Prevalence and Clinical Correlation of Decayed, Missing, and Filled Teeth in Elderly Inpatients With Schizophrenia

Abstract

Introduction: Schizophrenia is a mental disease with a profound impact on human health. Patients with schizophrenia have poor oral hygiene, increasing their risk of systemic diseases, such as respiratory infections, and declining their quality of life. Therefore, this study aims to assess the oral health status of inpatients with schizophrenia, analyze its related factors, and thus provide scientific evidence for further exploration of corresponding control strategies.Methods: A total of 425 inpatients older than 50 years with a diagnosis of schizophrenia from two psychiatric hospitals (mean age 58.49 ± 5.72 years) were enrolled. The demographic data of the patients were checked on admission. Two independent dentists examined caries, missing teeth, and fillings. Mini-Mental State Examination (MMSE) and Global Deterioration Scale were performed as cognitive tests. Positive and Negative Syndrome Scale and Repeatable Battery for the Assessment of Neuropsychological Status rating scale were used to determine their mental status.Results: The average decayed, missing, and filled teeth index was 12.99 ± 8.86. Linear regression analysis showed that the decayed, missing, and filled teeth index had a significantly positive relationship with age (p < 0.001) and smoking (p < 0.001) and a negative relationship with MMSE (p = 0.029). The missing teeth index had a positive relationship with age (p < 0.001), smoking (p < 0.001), and Global Deterioration Scale (p = 0.014) and a negative relationship with MMSE (p = 0.004).Conclusion: The oral health of elderly patients with schizophrenia is poor, which may be related to the cognitive level of patients and affect their quality of life. The focus should be provided to the oral care of patients with schizophrenia, and investment in their specialized oral treatment should be increased.

Association Between the Number of Remaining Teeth and Body Mass Index in Japanese Inpatients with Schizophrenia

“…The prevalence of underweight was higher among our Japanese inpatients with schizophrenia (17.0%) compared with the prevalence reported in previous studies of Taiwanese (4.3%) 11 and Chinese (6.6%) samples. 12 Previous large-scale studies reported that the prevalence rates of underweight were 20.2% and 17.4% in 15,171 and 14,237 Japanese inpatients with schizophrenia, respectively. 15 , 16 Additionally, a meta-analysis indicated an odds ratio of 4.4 for underweight in Japanese inpatients with schizophrenia.…”

“…This score significantly differed in 878 Taiwanese inpatients with schizophrenia, 11 but not in 425 Chinese inpatients with schizophrenia. 12 Although the Decayed-Missing-Filled Teeth score is a standard index for assessing dental status, it is difficult for psychiatrists and nurses to measure this score in real-world practice. Therefore, we used the number of remaining teeth as a measure in this study.…”

“…The Decayed-Missing-Filled Teeth score was associated with BMI in 878 Taiwanese inpatients with schizophrenia, 11 but not in 425 Chinese inpatients with schizophrenia. 12 Here, we performed a cross-sectional study to examine the effects of the number of remaining teeth and relevant variables (eg, age, sex, and the number of antipsychotics prescribed) 13 on BMI in Japanese inpatients with schizophrenia. Our recent study has shown that age, sex, type of care (outpatient/inpatient), the number of antipsychotics prescribed, aripiprazole, and olanzapine were correlated with BMI in 19,675 patients with schizophrenia.…”

“…The Decayed-Missing-Filled Teeth score was associated with BMI in 878 Taiwanese inpatients with schizophrenia, 11 but not in 425 Chinese inpatients with schizophrenia. 12 …”

Oral Health Status and Factors Related to Oral Health in Patients with Schizophrenia: A Matched Case-Control Observational Study

“…Mean DMF-T values were 12.99 ± 8.86 in their patient population (prevalence of caries and tooth loss: 83.1% and 83.3%), which were significantly higher in individuals who smoked or who used to smoke; DMF-T values and M values showed significant negative correlation with the Mini-Mental State Examination Scale (MMSE) score, but significant positive correlation with age and the Global Deterioration Scale (GDSRANK) scores, respectively [ 60 ]. A Japanese observational study assessed the oral health status (using the DMF-T index, calculus index [CI], debris index [DI] and Revised Oral Assessment Guide [ROAG]) of hospitalized SCZ patients; significant negative correlations were shown between DMF-T values (mean: 21.7 ± 7.3, higher in males), chlorpromazine equivalents (CPZE) and Barthel index (BI) (denoting mental illness severity), while positive correlations were found with age and length of hospitalization [ 61 ]. Another Spanish case-control study compared the dental and periodontal health status among SCZ patients and controls without psychiatric illnesses: mean dental status indices (D: 4.39, M: 5.66, F: 3.53, DMF-T: 13.51) were lower compared to our study, while the mean periodontal health (expressed using the community periodontal index [CPI]) score was 2.32.…”