A Systematic Review and Meta-Analysis of the Association Between Poor Oral Health and Severe Mental Illness

Kisely, Steve; Baghaie, Hooman; Lalloo, Ratilal; Siskind, Dan; Johnson, Newell W.

doi:10.1097/psy.0000000000000135

Cited by 177 publications

(234 citation statements)

References 51 publications

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“…The biological plausibility for the association between CMD and periodontitis is based on the observation that individuals diagnosed with this psychological condition, in general, are affected by several oral alterations. These oral outcomes are resulted from psychomotor damage, which undermines the necessary motor coordination for an adequate hygiene routine, decreased salivary flow due to drug use, and no access to dental services . CMD can also affect the individual's immune response, making them more susceptible to the development of unhealthy or unhygienic conditions that affect periodontal health …”

Section: Introductionmentioning

confidence: 99%

Common mental disorder is associated with periodontitis

Coelho

Miranda

Cruz

et al. 2019

J of Periodontal Research

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Objectives This research evaluated the association between exposure to common mental disorder (CMD) and the presence of periodontitis. Background Common mental disorder is characterized by the presence of irritation, fatigue, insomnia, forgetfulness, decreased ability to concentrate, anxiety, and depression. It has been associated with several diseases; however, there are few studies that have associated it with periodontitis. Methods This cross‐sectional study was carried out with 621 individuals. Data collection involved the application of a general questionnaire and the self‐reporting questionnaire for diagnosis of CMD. The diagnosis of periodontitis involved a full mouth periodontal examination using: clinical attachment level, probing depth, and bleeding on probing. Prevalence ratios and 95% confidence intervals between CMD (exposure) and periodontitis (outcome) were obtained. Results In the final sample, 38.16% (237) of the individuals were classified with CMD. Among these, 28.27% (67) had periodontitis. Association measurements showed that the occurrence of periodontitis among those exposed to CMD is approximately 50% higher than in those without this mental condition, with statistical significance, after adjustment for age, sex, family income, current smoking habit, alcohol beverage consumption, and cardiovascular disease (PRadjusted = 1.54, 95% CI: [1.13 to 2.10]). Conclusions The findings showed a positive association between exposure to CMD and periodontitis, revealing the importance of broadening public actions targeting mental health, which seems to be related to oral health, mainly due to the high frequency of the diseases in the studied sample.

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Section: Introductionmentioning

confidence: 99%

Common mental disorder is associated with periodontitis

Coelho

Miranda

Cruz

et al. 2019

J of Periodontal Research

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“…Schizophrenic patients have excess mortality (their life expectancy is reduced by 20%) and excess morbidity [3]. Among somatic comorbidities in schizophrenia patients, poor oral health has been reported by many authors and contributes to the overall poor health of these patients [4, 5]. Generally, schizophrenia leads to disturbances in the progression of thought, errors in contextual analysis and errors of logic.…”

Section: Introductionmentioning

confidence: 99%

Psychometric characteristics of the “General Oral Health Assessment Index (GOHAI) » in a French representative sample of patients with schizophrenia

Denis

Hamad²,

Trojak

et al. 2017

BMC Oral Health

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BackgroundThe “General Oral Health Assessment Index” (GOHAI) was widely used in clinical or epidemiological studies worldwide, as it was available for use in different languages. Therefore, the aim of this study was to evaluate the psychometric characteristics of the GOHAI in a representative sample of patients with schizophrenia.MethodsA total of 90 schizophrenic patients (in-patients and out-patients) were recruited from the participants of the “buccodor study” (NCT02167724) between March and September 2015. They were selected using a random stratified sampling method according to their age, sex, or residential area (urban/rural area). GOHAI validity (construct, predictive, concurrent and known group validity) and internal consistency (reliability) were tested. Test-retest reliability was evaluated in 32 subjects.ResultsThe mean age was 47.34 (SD = 12.17). Internal consistency indicated excellent agreement, with a Cronbach’s value of 0.82 and average inter-item correlation of 0.65. Intraclass correlation coefficients for test-retest reliability with 95% confidence intervals were not significantly different (p > 0.05). Construct validity was supported by three factor that accounted for 60.94% of the variance observed. Predictive validity was corroborated as statistically significant differences were observed between a high GOHAI score, which was associated with self-perceived satisfaction with oral health, lower age and high frequency of toothbrushing. Concurrent validity was corroborated as statistically significant relationships were observed between the GOHAI scores and most objective measures of dental status. For known group validity, they was no significant difference of the mean GOHAI score between out or in-patients (p > 0.05).ConclusionAcceptable psychometric characteristics of the GOHAI could help caregivers to develop ways to improve the Oral Health related Quality Of Life of schizophrenic patients.Trial registrationClinical Trials Gov NCT02167724. Date registered 17 June, 2014.

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“…Heaton and colleagues found adults with at least one mental health condition were twice as likely to report having unmet dental need than adults without mental illness. 1 Having some kind of mental illness has been associated with a host of poor oral health outcomes, 2 including periodontal disease, 3 edentulism, 4–5 and increased caries rates in hospitalized patients. 6 …”

Section: Introductionmentioning

confidence: 99%

Oral health in patients taking psychotropic medications: Results from a pharmacy-based pilot study

Heaton¹,

Swigart²,

McNelis³

et al. 2016

Journal of the American Pharmacists Association

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Objectives Individuals with mental illness face an increased risk of oral disease compared to those without mental illness. The goals of this study were to examine the self-reported oral health and dental access of individuals filing psychotropic medication prescriptions; and to determine whether pharmacy patients would choose to speak with a pharmacist about their oral health if given the option to do so. Design Pharmacists across 6 community pharmacies within a local chain identified and surveyed adult patients filling prescriptions for psychotropic medications. Surveys included questions about oral health, dry mouth, and dental care utilization. Setting Six community pharmacy locations. Participants Adults (18+ years) filling prescriptions for psychotropic medications. Intervention Not applicable. Main Outcome Measures Self-reported oral health, dental utilization, desire to discuss oral health with a pharmacist. Results Participants (N=178) filling prescriptions were mostly (65.9%) female with a mean age of 48.2 years (s.d.=14.3; range 19–82 years). One in four (24.9%) said their mouths “always” or “frequently” felt dry; these individuals were significantly more likely to have last seen a dentist for emergency (rather than routine) treatment (p<0.01) and rated their oral health as significantly worse (p<0.001) than participants whose mouths “never” or “occasionally” feel dry. A small percentage (5.7%) requested to speak with pharmacists about oral health; they reported poorer oral health than those who opted not to speak with a pharmacist (p<0.05). Conclusions One in four patients reported having dry mouth, and those with dry mouth reported significantly worse oral health than patients without dry mouth. While dry mouth and poor oral health were common in this sample of individuals taking psychotropic medications, this did not consistently translate into information seeking regarding oral health. Future research will focus on pharmacist-initiated oral health interventions with high-risk patients.

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A Systematic Review and Meta-Analysis of the Association Between Poor Oral Health and Severe Mental Illness

Cited by 177 publications

References 51 publications

Common mental disorder is associated with periodontitis

Common mental disorder is associated with periodontitis

Psychometric characteristics of the “General Oral Health Assessment Index (GOHAI) » in a French representative sample of patients with schizophrenia

Oral health in patients taking psychotropic medications: Results from a pharmacy-based pilot study

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