Oral health of psychiatric inpatients: a survey of central Taiwan hospitals

Teng, Po-Ren; Su, Jo-Mei; Chang, Wen-Hsin; Lai, Te-Jen

doi:10.1016/j.genhosppsych.2011.03.001

Cited by 30 publications

(60 citation statements)

References 21 publications

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“…However, in Taiwan, dental care for all residents is covered by the NHI, so cost may not be the principal barrier to receiving dental care of Taiwanese patients with severe mental illness. Other factors, including the subjects’ lack of awareness of the importance of dental care, their low levels of perceived need, anxiety about visiting the dentist, difficulty in assessing the dental care needs of institutionalized patients [15], the reluctance of dentists to provide dental care, and possibly negative dental staff attitudes toward the subjects, may account for the under-utilization of the already-insured dental care services [29]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Many patients lack awareness of the importance of dental care [15]. They neglect making appointments for routine dental checkups and are more likely to seek dental help only when they experience pain [15]. Besides, prolonged stay in institutions may limit psychiatric patients’ ability to access dental care [19].…”

Section: Introductionmentioning

confidence: 99%

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Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database

2016

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BackgroundThe 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.MethodsThis 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.ResultsOnly 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).ConclusionsPatients 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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database

2016

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“…Restricting studies to those of inpatients (n = 9) made no difference to the results for DMFS (mean difference = 20.4, 95% CI = 14.9Y25.9) or DMFT (mean difference = 5.6, 95% CI = 2.5Y8.8) (15,21,30,33,37,42,43,45,48). Only including those studies that used psychiatric diagnostic criteria (Table 1) also had no effect on the DMFS scores and little on the DMFT index (mean difference = 6.6, 95% CI = 4.5Y8.7).…”

Section: Dental Cariesmentioning

confidence: 91%

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

Kisely

Baghaie

Lalloo

et al. 2015

Psychosomatic Medicine

176

200

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“…From the awareness that co-morbidity is often common in DA, researchers have re-ported that people with psychiatric disorders are significantly more prone to poor oral health [20] [21] [22] [23] [24], but there was little or no validated testing for intensity of DA or avoidance. Even though co-morbidity would seem to be a logical hypothesis in studying DA among psychiatric patients, only a German study by Lenk et al [21] used standardized psychometric scales [25] to reflect on DA and avoidance behavior among 212 psychiatric patients compared with 95 healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Reconsidering Co-Morbid Traits in Explanatory Models of High Dental Anxiety Using a Comparison of Psychiatric and Normal Patient Samples

Moore¹,

Jensen²,

Andersen³

et al. 2016

OJST

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Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears; 2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.; 25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.

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Oral health of psychiatric inpatients: a survey of central Taiwan hospitals

Cited by 30 publications

References 21 publications

Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database

Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database

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

Reconsidering Co-Morbid Traits in Explanatory Models of High Dental Anxiety Using a Comparison of Psychiatric and Normal Patient Samples

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