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      Oral health of psychiatric patients: A cross-sectional comparision study

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          Abstract

          Background:

          Mental illness is associated with physical health. Oral health affects people physically and psychologically and influences how they grow, enjoy life, look, speak, chew, taste food and socialize. Oral health may have lower priority in the context of mental illness and these diverse and changing client group experiences similar oral and dental problems.

          Objective:

          To assess oral health problems in psychiatric patients.

          Materials and Methods:

          This cross-sectional study included 133 patients attending the psychiatric outpatient department (OPD) as the study group and 133 patients attending the general OPD of the same hospital as the control group. Both groups were examined for oral health status.

          Results:

          Mean age of the study group was 40.2 years, 66.17% were males, 66.17% were married and 83.67% belonged to middle or lower class. 39.8% of patients had mental illness for 1-5 years, 88% were self sufficient and 34.6% had healthy oral practices. These results are very much comparable with the control group. Mean decayed missed filled teeth (DMFT) score (2.10) and mean oral hygiene index-simplex (OHI-S) score (3.6) increased with age. Difference in DMFT score with age was not statistically significant ( P>0.5) while it was highly significant for OHI-S score ( P<0.0001). Periodontal condition worsened as age increased, suggested by community periodontal index. Only 26.7% of patients had healthy gingiva in the age group 20-50 years while it was zero for 50 years and above. This difference is statistically significant ( P<0.001).

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          Most cited references25

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          Oral impacts affecting daily performance in a low dental disease Thai population.

          The aim of the study was to measure incidence of oral impacts on daily performances and their related features in a low dental disease population. 501 people aged 35-44 years in 16 rural villages in Ban Phang district, Khon Kaen, Thailand, were interviewed about oral impacts on nine physical, psychological and social aspects of performance during the past 6 months, and then had an oral examination. The clinical and behavioural data showed that the sample had low caries (DMFT = 2.7) and a low utilization of dental services. 73.6% of all subjects had at least one daily performance affected by an oral impact. The highest incidence of performances affected were Eating (49.7%), Emotional stability (46.5%) and Smiling (26.1%). Eating, Emotional stability and Cleaning teeth performances had a high frequency or long duration of impacts, but a low severity. The low frequency performances; Physical activities, Major role activity and Sleeping were rated as high severity. Pain and discomfort were mainly perceived as the causes of impacts (40.1%) for almost every performance except Smiling. Toothache was the major causal oral condition (32.7%) of almost all aspects of performance. It was concluded that this low caries people have as high an incidence of oral impacts as industrialized, high dental disease populations. Frequency and severity presented the paradoxical effect on different performances and should both be taken into account for overall estimation of impacts.
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            Cross-national comparisons of the prevalences and correlates of mental disorders. WHO International Consortium in Psychiatric Epidemiology.

            The International Consortium in Psychiatric Epidemiology (ICPE) was established in 1998 by WHO to carry out cross-national comparative studies of the prevalences and correlates of mental disorders. This article describes the findings of ICPE surveys in seven countries in North America (Canada and USA), Latin America (Brazil and Mexico), and Europe (Germany, Netherlands, and Turkey), using a version of the WHO Composite International Diagnostic Interview (CIDI) to generate diagnoses. The results are reported using DSM-III-R and DSM-IV criteria without diagnostic hierarchy rules for mental disorders and with hierarchy rules for substance-use disorders. Prevalence estimates varied widely--from > 40% lifetime prevalence of any mental disorder in Netherlands and the USA to levels of 12% in Turkey and 20% in Mexico. Comparisons of lifetime versus recent prevalence estimates show that mental disorders were often chronic, although chronicity was consistently higher for anxiety disorders than for mood or substance-use disorders. Retrospective reports suggest that mental disorders typically had early ages of onset, with estimated medians of 15 years for anxiety disorders, 26 years for mood disorders, and 21 years for substance-use disorders. All three classes of disorder were positively related to a number of socioeconomic measures of disadvantage (such as low income and education, unemployed, unmarried). Analysis of retrospective age-of-onset reports suggest that lifetime prevalences had increased in recent cohorts, but the increase was less for anxiety disorders than for mood or substance-use disorders. Delays in seeking professional treatment were widespread, especially among early-onset cases, and only a minority of people with prevailing disorders received any treatment. Mental disorders are among the most burdensome of all classes of disease because of their high prevalence and chronicity, early age of onset, and resulting serious impairment. There is a need for demonstration projects of early outreach and intervention programmes for people with early-onset mental disorders, as well as quality assurance programmes to look into the widespread problem of inadequate treatment.
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              Oral health of psychiatric in-patients in Hong Kong.

              Poor oral health has been reported among various psychiatric populations. Little is known regarding the oral health among psychiatric patients in Asia. To examine the oral health status of a group of Chinese psychiatric in-patients in a long-term rehabilitation facility. A dental survey using the WHO standardised dental evaluation form was conducted in adult psychiatric patients in a rehabilitation programme. A qualified dentist examined all consenting patients. Ninety-one patients (64.8% male; mean age: 44.7 +/- 9.9 years; mean length of illness: 20.3 +/- 11.5 years) were included in the study, the majority (80.2%) diagnosed with schizophrenia. Malocclusion was found in 79.1% of patients. The mean number of missing teeth was 9.5 +/- 8.9. Bleeding on probing, calculus, shallow and deep pockets were found in 7.1%, 71.8%, 72.9% and 28.2% of patients, respectively. Dental caries were found in 75.3% of dentate patients. The mean number of caries per patient was 5.5 +/- 6.1. Fifty-four per cent of patients needed dental extraction and 78.8% required conservative dental treatment. Older age and length of illness were significantly associated with poor dental health. Oral health status of chronic psychiatric patients seems to be considerably worse than that of the general population. Mental health professionals should pay more attention to preventive oral health habits of psychiatric patients.
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                Author and article information

                Journal
                Dent Res J (Isfahan)
                Dent Res J (Isfahan)
                DRJ
                Dental Research Journal
                Medknow Publications & Media Pvt Ltd (India )
                1735-3327
                2008-0255
                Mar-Apr 2012
                : 9
                : 2
                : 209-214
                Affiliations
                [1 ]Department of Community Medicine, Shri M. P. Shah Medical College, Jamnagar, Gujarat, India
                [2 ]Department of Oral MaxilloFacial Surgery, Government Dental College and Hospital, Jamnagar, Gujarat, India
                [3 ]Department of Periodontics, Government Dental College and Hospital, Jamnagar, Gujarat, India
                Author notes
                Address for correspondence: Dr. Viral R. Shah, Department of Community Medicine, Shri M. P. Shah Medical College, Jamnagar - 361 008, Gujarat, India. E-mail: viralpsm@ 123456rediffmail.com
                Article
                DRJ-9-209
                3353700
                22623940
                0f72d011-a645-446f-8951-9be8ff2318c7
                Copyright: © Dental Research Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : January 2011
                : July 2011
                Categories
                Original Article

                Dentistry
                dental caries,oral pathology,oral hygiene,periodontal diseases
                Dentistry
                dental caries, oral pathology, oral hygiene, periodontal diseases

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