Factors which influence the oral condition of chronic schizophrenia patients (original) (raw)
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Dental Health and the Type of Antipsychotic Treatment in Inpatients with Schizophrenia
2015
AIM This study examined the association between dental conditions in hospitalized patients with ICD-10 schizophrenia and type of antipsychotic treatment. Based on the literature suggesting that atypical antipsychotics are thought to be more tolerable than typical antipsychotics, we hypothesized that hospitalized patients with schizophrenia treated with atypicals would have better dental health than those treated with typicals alone or with a combination of both (combined group). METHODS A representative sample of 348 patients (69% males), aged 51.4 (SD=14.5, range 31-58) years, was assessed on the standardized criteria of the Decayed, Missing and Filled Teeth (DMFT) index and component scores. Data on medication were extracted from patients' electronic medical records. RESULTS Patients treated with typicals had significantly higher DMFT index scores than those who received atypicals (23.5±9.9 vs. 19.0±10.5; p < 0.05), and higher Missing (20.2±11.6 vs. 13.5±11.2; p < 0.01) ...
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Background. Schizophrenic disturbances are a group of disorders that influence approximately one percent of the overall population. The symptoms of schizophrenia can be divided into several groups. There are positive symptoms and negative symptoms, general psychopathological symptoms and disintegration or disorganization symptoms. As far as dental healthcare is concerned, that group of patients has serious problems with improper hygiene of the oral cavity. Additionally, those patients are usually not concerned about their own state of health. Objectives. Assessment of state of the oral cavity in schizophrenic inpatients treated with atypical and classical neuroleptics and its comparison with a healthy group; assessment of the efficiency of pro-hygienic activities conducted in the researched groups and the control group. Material and Methods. The research group was comprised of patients of the Psychiatric Clinical Ward of the Medical University of Silesia (MUS) in Tarnowskie Góry, Poland. The research group was comprised of 100 schizophrenics (male and female), treated with atypical (group 1) and classical neuroleptics (group 2). The control group was comprised of 50 healthy people who did not stay at the hospital and who, during the interview, did not give any information about the possible diagnosis of any physical illness in their cases (group 3). Each group was randomly divided into subgroups 1A, 2A and 3A, where professional hygienic training was provided, and into subgroups 1B, 2B and 3B, where such training was not provided. The patients were assessed for DMFT (decayed, missing, filled and total), OHI (oral hygiene) and API (approximal plaque) indices. Results. In case of patients from the research group (1 and 2), all components of the DMFT index reached values that indicated a less than satisfactory state of the dentition when compared to the control group. Schizophrenics do not maintain proper hygiene of the oral cavity and can be classified in the highest range that corresponds to the description "bad or average hygiene level". Conclusions. Schizophrenics show significantly less interest in hygiene of the oral cavity and the state of their own dentition. Atypical neuroleptics used in the process of pharmacotherapy of schizophrenia can have an advantageous influence on the degree of interest of the treated person on the state of hygiene of their oral cavity. Patients undergoing treatment with classical neuroleptics should be taken under particular care, as the effectiveness of dental hygienic activities in that group, including hygienic training for the oral cavity, is lower than in the group which was treated with atypical neuroleptics .
Schizophrenia and Oral Healthcare
Dental Update, 2004
Schizophrenia is a relatively common form of psychotic illness, which can be extremely debilitating. This article aims to present an overview for the dental team, including the implications for oral health and dental treatment.
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 devia- tion=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 ill- ness. 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.
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.
The Effect of Antipsychotic Drugs on Salivary Flow Rate and Dental Caries in Schizophrenic Patients
This study sought to ascertain how antipsychotics affected patients with schizophrenia's salivary flow and risk of dental caries. 24 individuals with recently diagnosed schizophrenia who were given antipsychotic medication by a licensed psychiatrist made up the study population. Patients with schizophrenia who are on first-generation antipsychotic medications make up 12 participants, while patients with schizophrenia who are taking second-generation antipsychotic medications make up another 12 participants. Participants' oral health status was assessed using the decay index/missing/filled teeth (DMFT) and salivary flow rate. The results of this study indicate that in the first-generation group, 50.0% of patients were hydrated for 30 to 60 seconds, 66.7% of patients had foamy or bubbly saliva, 50% of patients had a PH of 6.0 to 6.8, and the mean salivation rate was 0.13 ± 0.06 milliliters per minute. In the second-generation group B, the mean salivation rate was 0.24 ± 0.09 (ml/min), 66.7% of patients had frothy or bubbly saliva, 66.7% had saliva with a PH of 6.8-7.8, and 58.3% had hydration 30 seconds. In terms of DMFT, 41.6 and 41.7% of patients in both groups they have had DMFT 0 at day zero. The DMFT score of zero, however, rapidly reduced in the second-generation group while remaining constant in the first-generation group. At 12 months, the variations in DMFT between the two groups were statistically significant (P <0.005). In conclusion, 2nd generation drug recipients with schizophrenia had much better oral health than the 1st generation group.
The oral health of people with chronic schizophrenia: A neglected public health burden
The Australian and New Zealand journal of psychiatry, 2015
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. 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. 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 ...
2017
1La Chartreuse Psychiatric Centre, 21033 Dijon, France. 2USMR-Réseau d’aide Méthodologiste, University Hospital of Dijon, 21079 Dijon Cedex, France. 3Direction de la Recherche Clinique, University Hospital of Dijon, 21079 Dijon Cedex, France. 4Department of Psychiatry, Robert Morlevat Hospital Center, 21140 Semur-en-Auxois, France. 5Department of Psychiatry and Addictology, University Hospital of Dijon, 21079 Dijon Cedex, France. 6Department of Psychiatry, Montreal University, Yale Program for Recovery and Community Health, 7401 Montréal, Canada. 7Regional forum of education and health promotion, 21000 Dijon, France.
Dental conditions in inpatients with schizophrenia: A large-scale multi-site survey
BMC Oral Health, 2012
Background Clinical relevance of dental caries is often underestimated in patients with schizophrenia. The objective of this study was to examine dental caries and to identify clinical and demographic variables associated with poor dental condition in patients with schizophrenia. Methods Inpatients with schizophrenia received a visual oral examination of their dental caries, using the decayed-missing-filled teeth (DMFT) index. This study was conducted in multiple sites in Japan, between October and December, 2010. A univariate general linear model was used to examine the effects of the following variables on the DMFT score: age, sex, smoking status, daily intake of sweets, dry mouth, frequency of daily tooth brushing, tremor, the Clinical Global Impression-Schizophrenia Overall severity score, and the Cumulative Illness Rating Scale for Geriatrics score. Results 523 patients were included in this study (mean ± SD age = 55.6 ± 13.4 years; 297 men). A univariate general linear model s...