Periodontal disease and effects of antipsychotic medications in patients newly diagnosed with schizophrenia: a population-based retrospective cohort

Abstract

Aim Compared with the general population, individuals with schizophrenia have a higher risk of periodontal disease, which can potentially reduce their life expectancy. However, evidence for the early development of periodontal disease in schizophrenia is scant. The current study investigated risk factors for periodontal disease in patients newly diagnosed with schizophrenia. Methods We identified a population-based cohort of patients in Taiwan with newly diagnosed schizophrenia who developed periodontal disease within 1 year of their schizophrenia diagnosis. Treatment with antipsychotics and other medications was categorised according to medication type and duration, and the association between medication use and the treated periodontal disease was assessed through logistic regression. Results Among 3610 patients with newly diagnosed schizophrenia, 2373 (65.7%) had an incidence of treated periodontal disease during the 1-year follow-up. Female sex (adjusted odds ratios [OR] 1.40; 95% confidence interval [CI] 1.20–1.63); young age (adjusted OR 0.99; 95% CI 0.98–0.99); a 2-year history of periodontal disease (adjusted OR 2.45; 95% CI 1.84–3.26); high income level (adjusted OR 2.24; 95% CI 1.64–3.06) and exposure to first-generation (adjusted OR 1.89; 95% CI 1.54–2.32) and secondary-generation (adjusted OR 1.33; 95% CI 1.11–1.58) antipsychotics, anticholinergics (adjusted OR 1.24; 95% CI 1.03–1.50) and antihypertensives (adjusted OR 1.91; 95% CI 1.64–2.23) were independent risk factors for periodontal disease. Hyposalivation – an adverse effect of first-generation antipsychotics (FGAs) (adjusted OR 2.00; 95% CI 1.63–2.45), anticholinergics (adjusted OR 1.27; 95% CI 1.05–1.53) and antihypertensives (adjusted OR 1.90; 95% CI 1.63–2.22) – was associated with increased risk of periodontal disease. Therefore, hypersalivation due to FGA use (adjusted OR 0.72; 95% CI 0.59–0.88) was considered a protective factor. Conclusions The current study highlights that early prevention of periodontal disease in individuals with schizophrenia is crucial. Along with paying more attention to the development of periodontal disease, assessing oral health regularly, helping with oral hygiene, and lowering consumption of sugary drinks and tobacco, emphasis should also be given by physicians to reduce the prescription of antipsychotics to the extent possible under efficacious pharmacotherapy for schizophrenia.

Prevalence of Gingival Inflammation among Patients Taking Antipsychotic Drugs

“…21 From the findings of the study, it could be concluded that early use of preventive measures can help in preventing the occurrence of gingival disease, periodontal disease, caries and eventually tooth loss in such patients. Very little data is present on this subject as majority of the international researches have been done on limited data, 19,20,23,24 whereas no research has been cited that is conducted in Pakistan.…”

Oral health self‐care behaviours in serious mental illness: A systematic review and meta‐analysis

“…65,66 Growing evidence suggests disparities exist in oral health. [2][3][4]67 The reasons for this are likely to be multifactorial and may include medication, 68,69 systemic issues 70,71 and personal capability. 72 Literature indicates that education alone does not improve oral health outcomes in this client group, despite guidance published by the British Society of Disability and Oral Health (BSDH).…”

Risk of motor vehicle collisions after methadone use

“…Data were retrieved from the Taiwan National Health Insurance Research Database (NHIRD) ( Wu and Lee, 2016 ; Hu et al, 2019 ) and six Taiwanese population-based administrative registries, namely the management information system of substitution maintenance therapy, Ministry of Health and Welfare, the road accident registry of injurious crashes, National Police Agency, Ministry of the Interior, and four independent management information systems at the Ministry of Justice, Republic of China (Taiwan). The four information systems were the case management system of Drug Prevention and Control Center, processing system of criminal records, criminal case system of drug case prosecutor briefed the transfer of information, and punitive administrative system for the use of Category 3 or 4 Narcotics (illicit drugs).…”