Prevalence of dental disorders among people with mental illness: An umbrella review

Abstract

Objective: Psychiatric patients have increased rates of comorbid physical illness. There are less data on dental disease, especially decay, despite risk factors including lifestyle and psychotropic side effects such as xerostomia. We therefore undertook an umbrella review of all meta-analyses on the association between mental illness and oral health. Methods: We searched PubMed, MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Embase and CINAHL. Articles were independently assessed. Outcomes were caries, periodontal disease, erosion, and partial or total tooth loss (edentulism), measured where possible with standardised measures such as the mean number of decayed, missing and filled teeth or surfaces. Quality was assessed in line with National Institutes of Health guidelines. Results: We identified 11 meta-analyses. The most information and strongest association was between dental decay and severe mental illness or substance use, as well as erosion and eating disorders. Depressive, anxiety and eating disorders were also associated with caries, but the datasets were small. People with severe mental illness had nearly three times the odds of having lost all their teeth than the general community (odds ratio = 2.81, 95% confidence interval = [1.73, 4.57]) and those with depression between 1.17 and 1.32. Findings for periodontal disease were more equivocal, possibly because of study heterogeneity. Conclusion: Mental health clinicians should screen for oral diseases when treating those with mental illness and facilitate referral to affordable dental clinics when indicated. Prevention should be a priority, including the promotion of dental care, as well as the management of xerostomia when psychopharmacologic agents are prescribed.

Periodontal Hastalıklarda Depresyon ve Anksiyete Düzeylerinin Değerlendirilmesi

“…Literatürdeki önemli miktardaki veri, iltihaplı ağız hastalıkları olan kişilerde ruh sağlığı sorunlarının arttığını veya kötü ruhsal durumun ağız hastalıkları riskini arttırdığını bildirmektedir [10,30]. Mevcut çalışmada, tüm klinik periodontal parametreler ile anksiyete ve depresyon skorları arasında pozitif korelasyonlar mevcuttu.…”

Mental Disorders and Oral Diseases: Future Research Directions

“…Evidence on the higher prevalence of oral diseases in people with mental disorders has been recently synthesized in an umbrella review and a subsequent meta-analysis (Cai et al 2022; Choi et al 2022). Compared with the general population, people with depression and anxiety have significantly higher experiences of decayed teeth, periodontal disease, and tooth loss (DMFT mean difference [MD]: 0.76; odds ratio [OR]: 1.54, 1.32, respectively).…”

A Systematic Review and Meta-Analysis of the Association Between Periodontal Disease and Severe Mental Illness

“…Data on sex were available for 4370 psychiatric cases, of which 2635 (60.3%) were male. Six studies (19,28,30,31,33,36), with 755 cases and 699 controls, had internal control groups, which were of a comparable population to the psychiatric cases (Table 2). For the other 11 studies (26,27,29,32,34,35,(37)(38)(39)(40)(41), comparison data were available from population surveys of a similar age group, conducted within 10 years of the study (Table 4: n = 95,411).…”