A systematic review and meta-analysis of the association between poor oral health and severe mental illness

Kisely, Steve, Baghaie, Hooman, Lalloo, Ratilal, Siskind, Dan and Johnson, Newell W. (2015) A systematic review and meta-analysis of the association between poor oral health and severe mental illness. Psychosomatic Medicine, 77 1: 83-92. doi:10.1097/PSY.0000000000000135


Author Kisely, Steve
Baghaie, Hooman
Lalloo, Ratilal
Siskind, Dan
Johnson, Newell W.
Title A systematic review and meta-analysis of the association between poor oral health and severe mental illness
Journal name Psychosomatic Medicine   Check publisher's open access policy
ISSN 1534-7796
0033-3174
Publication date 2015-01
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/PSY.0000000000000135
Open Access Status
Volume 77
Issue 1
Start page 83
End page 92
Total pages 10
Place of publication Philadelphia PA, United States
Publisher Lippincott Williams and Wilkins
Collection year 2015
Language eng
Formatted abstract
Background: Psychiatric patients have increased comorbid physical illness. There is less information, however, on dental disease, especially tooth decay, despite life-style risk factors or psychotropic-induced dry mouth in this population. Importantly, poor oral health can predispose people to chronic physical disease leading to avoidable admissions to hospital for medical causes.

Methods: Using MEDLINE, PsycInfo, EMBASE, and article bibliographies, we undertook a systematic search for studies from the last 25 years regarding the oral health of people with severe mental illness (SMI). Results were compared with the general population. The two outcomes were total tooth loss (edentulism) and dental decay measured through the following standardized measures: the mean number of decayed, missing, and filled teeth or surfaces.

Results: We identified 25 studies that had sufficient data for a random-effects meta-analysis. These covered 5076 psychiatric patients and 39,545 controls, the latter from either the same study or community surveys. People with SMI had 2.8 the odds of having lost all their teeth compared with the general community (95% confidence interval [CI] = 1.7–4.6). They also had significantly higher decayed, missing, and filled teeth (mean difference = 5.0, 95% CI = 2.5–7.4) and surfaces scores (mean difference = 14.6, 95% CI = 4.1–25.1).

Conclusion: The increased focus on the physical health of people with SMI should encompass oral health. Possible interventions could include oral health assessment conducted using standard checklists that can be completed by non–dental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print August 24 2014

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
School of Public Health Publications
School of Dentistry Publications
School of Medicine Publications
 
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