary survey. SPECIAL CARE IN DENTISTRY 2011; 31:134-7. [PMID: 21729122 DOI: 10.1111/j.1754-4505.2011.00193.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although individuals with mental disorders are reported to experience dental problems similar to the general population, evidence suggests they actually have higher risks of dental disease and increased oral health needs. This study describes the dental status of 105 psychiatric outpatients in a Nigerian hospital. Information was obtained from subject interviews, medical records, and an oral examination to determine their dental caries and periodontal disease status. The oral hygiene status of the study participants was poor; the mean oral hygiene index score was 2.7 ± 1.20. The decayed, missing, and filled teeth ranged from 0 to 9 with a mean of 2.3 ± 2.28. Only five subjects (4.9%) had restorations and the mean number of filled teeth was .14 ± .67. The subjects' age was significantly related to the mean oral hygiene score (p= .005), the mean gingival score (p= .006), and caries occurrence (p= .047). The oral health status of psychiatric patients in Nigeria is poor, indicating the need to provide oral health education and increase access to dental care for these patients.
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Affiliation(s)
- Abiola A Adeniyi
- Preventive Unit, Dental Department, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.
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Kisely S, Quek LH, Pais J, Lalloo R, Johnson NW, Lawrence D. Advanced dental disease in people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry 2011; 199:187-93. [PMID: 21881097 DOI: 10.1192/bjp.bp.110.081695] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Psychiatric patients have increased comorbid physical illness. There is less information concerning dental disease in this population in spite of risk factors including diet and psychotropic side-effects (such as xerostomia). Aims To compare the oral health of people with severe mental illness with that of the general population. METHOD A systematic search for studies from the past 20 years was conducted using Medline, PsycINFO, Embase and article bibliographies. Papers were independently assessed. The primary outcome was total tooth loss (edentulousness), the end-stage of both untreated caries and periodontal disease. We also assessed dental decay through standardised measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS). For studies lacking a control group we used controls of similar ages from a community survey within 10 years of the study. RESULTS We identified 21 papers of which 14 had sufficient data (n = 2784 psychiatric patients) and suitable controls (n = 31 084) for a random effects meta-analysis. People with severe mental illness had 3.4 times the odds of having lost all their teeth than the general community (95% CI 1.6-7.2). They also had significantly higher scores for DMFT (mean difference 6.2, 95% CI 0.6-11.8) and DMFS (mean difference 14.6, 95% CI 4.1-25.1). Fluoridated water reduced the gap in oral health between psychiatric patients and the general population. CONCLUSIONS Psychiatric patients have not shared in the improving oral health of the general population. Management should include oral health assessment using standard checklists that can be completed by non-dental personnel. Interventions include oral hygiene and management of xerostomia.
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Affiliation(s)
- Steve Kisely
- Health LinQ, Room 518(A), MacGregor Building (No. 64), University of Queensland, St Lucia, Brisbane, Qld 4072, Australia.
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Arnaiz A, Zumárraga M, Díez-Altuna I, Uriarte JJ, Moro J, Pérez-Ansorena MA. Oral health and the symptoms of schizophrenia. Psychiatry Res 2011; 188:24-8. [PMID: 21055830 DOI: 10.1016/j.psychres.2010.09.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 09/10/2010] [Accepted: 09/27/2010] [Indexed: 10/18/2022]
Abstract
The objectives of this study were to evaluate the oral health of a group of schizophrenic outpatients and a control group without psychiatric illness. The study also aimed to assess the influence of positive and negative symptomatology on oral health among outpatients with schizophrenia. The DMF-T Index (sum of decayed, missing and filled teeth) and the Community Periodontal Index of Treatment Needs (CPITN) were assessed in both groups. We evaluated the psychopathological state of the patient group using the Positive and Negative Syndrome Scale (PANSS). The schizophrenic patients had higher scores than the control group with respect to decayed teeth (4.39 vs. 0.72), missing teeth (5.66 vs. 1.50), the DMF-T index (13.51 vs. 7.8) and CPITN (2.32 vs. 1.04); and lower scores for filled teeth (3.53 vs. 5.54). The PANSS negative subscale score correlated positively with the oral health variables studied, whereas the PANSS positive subscale score correlated negatively and exclusively with the number of missing teeth. Age and smoking status affected oral health in both groups, but even when the influence of these factors was considered, the oral health of the patients was poorer than that of the control group.
