The oral health of people with anxiety and depressive disorders - A systematic review and meta-analysis

Kisely, Steve, Sawyer, Emily, Siskind, Dan and Lalloo, Ratilal (2016) The oral health of people with anxiety and depressive disorders - A systematic review and meta-analysis. Journal of Affective Disorders, 200 119-132. doi:10.1016/j.jad.2016.04.040


Author Kisely, Steve
Sawyer, Emily
Siskind, Dan
Lalloo, Ratilal
Title The oral health of people with anxiety and depressive disorders - A systematic review and meta-analysis
Journal name Journal of Affective Disorders   Check publisher's open access policy
ISSN 1573-2517
0165-0327
Publication date 2016-08
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jad.2016.04.040
Volume 200
Start page 119
End page 132
Total pages 14
Place of publication Amsterdam, Netherlands
Publisher Elsevier BV
Collection year 2017
Language eng
Formatted abstract
Background
Many psychological disorders are associated with comorbid physical illness. There are less data on dental disease in common psychological disorders such as depression and anxiety in spite of risk factors in this population of diet, lifestyle or antidepressant-induced dry mouth.

Methods
We undertook a systematic search for studies of the oral health of people with common psychological disorders including depression, anxiety and dental phobia. We searched MEDLINE, PsycInfo, EMBASE and article bibliographies. Results were compared with the general population. Outcomes included partial or total tooth-loss, periodontal disease, and dental decay measured through standardized measures such as the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS).

Results
There were 19 papers on depression and/or anxiety, and seven on dental phobia/anxiety (total n=26). These covered 334,503 subjects. All the psychiatric diagnoses were associated with increased dental decay on both DMFT and DMFS scores, as well as greater tooth loss (OR=1.22; 95%CI=1.14–1.30). There was no association with periodontal disease, except for panic disorder.

Limitations
Cross-sectional design of included studies, heterogeneity in some results, insufficient studies to test for publication bias.

Conclusion
The increased focus on the physical health of psychiatric patients should encompass oral health including closer collaboration between dental and medical practitioners. Possible interventions include oral health assessment using standard checklists that can be completed by non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral. Mental health clinicians should also be aware of the oral consequences of inappropriate diet and psychotropic medication.
Keyword Anxiety
Caries
Dental anxiety
Dental disease
Dental erosion
Dental phobia
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
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