Oral health status and treatment needs among psychiatric inpatients in Rennes, France: a cross-sectional study

BMC Psychiatry

Frederique Richard³  Gilda Trohel³  Catherine Perrus²  Viviane Kovess-Masfety¹  Valerie Bertaud-Gounot³ 

[1] EHESP School of Public Health, Epidemiology and Biostatistics Department, Avenue Professor Leon Bernard, CS 74312, 35043 Rennes, France;Guillaume Régnier Psychiatric Center, 108, av. du Général Leclerc, BP 60321-35703 Rennes, France;University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9, France

关键词: Schizophrenia/complications;    Hospital, Psychiatric;    Dental health survey;    Dental caries/epidemiology;   

Others  :  1123966
DOI  :  10.1186/1471-244X-13-227

 received in 2012-08-28, accepted in 2013-09-06,  发布年份 2013

【 摘 要 】

Background

Severe mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality and oral health is critical for overall systemic health. But general health care needs in this population are often neglected. Some studies have aimed at determining the oral health status of psychiatric in-patients but to date, no emphasis has been placed on oral health of psychiatric patients in France. The goal of this study was to assess the oral health and treatment needs of institutionalized patients in a large psychiatric hospital, where a dental service was available and free, to compare it with the average population, with psychiatric in-patients in other countries and to provide recommendations for psychiatrists and care-giving staff.

Methods

The dental status (DMFT), the oral hygiene (OHIS: Simplified Oral Hygiene Index), the saliva flow rate were recorded on a randomized patient sample. Demographic and medical data were retrieved from the institutional clinical files.

Results

Among the 161 examined patients, 95 (59.0%) were men and 66 (41.0%) were women. The mean age was 46.9 ± 17.5 years. The majority was diagnosed schizophrenia (36.6%) or mood disorders (21.1%). The mean OHIS was 1.7 ± 1.1. Among the 147 patients who agreed to carry out the salivary examination, the average saliva flow rate was 0.3 g ± 0.3 g/min. Saliva flow under the average rest saliva flow (0.52 mg/min) was found for 80.3% of the patient. The mean DMFT was 15.8 ± 8.8 (D = 3.7 ± 4.4, M = 7.3 ± 9.4, F = 4.7 ± 4.9) and significantly increased with age (p < 0.001) and degree of disability (p = 0.003) (stepwise linear regression). Eighteen patients (11.2%) were edentulous.

Conclusions

The DMFT was similar to low income French population but psychiatric patients had almost 4 times more decayed teeth, slightly less missing teeth and 1.5 times less filled teeth. Oral health appeared to be better than in most other countries. But compared to general population, the still unmet dental and prosthetic needs indicated the major need of enhanced access to dental care and specific preventive programs.