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Affiliation(s)
- Ainara Arnaiz
- Servicio de Rehabilitación, Hospital de Zamudio, Osakidetza, Zamudio, Vizcaya, Spain.
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Teng PR, Su JM, Chang WH, Lai TJ. Oral health of psychiatric inpatients: a survey of central Taiwan hospitals. Gen Hosp Psychiatry 2011; 33:253-9. [PMID: 21601722 DOI: 10.1016/j.genhosppsych.2011.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Revised: 02/26/2011] [Accepted: 03/01/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective was to investigate the status of oral health and its determinants in a group of psychiatric inpatients in central Taiwan. METHOD A cross-sectional study of the oral health of psychiatric inpatients (n=200) in three hospitals in central Taiwan was carried out during a half-year period. Demographic data and data on oral health habits, dental visit frequency, treatment fear and dental health knowledge were collected. Oral health was determined by the Decayed/Missing/Filled Teeth (DMFT) index, Community Periodontal Index (CPI), Plaque Index and Gingival Index. RESULTS In terms of prevalence of caries, the mean DMFT score for all patients was 14.9 ± 8.8 (S.D.), which was significantly worse than that in the general population. The CPI showed that only 10% of patients were periodontally healthy, 9.5% had bleeding, 31% had calculus and 49.5% had periodontal pockets. Increasing age, treatment anxiety, neglect of tooth-brushing and chronic ward inpatients were predictive factors for poor periodontal health. The self-awareness of poor oral health was inadequate and the treatment needs were huge in psychiatric inpatients. CONCLUSION The oral health of psychiatric inpatients was poor compared with the general population and was generally ignored by the patients themselves. The phenomenon is universal, occurring in both Western and Eastern countries.
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Affiliation(s)
- Po-Ren Teng
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, Lu-Kang, Taiwan
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Jovanovic S, Milovanovic SD, Gajic I, Mandic J, Latas M, Jankovic L. Oral health status of psychiatric in-patients in Serbia and implications for their dental care. Croat Med J 2011; 51:443-50. [PMID: 20960594 DOI: 10.3325/cmj.2010.51.443] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To determine oral health status and identify predictors of oral health in a representative sample of psychiatric in-patients in Serbia. METHODS The study included 186 psychiatric in-patients and 186 control participants without psychiatric illness matched to the study group by age, sex, marital status, education level, employment, and monthly income. Dental examinations were done in both groups to measure the following indices of oral health: decayed, missing, and filled teeth (DMFT) index; community periodontal index; and plaque index. Participants were also interviewed about their dental health behavior and their medical records were examined. RESULTS Psychiatric in-patients had higher caries prevalence, poorer periodontal health, and poorer oral hygiene than controls. The average DMFT score in the patient group was 24.4 and 16.1 in the control group (P<0.001). Periodontal diseases were significantly more prevalent among psychiatric in-patients than among controls (P<0.001). The average plaque index for patients was 2.78 and 1.40 for controls (P<0.001). Multiple regression analysis demonstrated that 1) DMFT index was associated with age, male sex, duration of mental illness, use of antidepressants, time since the last visit to the dentist, and snacking frequency; 2) community periodontal index was associated with male sex; and 3) plaque index was associated with age, male sex, education level, employment, monthly income, tooth brushing technique, and snacking frequency. CONCLUSION Psychiatric in-patients in Serbia have poorer oral health than healthy controls. It is necessary to intensify preventive dental care in this vulnerable population.
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Affiliation(s)
- Svetlana Jovanovic
- Department of Public Health, School of Dentistry, University of Belgrade, Dr Subotica 1, 11 000 Belgrade, Serbia.
