Is institutionalization a risk factor for poor oral health; a comparison of the oral status of schizophrenia and bipolar affective disorders

Background:Oral health is an integral part of general health and psychiatric disorders lead them to change their life style and lose concern for general and oral health. In view of this, the study was planned to compare the oral health status in different types of in-patient psychiatric patients. Objective of current study was to study the oral health status in schizophrenia and bipolar affective disorders institutionalized in psychiatric hospital.Methods:50 Psychiatric patient (43 patients suffering from schizophrenia, 7 patients of bipolar affective disorder,) and 50 unrelated healthy volunteers were taken in the study. Dental examinations were done in both groups to measure the following indices of oral health: decayed, missing, and filled teeth index (DMFT)  for caries; simplified oral hygiene index (OHI-S) for oral hygiene status; and tooth wear index for the wear of teeth. For comparison analyses t test was used.Results: Mean age of the study group was 37.74 years. Mean decayed missing filled teeth index (DMFT) score for study group and control population was 8.52 ± 4.36 vs. 4.72 ± 2.74 vs. 1.81 ± 1.00 (P ≤0.0001). The mean simplified oral hygiene index (OHI-S) for study group was 3.87±1.21, while that of control was (p≤0.0001).The mean Tooth wear index (TWI) score for study group was found to be 1.62 ± 0.75 and for control group was 1.08±0.48 (P ≤0.0001).Conclusion: Oral health status is affected in psychiatric patients and improving the oral health in psychiatric patients can go long way in improving the quality and management of these patients.

Schizophrenia and oral health: a literature review [Skizofrénia és szájhigiénia: irodalmi áttekintés]

Az általános betegségek közvetlenül vagy közvetve befolyásolhatják a fogak egészségét és a páciens szájhigiénéjét.A fogorvosi rendelőben megjelenő betegek körében a pszichiátriai kórképek a leggyakoribb rendellenességek közé tartoznak.A fogászati kezelések során az érintetteknek speciális igényeik vannak. A skizofrénia egy olyan krónikus mentálisbetegség, amely a személyes érzelmek és érzések zavaraival jár, illetve mentális és bizonyos tudati funkciók romlásáhozvezet. A tünetek közé tartoznak a téveszmék, a hallucinációk, a rendezetlen gondolkodás és a következetlenség.Amennyiben hasadásos elmezavarban szenvedő páciens jelentkezik kezelésre a fogorvosi rendelőben, pszichiátriaikonzultációt kell biztosítani. Az elektív fogászati beavatkozásokat el kell halasztani mindaddig, amíg a páciens tüneteikontroll alá kerülnek. A gyógyszerek mellékhatásai súlyosak lehetnek, ezért elengedhetetlen a beteg gondos és folyamatosellenőrzése

Dental erosions in patients with anorexia and bulimia nervosa

Bulimia nervosa and anorexia are among the most common chronic, psychosocial pathological eating disorders. Fear of obesity is the main element in both diseases. Restricted food intake associated with extreme weight loss is characteristic of anorexia. Bulimia nervosa is characterized by repeated episodes of uncontrolled and unrestricted eating followed by starvation, self-induced vomiting, or intake of laxatives.Eating disorders have severe consequences for the cardiovascular system, the gastrointestinal system, the skeletal system, and reproductive health. In addition to having the potential to impair physical and psychoemotional health, these diseases also affect the oral cavity. Eating disorders are serious and potentially dangerous conditions leading to a number of disturbances in the body, some of which are reversible, but those that affect the hard dental tissues do not undergo reverse development

Frequency of daytime tooth clenching episodes in individuals affected by masticatory muscle pain and pain-free controls during standardized ability tasks

Tooth clenching has been suggested to be related to temporomandibular pain. However, the electromyographic characteristics of daytime clenching episodes have been minimally investigated. This study aimed to analyze the frequency, amplitude, and duration of daytime clenching episodes in patients with masticatory muscle pain and pain-free individuals

Association between awake oral parafunctional behaviors and temporomandibular disorders

Temporomandibular disorders (TMD) represent a very common public health problem. Awake oral parafunctional behaviors may contribute to their establishment. They include oral habits that differ from physiological functional needs such as mastication, communication, swallowing or breathing and they could be considered as adverse behaviors because of their detrimental effects on teeth, temporomandibular joints and jaw muscles. Awake oral parafunctions can be detected through surface electromyography (EMG) or questionnaires completed from the patient, like the Oral Behaviors Checklist (OBC). This thesis is the result of researches showing that a strong relationship between such behaviors and TMD exists, by confirming what widely explained in literature. The strength of the present findings is that they have been obtained through standardized Diagnostic Criteria (DC) to make TMD diagnosis and through valid methods for the assessment of wake-time oral parafunctions. Based on these data, clinicians should focus on the reduction of awake parafunctions in the multifactorial treatment of patients affected from TMD by carefully administering them a correct behavioral counselling. Therefore, this might reduce the overload on temporomandibular joint and consequently the development of TMD. However, more researches based on greater samples and standardized methods, should be conducted to expand and clarify the knowledge about this controversial topic

