A Systematic Review and Meta-Analysis of the Association Between Poor Oral Health and Severe Mental Illness
A Systematic Review and Meta-Analysis of the Association Between Poor Oral Health and Severe Mental Illness
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DOI：
10.1097/psy.0000000000000135
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发表时间：
2015-01-01
影响因子：
3.3
通讯作者：
Johnson, Newell W.
中科院分区：
文献类型：
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作者：
Kisely, Steve;Baghaie, Hooman;Johnson, Newell W.
精神科患者的躯体疾病合并症增加。然而，关于牙病，特别是蛀牙的信息较少，尽管生活方式的风险因素或精神药物引起的口干在这一人群中存在。重要的是，口腔健康状况不佳会使人们容易患上慢性身体疾病，导致本可避免的因医疗原因住院。方法使用MEDLINE、PsycInfo、EMBASE和文献参考文献，我们对过去25年来关于重度精神疾病（SMI）患者口腔健康的研究进行了系统的检索。结果与一般人群进行比较。这两个结果是全牙脱落（无牙）和蛀牙，通过以下标准化措施测量：蛀牙，缺失和填充牙齿或表面的平均数量。结果：我们确定了25项有足够数据进行随机效应荟萃分析的研究。这些研究涵盖了5076名精神病患者和39,545名对照组，后者来自同一研究或社区调查。重度精神障碍患者牙齿全部脱落的几率是普通人群的2.8倍（95%可信区间[CI] = 1.7-4.6）。他们的蛀牙、缺牙和补牙（平均差值= 5.0,95% CI = 2.5-7.4）和牙面评分（平均差值= 14.6,95% CI = 4.1-25.1）也明显更高。结论对重度精神分裂症患者身体健康的关注应包括口腔健康。可能的干预措施包括使用可由非牙科人员完成的标准检查清单进行口腔健康评估，帮助进行口腔卫生，处理医源性口干，以及早期牙科转诊。
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.