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Abstract
INTRODUCTION Oral diseases in psychiatric patients are usually a result of bad oral hygiene and psychopharmaceutical side-effects. OBJECTIVE The aim of this study was to detect oral lesions in patients hospitalized in psychiatric institutions with the confirmed diagnosis of psychiatric illness and mood disorder with psychotic characteristics, as well as to discover the factors that can influence these oral lesions. METHODS Cross-section study consisted of 186 hospitalized patients with psychiatric disorders in the experimental group, out of whom 87 were males and 99 females. Patients were aged from 18 to 59 years, mean age 46.0 +/- 8.0 years. The control group consisted of 186 healthy persons matched for age and gender. Data on oral lesions were obtained within history and clinical examination of the oral cavity. Other medical data were collected from medical documentation. Statistical analysis was performed by Student's t-test, chi-square test and logistic regression. RESULTS Dry mouth was registered in 78.5% of patients. The difference in tongue and lip lesions, burning and stinging symptoms, bruxism, facial pain, low saliva rates, halitosis, taste changes and swallowing difficulties between the patients and healthy persons was highly statistically significant (p < 0.001). Age and gender, as well as the factors of main disease, influence burning and stinging, bruxism, low saliva rates, swallowing difficulties, taste changes and facial pain of the psychiatric patients. CONCLUSION Results imply that psychiatric patients are more frequently involved with oral lesions than healthy persons. It is necessary to organize specific preventive and educational oral health programmes with these patients, as well as with doctors who treat the basic illness.
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Factors associated with dental caries among institutionalized residents with schizophrenia in Taiwan: a cross-sectional study. BMC Public Health 2010; 10:482. [PMID: 20707911 PMCID: PMC2931468 DOI: 10.1186/1471-2458-10-482] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 08/13/2010] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Little research has been done on the relationship between dental caries and the personal characteristics of institutionalized residents diagnosed with schizophrenia. This study investigates the individual and treatment factors associated with the dental caries among institutionalized residents with schizophrenia in Taiwan. METHODS An oral health survey of institutionalized residents with schizophrenia in the largest public psychiatric hospital was conducted in Taiwan in 2006. Based on this data, multiple logistic analyses were used to determine the relationship between some explanatory variables and the outcome variables of dental caries among subjects with schizophrenia. RESULTS Among the 1,108 subjects with schizophrenia, age was the only variable independently associated with DMFT > 8 (OR = 7.74, 95% CI = 3.86-15.55, p < 0.001 in comparison to residents aged 65 + years vs. 20-44 years; OR = 3.06, 95% CI = 2.03-4.61, p < 0.001 in comparison to residents aged 55-64 years vs. 20-44 years) after making adjustments for other explanatory variables. In addition, those with an education of only elementary school (OR = 1.67, 95% CI = 1.08-2.56, p = 0.021), low income (OR = 1.58, 95% CI = 1.02-2.44, p = 0.039), and length of stay (LOS) of > 10 years (OR = 2.09, 95% CI = 1.30-3.37, p = 0.002) were associated with a care index < 54.7%. Older age, lower educational level, and longer hospital stays were associated with number of remaining teeth being < 24. CONCLUSIONS Aging was the most important factor related to a high level of dental caries. Low educational level, low income, and LOS were also associated with the indicators of dental caries among institutionalized subjects with schizophrenia. It is necessary to address the treatment factors such as prolonged stay in institutions when decision-makers are planning for preventive strategies of oral health for institutionalized residents with schizophrenia.
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[Health habits, attitudes and behaviour towards oral health of psychiatric patients]. SRP ARK CELOK LEK 2010; 138:136-42. [PMID: 20499491 DOI: 10.2298/sarh1004136j] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION People with psychiatric disorders are at high risk of oral diseases due to the impact of their primary psychiatric condition and the side-effects of antipsychotic medications. OBJECTIVE The aim of this study was to identify habits, attitudes and behaviour towards oral health of hospitalized psychiatric patients with psychotic disorders, including mood disorders with psychotic characteristics, as well as to identify factors that could influence those habits, attitudes and behaviour. METHODS The experimental group consisted of 186 hospitalized patients with psychiatric disorders (87 males and 99 females), aged from 18 to 59 years (mean age 46.0-8.0 years). The control group consisted of 186 healthy persons matched for age and gender. Data were obtained by using specially designed questionnaires with questions about the subjects' social, economic and demographic characteristics, as well as their habits, attitudes and behaviour concerning their oral health, in a form of a standardized interview. Other medical data were collected from medical documentation of disease history. Statistical analysis was performed by Student's t-test, Chi-square test, ANOVA, Logistic Regression and simultaneous multiple regression. RESULTS Psychiatric patients have worse habits, attitudes and behaviour concerning their oral health in comparison with healthy persons (p < 0.001): they wash their teeth more rarely and in a shorter time, have less knowledge of oral diseases and their effect on general health, and visit their dentist more rarely. The obtained results depend on social, economic and demographic characteristics and on the underlying illness of patients. CONCLUSION Health educational work concerning oral health of patients should be included in psychiatric treatment, as a part of an existing therapy with the aim of improving the general quality of their life.
