People with mental illness more likely to lose teeth

People with severe mental illnesses are more than three times more likely to lose their teeth because of poor oral health than the general population, according to a new study in the British Journal of Psychiatry (September 2011, Vol. 199:3, pp. 187-193).

Researchers from the University of Queensland analyzed 14 studies about the oral health of people with severe mental illness published over the past 20 years. All the psychiatric patients in the studies (2,784) had been diagnosed with severe mental illness, such as schizophrenia, dementia, bipolar disorder, or other affective disorders.

The review found that the psychiatric patients were 3.4 times more likely to have lost all their teeth. They were also 6.2 times more likely to have decayed, filled, or missing teeth.

Lead researcher Steve Kisely, MD, PhD, believes a combination of factors are to blame.

"People with severe mental illness may not be able to clean their teeth properly because of poor housing or homelessness," he stated in a university news release. "Some medications such as antidepressants and mood stabilisers can also reduce the flow of saliva and cause xerostomia, which increases plaque formation."

These patients may also be reluctant to see a dentist because they are scared of treatment or worried about the cost, he added.

"Our analysis shows that, although the oral health of the general population has improved in much of the world, psychiatric patients remain at a disadvantage," Dr. Kisely said. "This mirrors findings in other areas such as cardiovascular disease, where the health of the general population has improved but not that of people with severe mental illness."

Oral health should be part of the standard assessment for all patients with severe mental illness, and when they are admitted to the hospital, their care plans should include a basic assessment of oral hygiene, he added.