Department of Oral Health Sciences, School of Dentistry, University of Washington, 1959 N.E. Pacific St., Box 357475, Seattle, Wash. 98195-7475, USA.
J Am Dent Assoc. 2013 Mar;144(3):e16-23. doi: 10.14219/jada.archive.2013.0122.
Mental illness (MI) affects approximately one in five U.S. adults, and it is associated with oral disease and poor dental treatment outcomes. Little is known about dental care utilization or unmet dental need in this population.
The authors examined data regarding presence or absence of dental visits and unmet dental need in community-dwelling adults with MI from the 2007 Medical Expenditure Panel Survey. They tested differences between adults with and without MI by using multivariate logistic regression.
Eighteen percent of adults (N = 19,368) had MI, and of these, 6.8 percent had unmet dental need. Although people with MI were not significantly more likely to have had a dental visit (46.3 percent) than were those without MI (42.2 percent; odds ratio [OR], 1.09; 95 percent confidence interval [CI], 0.97-1.23), they were significantly more likely to report unmet need (11.0 versus 5.3 percent; OR, 2.00; 95 percent CI, 1.67-2.41). Those with mood or anxiety disorders were most likely to report having an unmet dental need (P < .001 for all values).
Although people with MI did not visit the dentist significantly more often than did adults without MI, their higher level of unmet need suggests that current use of dental services is not addressing their needs adequately.
Dentists should be familiar with MI conditions as patients with MI may have greater unmet dental need.
精神疾病（MI）影响了大约五分之一的美国成年人，它与口腔疾病和较差的牙科治疗结果有关。在该人群中，人们对牙科保健的利用或未满足的牙科需求知之甚少。
作者从 2007 年医疗支出面板调查中研究了患有 MI 的社区居住成年人的牙科就诊情况和未满足的牙科需求数据。他们通过使用多变量逻辑回归测试了患有 MI 和未患有 MI 的成年人之间的差异。
18%的成年人（N=19368）患有 MI，其中 6.8%有未满足的牙科需求。尽管患有 MI 的人看牙的可能性（46.3%）并不比没有 MI 的人（42.2%；比值比[OR]，1.09；95%置信区间[CI]，0.97-1.23）高，但他们更有可能报告有未满足的需求（11.0%比 5.3%；OR，2.00；95%CI，1.67-2.41）。患有情绪或焦虑障碍的人最有可能报告有未满足的牙科需求（所有值均为 P<0.001）。
尽管患有 MI 的人看牙医的频率并不明显高于没有 MI 的成年人，但他们更高的未满足需求表明，目前对牙科服务的利用并未充分满足他们的需求。
牙医应该熟悉 MI 状况，因为 MI 患者可能有更大的未满足的牙科需求。
