Oral Health Status among Psychiatric Patients in Riyadh, Saudi Arabia

Abstract

Objective: The purpose of this study is to describe the oral health status among psychiatric patients as compared to psychologically normal controls. Method: A convenience sample of 100 patients who regularly attended a psychiatric clinic in King Saud University, King Khalid Hospital, Riyadh, Saudi Arabia, was selected as the study group. The control group consisted of 84 age-and gender-matched volunteers. All controls were screened using the General Health Questionnaire (GHQ-28) and five persons were excluded based on this. All the participants were interviewed and a comprehensive review questionnaire designed for this survey was completed, then they were examined. The examination involved an extra-oral examination as well as examination of teeth and soft tissues using the decayed, missing, filled teeth (DMFT) index, the Silness and Löe plaque index and the bleeding index. Results: The study group had more tenderness in the masticatory muscles, especially the temporalis muscle. Temporomandbular joint findings showed no significant differences between groups. Decayed, missing, filled teeth index, plaque and bleeding indices were higher among the study group. The incidence of scalloped tongue was significantly higher among psychiatric patients. Conclusion: Oral health status is worse among psychiatric patients, who are more likely to develop some oral conditions, such as temporomandibular disorder and dental caries. It is necessary for both dental and mental healthcare providers to be aware of patients' needs and preventive measures to be instituted for them.

Normal Variations of Oral Anatomy and Common Oral Soft Tissue Lesions

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Schizophrenia and oral health: Review of the literature

“…In the oral cavity of these patients, in addition to tooth decay and periodontal disease, several other changes may occur, such as: the ulcer-necrotic gingivitis, recurrent oral ulcers, lichen planus, geographic tongue, secondary infections, as well as changes that accompany the side-effects of drugs 95 . In schizophrenic patients a self-injury of oral soft tissues can sometimes be noticed, as well as attrition or abrasion of teeth (due to manic behaviour), temporomandibular joint dysfunction, bruxism, hyper-salivation, chronic oro-facial pain syndrome, infections of oral tissues and other 3,6,18,76,95,96 . All this strengthens the need for much better dental health control of persons with psychiatric diseases, including schizophrenia.…”

“…Recent studies, done elsewhere, pointed to the increased prevalence of caries and periodontal disease in psychiatric patients compared to mentally healthy individuals 3,4,6,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] . There are several reasons for this finding 20,25 : (1) the primary illness lessens motivation for oral care, sometimes even reducing capability for use the adequate technique of tooth-brushing; (2) some antipsychotics have oral side-effects, such as xerostomia;…”

Barriers to special care patients with mental illness receiving oral healthcare.

“… 4 In KSA, oral health is poorer among patients with mental and behavioral disorders, and they are more likely to develop oral conditions such as temporomandibular disorder and dental caries. 5 The treatment of mental illness includes psychological intervention and involves antipsychotic medications. These antipsychotic agents have a negative impact on oral healthcare, such as: dry mouth, 6 which is a significant risk factor for developing dental caries, periodontal diseases, and gingivitis.…”