Author:
Kisely Steve,Quek Lake-Hui,Pais Joanne,Lalloo Ratilal,Johnson Newell W.,Lawrence David
Abstract
BackgroundPsychiatric 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).AimsTo compare the oral health of people with severe mental illness with that
of the general population.MethodA 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.ResultsWe 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.ConclusionsPsychiatric 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.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
132 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献