Prevalence of dental caries in hospitalized patients with schizophrenia
Abstract
Background/Aim. It is considered that over 450 million people worldwide suffer from some form of mental disorder. Previous studies in other countries have shown that schizophrenia is among the most frequent. Oral health is significant for general health and should not be separated from mental health. Studies in other countries have shown an increased incidence of carious and extracted teeth, and less incidence of filled teeth in this group of psychiatric patients. The aim of this study was to establish condition of the existing teeth, to determine the prevalence of caries and to consider possible risk factors that contribute to the current oral health status of hospitalized patients with schizophrenia. Methods. The study comprised 190 patients with schizophrenia, hospitalized at the Clinic for Psychiatric Disorders “Dr. Laza Lazarević” in Belgrade, and 190 mentally healthy patients at the Clinic for Periodontology and Oral Medicine, Faculty of Dental Medicine in Belgrade. The decayed, missing, filled (DMF) index, sociodemographic and economic characteristics were registered in both groups, as well as characteristics of the primary disease of hospitalized patients with schizophrenia. Results. The value of DMF index (representing the sum of carious, extracted and filled teeth), in the hospitalized patients with schizophrenia was 18.57 ± 7.07 and 12.47 ± 5.64 in the healthy group (p = 0.000). The structure of the DMF index in the study group showed that caries and extracted teeth dominated with 88.1%; in the control group, filled teeth dominated with 55.6%, which was a statistically significant difference for all the three observed variables. Conclusion. Hospitalized patients with schizophrenia had twice as many caries and extracted teeth, and five time less filled teeth than healthy people. The patient’s age and taking antiparkinsonics were established as predictors of the increased DMF index in hospitalized patients with schizophrenia.
References
World Health Organization. Promoting mental health: Concepts, emerging evidence, practice. Geneva: World Health Organiza-tion; 2005.
World Health Organization. Investing in mental health: Evi-dence for action. Geneva: World Health Organization; 2003.
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(1): e71−5.
Morales-Chavez MC, Rueda-Delgado YM, Pena-Orozco DA. Preva-lence of bucco-dental pathologies in patients with psychiatric disorders. J Clin Exp Dent 2014; 6(1): 7−11.
Kossioni AE, Kossionis GE, Polychronopoulou A. Oral health status of elderly hospitalised psychiatric patients. Gerodontology 2012; 29(4): 272−83.
Bertaud-Gounot V, Kovess-Masfety V, Perrus C, Trohel G, Richard F. Oral health status and treatment needs among psychiatric in-patients in Rennes, France: a cross-sectional study. BMC Psy-chiatry 2013; 13: 227.
Zusman SP, Ponizovsky AM, Dekel D, Masarwa A, Ramon T, Na-tapov L, et al. An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel. Spec Care Dentist 2010; 30(1): 18−22.
Ministry of Health, Serbia. National guideline of good clinical practice for diagnostic and theraphy of schizophrenia. Availa-ble from: http://www.batut.org.rs/download/aktuelno/klinicka%20praksa/Shizofrenija.ppd (Serbian)
Đukić Dejanović S. Psychiatry. Kragujevac: Faculty of Medicine, University of Kragujevac; 2006. (Serbian)
Griffiths J, Jones V, Leeman I, Lewis D, Patel K, Wilson K, et al. Oral Health Care for People with Mental Health Problems Guidelines and Recommendations. London: British Society for Disability and Oral Health; 2000.
Cormac I, Jenkins P. Understanding the importance of oral health in psychiatric patient. Adv Psychiatr Treat 1999; 5: 53–60.
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(1): 24−8.
Al-Mobeeriek A. Oral health status among psychiatric patients in Riyadh, Saudi Arabia. West Indian Med J 2012; 61(5): 549−54.
Gowda EM, Bhat PS, Swamy MM. Dental health for psychiatric patients. MJAFI 2007; 63(4): 328−30.
Lewis S, Jagger RG, Treasure E. The oral health of psychiatric in-patients in South Wales. Spec Care Dentist 2001; 21(5): 182−6.
Ramon T, Grinshpoon A, Zusman SP, Weizman A. Oral health and treatment needs of institutionalized chronic psychiatric patients in Israel. Eur Psychiatry 2003; 18(3): 101−5.
Marić J. Clinical Psychiatry. Belgrade: Megraf; 2005. (Serbian)
Janković LJ. Oral medicine: practicum. Belgrade: Zavod za udžbenike i nastavna sredstva; 2007. (Serbian)
Petersen PE, Baez RJ, World Health Organisation. Oral health sur-veys: Basic methods. 5th ed. Geneva: World Health Organisa-tion; 2013.
Klein H, Palmer CE, Knutson JW. Studies on dental caries. Public Health Rep 1938; 53: 751−65.
Adeniyl A, Ola B, Edeh C, Ogunbanjo O, Adewuya A. Dental status of patients with mental disorders in a Nigerian teaching hospital: A preliminary survey. Spec Care Dentist 2011; 21(4): 134−7.
Chu KY, Yang NP, Chou P, Chiu HJ, Chi LY. Factors associated with dental caries among institutionalized residents with schiz-ophrenia in Taiwan: A cross-sectional study. BMC Oral Health 2010; 10: 482.
Tani H, Uchida H, Suzuki T, Shibuya Y, Shimanuki H, Watanabe K, et al. Dental conditions in inpatients with schizophrenia: A large-scale multi-site survey. BMC Oral Health 2012; 12: 32.
Krunic J, Stojanovc N, Ivkovic N, Stojic D. Salivary flow rate and decayed, missing and filled teeth (DMFT) in female patients with schizophrenia on chlorpromazine therapy. J Dental Sci 2013; 8(4): 418−24.