Psychophysiological and Oral Impact of The Covid-19 Health Crisis

Aim: The infectious disease known as COVID-19, caused by the SARS-CoV-2 virus, has had a diverse impact on the population, affecting each person individually. Material and method: As a measure to curb its rapid spread, a mandatory quarantine was implemented involving the isolation of both carriers and non-carriers of the disease. This situation has triggered negative psychological and oral responses, generating disorders such as stress, depression and anxiety, which are characterized by alterations in cognition, emotional regulation and behavior. Statistics and Result: In addition, oral manifestations such as bruxism, periodontal disease and other lesions have been observed. The purpose of this literature review is to investigate the possible relationship between the oral and psychophysical state of people due to the isolation caused by the pandemic and COVID-19 disease

Eating and oral hygiene habits in a population of young adults: An observational study

Aim: Eating Disorders (ED) are a group of psychological disorders affecting patients’ relationship with food and their own body. In particular, they have an impact on teeth and oral mucosa and may cause dental caries, erosions, xerostomia, salivary glands modifications and perioral tissue metabolic impairment. The aim of this paper is to investigate the risk factors associated with ED in a population of young adults by considering the impact such disorders have on oral health, particularly in view of the increased rate of tooth erosion recorded in recent years. Materials and methods: An observational study was conducted by submitting, to a population of young adults in the Brescia area, an anonymous questionnaire (39 questions) to reveal their behaviours regarding their eating habits and lifestyles. The areas investigated were oral hygiene and eating habits. Results: A total of 212 young people were interviewed (M/F 18-25 in Brescia and its province) and the sample is at risk of developing ED in general owing to their eating habits and lifestyles: 65% of the respondents think diligently about food, and 57% of them worry about putting on weight, both these characteristics are typical to all EDs; 14% of the sample stated not eating in the company of family and friends in the way they would like out of embarrassment and shame. After eating, 8% of them “nearly always” feel remorse, and 41% “only on some occasions”. After having ‘transgressed’, 22% will fast or go on a diet to compensate for their excesses. Conclusions: EDs are a continually growing and evolving pathological problem. Informing and training healthcare professionals and citizens about the damage caused by EDs to the entire body could help to understand the importance of making a multidisciplinary evaluation from the outset of the problem and right from the first contact with the patient. To this end, dentists and dental hygienists are in the delicate situation of being among the first health professionals able to see early signs and symptoms of ED in the mouth and elsewhere

Bruxism and psychotropic medications

This is an accepted manuscript of an article published by Wiley in Progress in Neurology and Psychiatry on 13/02/2020, available online: https://wchh.onlinelibrary.wiley.com/doi/10.1002/pnp.560 The accepted version of the publication may differ from the final published version.Mental Health Disorders including schizophrenia, bipolar and schizoaffective disorders are often treated using psychotropic medications with evidence that some of these medications such as antipsychotics could be associated with significant oral side-effects. In this comprehensive review, we examine the psychotropic medications mechanisms of action and their oral side-effects, with specific focus on psychotropic medications and bruxism as a major oral health complication with a negative impact on the quality of life of mental health sufferers, relevant to psychiatrists, dentists and general practitioners. Bruxism could be caused by the antipsychotics extrapyramidal side-effects through dopaminergic receptors. Bruxism as a side-effect of psychotropic medications could result in significant consequences to oral health such as tooth structure destruction and irreversible harm to the temporomandibular joint. The review findings could assist in understanding the aetiology of bruxism, establish appropriate management plan, while supporting psychiatrists and dentists to detect temporomandibular dysfunctions (TMD) such as bruxism

The impact of nocturnal wear of the prosthesis on the oral health-related quality of life of an apneic edentulous population

