Wey Mang Chek, Loh SiewYim, Doss Jennifer Geraldine, Abu Bakar Abdul Kadir, Kisely Steve
Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Aust N Z J Psychiatry. 2016 Jul;50(7):685-94. doi: 10.1177/0004867415615947. Epub 2015 Nov 11.
People with chronic schizophrenia have high rates of physical ill-health such as heart disease. However, there has been less attention to the issue of poor oral health including dental caries (tooth decay) and periodontal (gum) disease, although both have consequences for quality of life and systemic physical health. We therefore measured tooth decay and gum disease in Malaysians with schizophrenia.
We recruited long-stay inpatients with schizophrenia from June to October 2014. Four dental specialists assessed oral health using the decayed-missing-filled teeth index, the Community Periodontal Index of Treatment Needs and the Debris Index of the Simplified Oral Hygiene Index. Results were compared with the 2010 Oral Health survey of the general Malaysian population.
A total of 543 patients participated (66.7% males, 33.3% females; mean age = 54.8 years [standard deviation = 16.0]) with a mean illness duration of 18.4 years (standard deviation = 17.1). The mean decayed-missing-filled teeth was 20.5 (standard deviation = 9.9), almost double that of the general population (11.7). Higher decayed-missing-filled teeth scores were associated with both older age (p < 0.001) and longer illness duration (p = 0.048). Only 1% (n = 6) had healthy gums. Levels of decay and periodontal disease were greatest in those aged between 45 and 64 years, coinciding with the onset of tooth loss.
Dental disease in people with schizophrenia deserves the same attention as other comorbid physical illness. The disparity in oral health is most marked for dental decay. Possible interventions include oral health assessments using standard checklists designed for non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth and early dental referral.
慢性精神分裂症患者患有心脏病等身体疾病的比例较高。然而，口腔健康不佳的问题，包括龋齿（蛀牙）和牙周（牙龈）疾病，却较少受到关注，尽管这两者都会对生活质量和全身身体健康产生影响。因此，我们对马来西亚精神分裂症患者的龋齿和牙龈疾病情况进行了测量。
我们于2014年6月至10月招募了长期住院的精神分裂症患者。四名牙科专家使用龋失补牙指数、社区牙周治疗需求指数和简化口腔卫生指数中的牙菌斑指数对口腔健康进行评估。将结果与2010年马来西亚普通人群的口腔健康调查结果进行比较。
共有543名患者参与（男性占66.7%，女性占33.3%；平均年龄 = 54.8岁[标准差 = 16.0]），平均病程为18.4年（标准差 = 17.1）。龋失补牙的平均数为20.5（标准差 = 9.9），几乎是普通人群（11.7）的两倍。龋失补牙得分较高与年龄较大（p < 0.001）和病程较长（p = 0.048）均相关。只有1%（n = 6）的患者牙龈健康。45至64岁人群的龋齿和牙周疾病水平最高，这与牙齿脱落的开始时间一致。
精神分裂症患者的牙齿疾病应与其他合并身体疾病受到同等关注。口腔健康方面的差异在龋齿方面最为明显。可能的干预措施包括使用为非牙科人员设计的标准检查表进行口腔健康评估、帮助进行口腔卫生护理、处理医源性口干以及早期转诊至牙科。
