Assessment of periodontal health among the inpatients with schizophrenia

Abstract

Background/Aim. Many studies on oral health of psychiatric inpatients reported schizophrenia as the most common psychiatric disorder among their sample population. The available evidence suggests the higher prevalence and severity of periodontal disease among the psychiatric inpatients. The aim of this study was to evaluate periodontal health among the inpatients with schizophrenia and to consider possible risk factors for their current periodontal diseases. Methods. This cross-sectional study comprised 190 inpatients with schizophrenia at the Clinic for Psychiatric Disorders "Dr Laza Lazarevic" in Belgrade, and 190 mentally healthy patients at the Clinic for Periodontology and Oral Medicine, Faculty of Dental Medicine, University in Belgrade. The Community Periodontal Index for Treatment Needs (CPITN) and sociodemographic characteristics were registered in both groups as well as the characteristics of the primary disease among the inpatients with schizophrenia. Results. The patients in the study group had significantly higher scores of the CPITN (2.24 ± 0.98) than the patients in the control group (1.21 ± 1.10). Most of the patients in the study group had supra-, or subgingival calculi (46.8%), in contrast to the control group patients, who had in most cases gingival bleeding (45.8%). The periodontal pockets where detected in 35.8% of schizophrenic inpatients. The linear regression analysis showed that the gender and age were statistically significant predictors of the CPITN value among the inpatients with schizophrenia. Conclusion. The results of this study generally indicate the need for continuous research of psychiatric patients' oral health, in order to determine the modes of its improvement. Similar studies should elucidate significance of psychiatric patients' periodontal health and sensitize psychiatrists and psychiatric nurses to the oral problems of their patients.

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

“…Mean CPI data were analyzed from Arnaiz et al (18) and Djordjević et al (28), with a statistically significant mean difference of 1.12 (95% CI = 0.89–1.36; p < .00001).…”

“…However, if only studies with internal controls were included (k = 3), the association between psychiatric status and a CPI score of 3 or 4 was no longer significant (ORs of 2.73 [95% CI = 0.90-8.33; p = .08] and 2.78 [95% CI = 0.77-10.01; p = .12], respectively). Mean CPI data were analyzed from Arnaiz et al (18) and Djordjević et al (28), with a statistically significant mean difference of 1.12 (95% CI = 0.89-1.36; p < .00001).…”

“…Study quality varied (Table 3). Only 12 studies used standardized diagnostic criteria for psychiatric illness (Table 2) (18,(26)(27)(28)30,31,33,34,36,(39)(40)(41). Psychiatric cases were assessed clinically in eight studies (18,26,28,31,33,34,36,41).…”

“…Ascertainment of periodontal status in 12 studies was by trained dental assessors (18,27,28,30,32,(34)(35)(36)(37)(38)40,41). Of these, six studies made mention of assessor calibration and measurement of interrater reliability (27,28,32,35,36,41). Only one study reported blinding of the dental assessor to psychiatric status (30).…”

“…Six further studies did not specify the approach or instrument for psychiatric diagnosis (29,32,35,(38)(39)(40). In terms of group comparability, six studies recruited internal controls from clinical settings matched by age and sex (18,28,30,31,33,36). In all other studies, comparisons were made against external controls from the community (26,27,29,32,34,35,37,(39)(40)(41).…”