【 授权许可】

   
2013 Bertaud-Gounot et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]De Hert M, van Winkel R, Silic A, Van Eyck D, Peuskens J: Physical health management in psychiatric settings. Eur Psychiatry 2010, 25(2):S22-S28.
• [2]Fleischhacker W, Cetkovich-Bakmas M, De Hert M, Hennekens C, Lambert M, Leucht S: Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. J Clin Psychiatry 2008, 69:514-519.
• [3]Kumar M, Chandu G, Shafiulla M: Oral health status and treatment needs in institutionalized psychiatric patients: one year descriptive cross sectional study. Indian J Dent Res 2006, 17(4):171-177.
• [4]Lamster I, Lalla E, Borgnakke W, Taylor G: The relationship between oral health and diabetes mellitus. J Am Dent Assoc 2008, 139:19S-24S.
• [5]Desvarieux M, Demmer R, Rundek T, Boden-Albala B, Jacobs D, Papapanou P: Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke 2003, 34:2120-2125.
• [6]Azarpazhooh A, Leake J: Systematic review of the association between respiratory diseases and oral health. J Periodontol 2006, 77:1465-1482. doi:9
• [7]Lewis S, Jagger R, Treasure E: The oral health of psychiatric in-patients in South Wales. Spec Care Dentist 2001, 21:182-186.
• [8]Ramon T, Grinshpoon A, Zusman S, Weizman A: Oral health and treatment needs of institutionalized chronic psychiatric patients in Israel. Eur Psychiatry 2003, 18(3):101-105.
• [9]Tang W, Sun F, Ungvari G, O’Donnell D: Oral health of psychiatric in-patients in HongKong. Int J Soc Psychiatry 2004, 50(2):186-191.
• [10]Mirza I, Day R, Wulff-Cochrane V, Phelan M: Oral health of psychiatric in-patients. A point prevalence survey of an inner-city hospital. Psychiatr Bull 2001, 25:143-145.
• [11]Zusman S, Ponizovsky A, Dekel D, Masarwa A, Ramon T, Natapov L: An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel. Spec Care Dentist 2010, 30(1):18-22.
• [12]Jovanovic S, Milovanovic S, Gajic I, Mandic J, Latas M, Jankovic L: Oral health status of psychiatric in-patients in Serbia and implications for their dental care. Public Health 2010, 51:443-450.
• [13]Chu K, Yang N, Chou P, Chiu H, Chi L: Factors associated with dental caries among institutionalized residents with schizophrenia in Taiwan: a cross-sectional study. BMC Publ Health 2010, 10:482. BioMed Central Full Text
• [14]Teng P, Su J, Chang W, Lai T: Oral health of psychiatric inpatients: a survey of central Taiwan hospitals. Gen Hosp Psychiatry 2011, 33:253-259.
• [15]Kisely S, Quek LH, Pais J, Lalloo R, Johnson NW, Lawrence D: Advanced dental disease in people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry 2011, 199(3):187-193.
• [16]Gurbuz O, Alatas G, Kurt E, Issever H, Dogan F: Oral health and treament needs of institutionalized chronic psychiatric patients in Istanbul. Community Dent Health 2010, 27:151-157.
• [17]Farrahi-Avval N: Oral health status and treatment needs of the Institutionalized chronic psychiatric patients in two Ontario Psychiatric Care Centres. Toronto: Oral Health Status and Treatment Needs of the Institutionalized; 2008. [PhD thesis]
• [18]Rekha R, Hiremath S, Bharath S: Oral health status and treatment requirements of hospitalized psychiatric patients in Bangalore city: a comparative study. J Indian Soc Pedo Prev Dent 2002, 20(2):63-67.
• [19]Hede B: Oral health in Danish hospitalized psychiatric patients. Community Dent Oral Epidemiol 1995, 23:44-48.
• [20]Chu K, Yang N, Chou P, Chi L, Chiu H: The relationship between body mass index, the use of second generation antipsychotics, and dental caries among hospitalized patients with schizophrenia. Int J Psychiatr Med 2011, 41(4):343-353.
• [21]Cabaret W: L’accès aux soins somatiques pour les patients suivis en psychiatrie. Soins Psychiatr 2010, 268:34-36.
• [22]Ponizovsky A, Zusman S, Dekel D, Masarwa A, Ramon T, Natapov L: Effect of implementing dental services in Israeli psychiatric hospitals on the l and dental health of inpatients. Psychiatr Serv 2009, 60:799-803.
• [23]WHO: Oral health surveys - basic methods. Fourth edition. Geneva: World health organization; 1997.
• [24]Greene J, Vermillion J: The simplified oral hygiene index. J Am Dent Assoc 1964, 68:7-13.
• [25]Navazesh M, Christensen C: A comparison of whole mouth resting and stimulated salivary measurement procedures. J Dent Res 1982, 61:1158-1162.
• [26]Greene J: The simlified oral hygiene index – development and uses. J Periodontol 1967, 38:625-637.
• [27]Angelillo I, Nobile C, Pavia M, De Fazio P, Puca M, Amati A: Dental health and treatment needs in institutionalized psychiatric patients in Italy. Community Dent Oral Epidemiol 1995, 23(6):360-364.
• [28]Hescot P, Bourgeois D, Doury J: Oral health in 35–44 year old adults in France. Int Dent J 1997, 47:94-99.
• [29]Bourgeois D, Berger P, Hescot P, Leclercq M, Doury J: Oral health status in 65–74 years old adults in France, 1995. Rev Epidém et Santé publ 1999, 47:55-59.
• [30]Almomani F, Brown C, Williams K: The effect of an oral health promotion program for people with psychiatric disabilities. Psychiatr Rehabil J 2006, 29(4):274-281.