Schizophrenia and periodontal disease: An oro-neural connection? A cross-sectional epidemiological study

Abstract

Background:Schizophrenia is a psychosis characterized by delusions and hallucinations occurring in clear consciousness. Studies have shown that the cytokines may modulate dopaminergic metabolism and schizophrenic symptomatology in schizophrenia. Cytokine involvement in periodontal disease is also well documented. To date, however, there has been relatively little research assessing periodontal status of patients with schizophrenia. The present study was therefore mainly intended to understand the exact link, if any, between periodontal disease and schizophrenia.Materials and Methods:A total of 250 schizophrenic patients (140 males and 110 females), between 25 and 55 years of age, were selected from the out patient department of National Institute of Mental Health and Neural Sciences, Bangalore and their periodontal status was assessed as part of this cross-sectional epidemiological survey.Results:ANOVA showed that there was increased evidence of poor periodontal condition, as evidenced by gingival index and plaque index in patients who had been schizophrenic for a longer duration of time (P < 0.001). So also, higher probing pocket depths were found in schizophrenics suffering from a longer period of time than others (P < 0.001).Conclusions:Although oral neglect might be a cause of poor periodontal health in schizophrenics, the possible link between periodontal diseases giving rise to schizophrenia cannot be overlooked due to the presence of cytokine activity which is present both in schizophrenia and periodontal disease.

Barriers and enablers for oral health care for people affected by mental health disorders

“…4,25,38,[40][41][42] Evidence suggests various reasons for this including stigma, feelings of shame, helplessness and low self-esteem; 20,43 lack of income and health insurance; 1,20,21 dental fear, anxiety and phobia; [42][43][44][45] and restlessness in the dental waiting environment. 32,46 Mistrust towards dental health providers was an issue identified in the published work that was compounded by negative and unsatisfactory prior encounters with dental professionals and health care providers, 20,32,43 poor communication with oral health providers, 8,20,32,47,48 and PMD's confusion and 59 Clark (2009), 60 Nielsen et al (2011), 61 Arnaiz (2011), 26 Lewis et al (2001), 53 Friedlander and Liberman (1991), 31 Tani (2012), 62 Eltas et al (2013), 63 Shetty (2014), 64 Tang 201465 Lower executive cognitive function and lower awareness of oral health problems Neilsen (2011), 61 Friedlander and Mander (2002), 66 Janardhanan (2011) 67 Loss of self-interest and/or self-esteem Friedlander and Liberman (1991), 31 Griffins et al 2000, 37 Thomas et al (1996) 68…”

Necessity of oral health intervention in schizophrenic patients – A review

“…A cross-sectional survey on 250 schizophrenic patients investigated the relationship between periodontal disease and schizophrenia. An increased gingival and plaque index, higher probing depths in chronic schizophrenic patients (P < 0.001) pointed towards poor periodontal conditions in these patients [ 30 ]. Smoking is one of the contributory factors to poor periodontal health, which is characterized by increased pocket depth, periodontal attachment loss leading to increased incidence of tooth loss [ 29 ].…”

Schizophrenia and oral health: Review of the literature

“…Psychiatrically ill persons being hospitalized in psychiatric institutions for a long period of time express an increased prevalence of oral diseases 4,5,17,29,[46][47][48][49][50][51][52][53] . It is reasonable to say that psychiatric patients who were hospitalized for a long time represent a high-risk group for the development of oral diseases comparing to mentally healthy persons 47 .…”