Medication impact on oral health in schizophrenia

Abstract

Background Patients with schizophrenia constitute a particularly vulnerable group for oral diseases. Among the different factors involved, we aimed to examine the evidence of how drugs could contribute to the poorer oral health of this population. Material and Methods An overview of the potential impact of medication on dental/oral health among people with schizophrenia was proposed focusing on selected literature. Results Studies show a higher dental caries and degree of periodontal diseases in this population and point to drug-induced xerostomia as an important risk factor for oral health deterioration. The risk of dry mouth depends on not only antipsychotics, but also drugs with anticholinergic activity. We hypothesize that antipsychotic induced glycaemic alterations might contribute to reduced oral health, and that the antimicrobial activity of certain antipsychotics could have an impact on oral microbiota affecting oral condition. Pharmacovigilance data show that involuntary movements are caused by typical and some atypical antipsychotics. Dry mouth is most frequently reported for quetiapine and olanzapine, while clozapine is more frequently associated with sialorrhea. Conclusions Literature clearly shows higher caries and periodontal disease in schizophrenic patients. However, overall, there is scarce literature about the potential influence of drugs in these disorders. Health professionals should be aware of this issue in order to implement adequate preventive measures in this vulnerable population. Key words: Schizophrenia, oral health, dental disease, antipsychotics, anticholinergic burden.

Oral discomfort and health behavior of patients with typical vs. atypical antipsychotic drugs

“…Psychiatric medicines have a poor reputation regarding oral side effects due to their mechanisms of action. In particular, the anticholinergic activity of antipsychotic drugs is well known in this respect as also recently reviewed (9,10). Derivatives of dopamine blockers are still the drugs of choice in schizophrenia and these drugs reduce salivary flow rate.…”