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Zusman SP, Ponizovsky AM, Dekel D, Masarwa AES, Ramon T, Natapov L, Grinshpoon A. An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel. SPECIAL CARE IN DENTISTRY 2010; 30:18-22. [DOI: 10.1111/j.1754-4505.2009.00118.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dellavia C, Allievi C, Ottolina P, Sforza C. Special care dentistry for people with intellectual disability in dental education: an Italian experience. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2009; 13:218-222. [PMID: 19824958 DOI: 10.1111/j.1600-0579.2009.00578.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM This study documented: (i) the curriculum in special care dentistry in the Italian dental schools, as perceived by Deans and by students, (ii) the rate of satisfaction of dental students with their curricular education in special care dentistry, (iii) the attitude of the dental students towards special care dentistry and towards the 'Special Smiles' programme. METHODS The quality and amount of didactic and clinical training delivered by each dental school for subjects with intellectual disability (ID), the interest of students towards this health field and the 'Special Smiles' programme were collected. Self-administered surveys were sent to the Dean and to all the final year students of all dental schools in 20 Italian Universities. RESULTS Only four Deans of the 20 dental schools answered the survey, stating to provide didactic and clinical education in special care dentistry. A 51% of student response rate was obtained. Dental students reported to spend about 4% of didactic and 5% of clinical training in the dental care for ID subjects. Most students (83%) rated the training they had received on the topic to be poor. Over 50% of students expressed interest in working in dental offices specifically dedicated to ID patients and 25% of students wished to become Special Smiles volunteers. CONCLUSIONS Although the paucity of didactic and clinical training in dental care for ID patients, this survey demonstrated a high level of student's interest in learning more about treating these subjects. The current results could suggest to revise the curricular standards of dental schools, by promoting ID-oriented education programmes.
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Affiliation(s)
- C Dellavia
- Department of Human Morphology, Functional Anatomy Research Center, University of Milan, Milan, Italy.
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Persson K, Axtelius B, Söderfeldt B, Ostman M. Monitoring oral health and dental attendance in an outpatient psychiatric population. J Psychiatr Ment Health Nurs 2009; 16:263-71. [PMID: 19291155 DOI: 10.1111/j.1365-2850.2008.01364.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Impaired mental health has been associated with an increased need for dental care. Population surveys have indicated that people with enduring mental health problems make less frequent planned visits to the dentist and report a greater number of missing teeth than the general population. The study aims to examine oral health status, attendance to dental care, and medication in an outpatient psychiatric sample. A descriptive study combining a structured interview with a visual oral examination carried out in 113 outpatients under psychiatric care. Dental health was described in terms of sound, missing and/or filled teeth, and showed a relation between these categories and types of psychiatric diagnosis, age and numbers of antidepressant and neuroleptic drugs. Oral hygiene was found to be more neglected among men and in patients with the diagnosis of schizophrenia. The need of dental treatment was widespread, although regular dental visits were commonly reported. In order to maintain good oral health, regular dental check-ups should be encouraged for patients under psychiatric care. Further studies are required to reveal contributory causes for/to decreased oral health. The difficulty such individuals have in maintaining additional self-efficacy raises questions about the necessity for oral health interventions in outpatient psychiatric services.
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Affiliation(s)
- K Persson
- Faculty of Health and Society, Malmö University, Malmö, Sweden.
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Dellavia C, Allievi C, Pallavera A, Rosati R, Sforza C. Oral health conditions in Italian Special Olympics athletes. SPECIAL CARE IN DENTISTRY 2009; 29:69-74. [DOI: 10.1111/j.1754-4505.2008.00065.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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