Oral health of individuals with mental health disorders

ABSTRACT

Objective: To analyze the oral and dental health conditions in a population of patients with a history of mental health disorders. Background: Individuals with mental health disorders are susceptible to dental disease related to poor oral hygiene, behavioral changes, medication effects, and systemic disease. Mental health and dental health reciprocally affect one another. Poor mental health has been associated with self-neglect, dry mouth, increased likelihood of substance abuse, and a higher susceptibility to oral infection. Similarly, poor dental health negatively affects mental health. Halitosis, dental caries, missing teeth, and affected speech can exacerbate mental health illness related to self-esteem and social anxiety. Methods: The Dental Registry and DNA repository (DRDR) at the University of Pittsburgh School of Dental Medicine was analyzed for patients with a history of mental health disorder. A total of 6,015 patient records were available from the DRDR at the time of this analysis. 1,068 patient records were available for individuals reporting a mental health disorder. We examined the prevalence of various dental conditions in a population of patients reporting a mental health disorder (N=1,068) in comparison to the rest of the registry (N=4,947), as well as the distribution of disorders and demographics. Mental health disorders included in this study are depression, anxiety, schizophrenia, bipolar disorder, post-traumatic stress disorder (PTSD), and eating disorders. Oral and dental health was assessed by dental caries, periodontal disease, gingivitis, tooth wear, complete and partial edentulism, xerostomia, coated tongue, gingivitis, oral ulceration, periapical lesions, and TMD. The prevalence of smoking, alcohol abuse, and substance abuse was also determined. Sex and ethnicity were also examined. Results: Of 6,015 patients, 1,068 reported a history of mental health disorder. 59.2% reported having depression, 16.7% reported anxiety, 13.3% reported bipolar disorder, 3.6% reported schizophrenia, 2.3% reported post-traumatic stress disorder (PTSD), and 2.3% reported an eating disorder. Mental illness was significantly associated with partial and complete edentulism, dental caries, tooth wear, xerostomia, erosion, TMD, ulceration, and gingivitis. Mental illness was also significantly associated with female sex and Whites. Conclusions: Mental health conditions can significantly affect the dental and oral health of affected individuals. Individuals with mental health conditions may be more susceptible to dental disease.

RESUMO

Objetivo: Analisar o estado de saúde oral e dentária de uma população de pacientes com história de problemas de saúde mental. Conhecimento Prévio Indivíduos com problemas de saúde mental só mais suscetíveis a doença oral relacionada a hygiene oral deficient, mudanças de comportamento, efeitos de medicações, e doenças sistêmicas. Saúde mental e oral afetam reciprocamente uma à outra. Problemas de saúde mental foram associados com falta de cuidado pessoal, boca seca, chance aumentada de uso de substâncias ilícitas, e risco aumentado de infecção oral. De forma semelhante, problemas de saúde oral afetam negativamente saúde mental. Halitose, cárie, perda de dentes, e problemas de fala podem agravar o estado de saúde mental relacionado com auto-estima e ansiedade. Métodos: The Dental Registry and DNA Repository (DRDR) da Faculdade de Medicina Dental da Universidade de Pittsburgh foi analisado na avaliação de pacientes com história de doença mental. Um total de 6.015 fichas de pacientes estava disponível no DRDR no momento dessa análise. Dessas, 1.068 eram fichas de pacientes com um problema mental. Prevalência de cárie, periodontite, atrição, edentulismo parcial e total, xerostomia, erosão, gengivite, disordem da articulação temporomandibular (TMD), e úlceras foram determinadas e comparadas com o resto do registro (N=4.947). Sexo e etnia foram também analisados. O teste to qui-quadrado com significância de 5% foi usado. Resultados: Dos 6.015 pacientes, 1.068 relataram história de problema de saúde mental. 59.2% reportou ter depressão, 16.7% ansiedade, 13.3% doença bipolar, 3.6% esquizofrenia, 2.3% transtorno de estresse pós-traumático (PTSD), e 2.3% problemas de alimentação. Doença mental estava significativamente associada com edentulismo parcial e total, cárie, atrição, xerostomia, erosão, TMD, ulceração, e gengivite. Doença mental também for significativamente associada com o sexo feminino e etinia branca. Conclusões: Problemas mentais signifcativamente afetam a saúde oral. Pessoas com problemas de saúde mental parecem ter risco aumentado à cárie, atrição, erosão, edentulismo, xerostomia, inflamcação das gengivas, e TMD. Esses resultados poderão ajudar a direcionar medidas de prevenção e tratamento dessas pessoas.