Résumé Problématique : La perte de dents est l’une des maladies chroniques associées à plusieurs altérations anatomiques et fonctionnelles de la cavité buccale et des voies respiratoires supérieures. Ces changements entraînent une détérioration de la qualité de vie liée à la santé bucco-dentaire (OHRQoL), en particulier chez les personnes âgées. Les prothèses complètes permettent d’améliorer l'apparence et peuvent restaurer certaines fonctions masticatoires altérées par l’édentement, créant ainsi un impact positif sur la qualité de vie liée à la santé buccodentaire. Cependant, le port continu des prothèses dentaires pendant la nuit, peut amener des problèmes de santé buccodentaires. Toutefois, certaines études ont montré que le fait de dormir avec une prothèse dentaire avait un impact positif sur la qualité du sommeil et la qualité de la vie. Objectifs : L’objet de ce projet de maîtrise est d’étudier l’impact du port nocturne des prothèses complètes sur l’OHRQoL, chez les patients âgés édentés et souffrant d’apnée obstructive du sommeil (AOS). Méthodologie : Ce projet de maîtrise est imbriqué dans un essai clinique croisé randomisé portant sur 70 patients âgés (65 ans et plus), complètement édentés et diagnostiqués avec une AOS modérée à sévère (IAH ≥ 10). Les participants ont été assignés au hasard à l'un des deux groupes (dormant avec ou sans les prothèses dentaires dans un ordre inverse), pendant deux périodes de 30 jours. Les données sur les effets du port nocturne des prothèses dentaires sur la qualité de vie liée à la santé et la qualité de vie liée à la santé buccodentaire ont été recueillies au début et au cours des deux visites de suivi, à l’aide du questionnaire Oral Health Impact Profil (OHIP-20) et du formulaire abrégé SF-36 respectivement. L'analyse des données a été réalisée à l'aide de modèles à effets mixtes pour les mesures répétées, considérant notamment le type d'intervention (dormir avec ou sans prothèses), la séquence d’intervention et la période. Résultats: Les résultats rapportés ci-dessous sont basés sur les données recueillies auprès de 63 patients. Le score global de l’OHIP-20 était légèrement plus élevé, mais non significatif (p=0.08), chez les patients qui dormaient avec leurs prothèses que chez ceux qui dormaient sans prothèses. Les scores de toutes les sous-échelles du questionnaire OHIP-20 ont augmenté chez les patients qui dormaient avec leurs prothèses, à l’exception de l’incapacité sociale, qui a légèrement diminué, et de handicap qui est resté inchangé. Cependant, l’impact négatif significatif n’a été signalé que pour deux scores de l’OHIP-20 : psycho-inconfort (p = 0,04) et incapacité physique (p = 0,05). Les scores OHIP-20 n’ont été influencés ni par la séquence de randomisation ni par le nombre de visites, à l’exception des scores de handicap, qui ont légèrement augmenté chez les sujets assignés à dormir avec leurs prothèses dentaires au cours de la première période de cette étude. En revanche, les résultats du SF-36 ont montré une amélioration des scores moyens de toutes les sous-échelles chez les personnes dormant avec leurs prothèses, mais les seuls impacts significatifs étaient constatés sur les aspects de la fonction sociale et du changement de l’état de santé (p <0,01 et p = 0,01 respectivement). La séquence d'attribution a eu un effet significatif sur la fonction physique (p = 0,03), la douleur (p = 0,02) et le changement de santé (p = 0,02). Le nombre de visites de suivi n'a eu un impact significatif que sur le domaine de la fonction physique (p = 0,03). Conclusion : Bien que dormir avec les prothèses dentaires puisse avoir un impact négatif sur les aspects psychiques et physiques d’OHRQoL, il pourrait également avoir un impact positif sur les aspects sociaux de la fonction et des changements de santé de la HRQoL. Les résultats de la recherche de ce travail de maitrise doivent être considérés comme préliminaires car l’analyse totale des données n’est pas encore terminée.Problematic: Tooth loss is one of the chronic diseases associated with several anatomical and functional alterations in the oral cavity and the upper airway tract. These changes result in the deterioration in oral health-related quality of life (OHRQoL), particularly among the elderly. Complete dentures can enhance the appearance and restore some impaired masticatory functions, creating a positive impact on OHRQoL. However, continuous nocturnal wear of dentures may raise oral health problems. In contrast, some studies have found that the impact of sleeping with dentures is positive with regard to the quality of sleep and quality of life. Objectives: The aim of this Master’s study is to investigate the impact of sleeping with dentures on OHRQoL in edentulous elderly patients who suffer from obstructive sleep apnea (OSA). Methodology: This master research project is nested in a randomized, crossover trial study of 70 edentulous elderly patients diagnosed with moderate to severe OSA (AHI ≥10). The participants were randomly assigned to one of two groups (sleeping with or without the prosthesis in opposite order), for two periods with a 30-day interval between them. Data on the effect of nocturnal wearing of dentures on OHRQoL and health-related quality of life (HRQoL) were collected at the baseline and during the two follow-up visits, using the Oral Health Impact Profile (OHIP-20) and Short form (SF-36) questionnaires respectively. Data analysis was performed using mixed effect models appropriate for repeated measures including types of intervention (sleeping with or without dentures), sequence and visit number. Results: Results reported below are based on data collected from 63 patients. The overall OHIP-20 score was slightly higher among patients who wore their dentures while sleeping than in those who did not, but not at a significant level (p=0.08). The scores of all OHIP-20 subscales were increased among patients who slept with prosthesis, except for the social disability which slightly decreased, and the handicap remained at the same average. However, the significant negative impact was reported only for two OHIP scores: psycho-discomfort (p=0.04) and physical disability (p=0.05). OHIP-20 scores were influenced neither by the assignment sequence nor by the period, with an exception for handicap scores which slightly increased among elders assigned to sleep with dentures in the first period of this study. In contrast, SF-36 results showed an improvement in the mean scores in all subscales among the elderly when participants were sleeping with dentures, but the only significant impacts were found on social function and health change aspects (p <0.01, and p=0.01, respectively). The assignment sequence had a significant effect on physical function (p=0.03), pain (p=0.02), and health change (p=0.02). The follow-up visit number had a significant impact only on the physical function domain (p=0.03). Conclusion: While sleeping with dentures could have a negative impact on psycho-discomfort and physical discomfort aspects of OHRQoL, it could have a positive impact on the social function and health change aspects of HRQoL. The results of this Master’s research should be considered as preliminary since the total data analysis has not completed yet