Oral Health Status and treatment needs in institutionalized psychiatric patients: descriptive cross sectional study
Department of Preventive and Community Dentistry, College of Dental Sciences, Davangere, Karnataka, India. Indian Journal of Dental Research
10/2006; 17(4):171-7. DOI: 10.4103/0970-9290.29868
Psychiatric patients are one of the special groups requiring attention as they are often neglected. Oral health is an major determinant of general health for psychiatric patients and may have a low priority in the context of mental illness. The present study was conducted to assess the oral health status and treatment needs of institutionalized psychiatric patients of Davangere.
220 psychiatric patients admitted in two general hospitals of Davangere during the period of one year were included in the study. The oral health status was evaluated with respect to caries, oral hygiene, and periodontal status.
Of the 180 examined with the response rate of 81.8%. 58.3% were males, mean age was 36.7 years, 57.8% had < 1 year of mental illness with a mean of 2.2 years, and 90% were self-sufficient. The multiple logistic regression analysis showed that the mean DMFT (0.92) increased with age, duration of mental illness, and irregularity of oral hygiene habits (P<0.001). Mean OHI-S score was 3.3 and multiple logistic regression analysis showed that the mean OHI-S score increased with age (P<0.001). The multiple logistic regression analysis showed that the CPI score increased with age, duration of mental illness, and degree of helplessness (P<0.001).
The findings of this study demonstrates low caries prevalence, poor oral hygiene, and extensive unmet needs for dental treatment.
Available from: Praveen Khairkar
- "None of the patients in the psychiatric groups were caries-free in our study, suggesting high treatment needs in the form of restoration or extraction due to extensive caries in both the groups. This finding is supported by Angelillo et al. (1993) who reported no caries-free patients in the study population; but is in contrast to the study by Vigild et al. (1993) and Kumar et al. (2006) in which 11% and 67% of the study population were cariesfree respectively. "
Available from: Valerie Bertaud
- "Indeed, numerous international original studies [3,7-14] and one meta-analysis  reported that oral health status of mentally ill patients was poor compared to normal population: in literature, DMFT (number of Decayed, Missing due to decay and Filled Teeth) ranged from 14.9  to 26.7  except in Davengere, India where the very low DMFT (0.9 with mean patients’ age 36.7)  was allotted by the authors to the water fluoride concentration (1.5-2 ppm). "
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ABSTRACT: Severe mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality and oral health is critical for overall systemic health. But general health care needs in this population are often neglected. Some studies have aimed at determining the oral health status of psychiatric in-patients but to date, no emphasis has been placed on oral health of psychiatric patients in France. The goal of this study was to assess the oral health and treatment needs of institutionalized patients in a large psychiatric hospital, where a dental service was available and free, to compare it with the average population, with psychiatric in-patients in other countries and to provide recommendations for psychiatrists and care-giving staff.
The dental status (DMFT), the oral hygiene (OHIS: Simplified Oral Hygiene Index), the saliva flow rate were recorded on a randomized patient sample. Demographic and medical data were retrieved from the institutional clinical files.
Among the 161 examined patients, 95 (59.0%) were men and 66 (41.0%) were women. The mean age was 46.9 +/- 17.5 years. The majority was diagnosed schizophrenia (36.6%) or mood disorders (21.1%). The mean OHIS was 1.7 +/- 1.1. Among the 147 patients who agreed to carry out the salivary examination, the average saliva flow rate was 0.3 g +/- 0.3 g/min. Saliva flow under the average rest saliva flow (0.52 mg/min) was found for 80.3% of the patient. The mean DMFT was 15.8 +/- 8.8 (D = 3.7 +/- 4.4, M = 7.3 +/- 9.4, F = 4.7 +/- 4.9) and significantly increased with age (p < 0.001) and degree of disability (p = 0.003) (stepwise linear regression). Eighteen patients (11.2%) were edentulous.
The DMFT was similar to low income French population but psychiatric patients had almost 4 times more decayed teeth, slightly less missing teeth and 1.5 times less filled teeth. Oral health appeared to be better than in most other countries. But compared to general population, the still unmet dental and prosthetic needs indicated the major need of enhanced access to dental care and specific preventive programs.
Available from: Hsien-Jane Chiu
- "Dental prosthesis is very important for patients with post-endodontic therapy and who are partially or completely edentulous because it improves their chewing ability, digestion, aesthetics, and quality of life. The need to obtain information on the dental prosthetic treatment needs (DPTNs) of handicapped individuals in general
[1-3] and of inpatients with psychiatric disorders in particular has been gaining recognition
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The need to obtain information on the dental prosthetic treatment needs (DPTNs) of inpatients with schizophrenia is unrecognized. This study aims to assess the DPTNs of this population and investigate the association between these needs and related factors.
The results of an oral health survey involving 1,103 schizophrenic adult inpatients in a long-term care institution in Taiwan were used. Chi-square tests and multiple logistic analyses were used to measure the independent effects of the characteristics of each subject on their DPTNs.
Of the subjects, 805 (73.0%) were men and 298 (27.0%) were women. The mean age was 50.8 years. A total of 414 (37.5%) required fixed prosthesis, whereas 700 (63.5%) needed removable prosthesis. Multivariate analyses show that fixed prosthesis is associated with age only after adjusting for other potential independent variables. Older subjects who had a lower educational attainment or a longer length of stay required removable prosthesis.
The findings of this study show that the DPTNs of schizophrenic inpatients are not being met. Therefore, a special approach to the dental prosthetic treatment of these patients should be developed.
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