Published in the September issue of the British Journal of Psychiatry, investigators from the University of Queensland have discovered compared to the general population, that individuals with severe mental illnesses are over three times more likely to lose their teeth due to poor oral health.

Researchers have called for free dental care for individuals with severe mental illness, after the investigation revealed that psychiatric patients have not shared in recent improvements in dental health.

Published over the past two decades, 14 studies regarding the oral health of those with severe mental illness were examined.

All 2784 of the psychiatric patients in the reports had been diagnosed with severe mental illness, such as schizophrenia, dementia, bipolar disorder or other affective disorders.

They discovered that psychiatric patients were 3.4 more likely to have lost all their teeth, and were 6.2 times more likely to have decayed, filled or missing teeth.

Lead investigator Professor Steve Kisely said that a combination of factors were to blame, explaining that:

“People with severe mental illness may not be able to clean their teeth properly because of poor housing or homelessness. Some medications such as antidepressants and mood stabilisers can also reduce the flow of saliva and cause dry mouth (xerostomia), which increases plaque formation. They may be reluctant to see a dentist because of they are scared of treatment, or worried about the cost. Our analysis shows that, although the oral health of the general population has improved in much of the world, psychiatric patients remain at a disadvantage. This mirrors findings in other areas such as cardiovascular disease, where the health of the general population has improved – but not that of people with severe mental illness. Oral health should be part of the standard assessment for all patients with severe mental illness. When patients are admitted to hospital, their care plans should include a basic assessment of oral hygiene – including factors known to cause oral ill-health such as medication, tobacco and drug use. Patients with mental illness who are treated in the community should be given advice on diet, smoking and brushing technique. We believe policy-makers should also consider providing free, accessible dental care for people with severe mental illness.”

Written by Grace Rattue