Sharma Dileep, Higgins Oliver, Sawicki Aleksander, Ramamurthy Poornima, Field Belinda, Hussein Paul, Singh Kiran, Ranjitkar Sarbin
Oral Health, University of Newcastle, Ourimbah, New South Wales, Australia.
Healthy Minds, Hunter Medical Research Institute, Lambton Heights, New South Wales, Australia.
J Oral Pathol Med. 2025 Jul;54(6):401-412. doi: 10.1111/jop.13639. Epub 2025 May 6.
There has been a significant increase in antipsychotic usage, particularly belonging to second-generation antipsychotics (SGAs), in the management of severe mental illnesses (SMIs) over the past few decades, but their impact on oral health is unclear. This review evaluated the oral side effects of the SGAs used in managing SMIs.
A PRISMA-guided scoping review was conducted, using predefined criteria and relevant word combination in Medline (PubMed), Embase, Scopus and Cochrane databases. Eligible studies were assessed for study type, population demographics, antipsychotic medication usage, oral diseases and conditions, and their outcomes. Primary outcomes were explicitly studied oral conditions or diseases, and secondary outcomes were broader oral or general "treatment-emergent adverse effects."
Twelve studies met the inclusion criteria for the primary outcomes and 13 for the secondary outcomes. The most reported primary outcomes were salivary gland dysfunction (hypofunction, three studies; hypersalivation, two studies), dental caries (positive association, three studies; no association, one study), and periodontal disease (five studies). Secondary outcomes included dysgeusia and oral hypoesthesia (six studies).
SGAs significantly compromise oral health, particularly through salivary gland and sensory dysfunction, highlighting the need for up-to-date guidelines on routine oral screening and preventive care.
在过去几十年中，抗精神病药物的使用显著增加，尤其是第二代抗精神病药物（SGA），用于治疗严重精神疾病（SMI），但其对口腔健康的影响尚不清楚。本综述评估了用于治疗SMI的SGA的口腔副作用。
采用PRISMA指导的范围综述，在Medline（PubMed）、Embase、Scopus和Cochrane数据库中使用预定义标准和相关词汇组合。对符合条件的研究进行评估，包括研究类型、人群统计学、抗精神病药物使用情况、口腔疾病和状况及其结果。主要结局是明确研究的口腔状况或疾病，次要结局是更广泛的口腔或一般“治疗中出现的不良反应”。
12项研究符合主要结局的纳入标准，13项符合次要结局的纳入标准。报告最多的主要结局是唾液腺功能障碍（功能减退，3项研究；唾液分泌过多，2项研究）、龋齿（正相关，3项研究；无关联，1项研究）和牙周疾病（5项研究）。次要结局包括味觉障碍和口腔感觉减退（6项研究）。
SGA显著损害口腔健康，尤其是通过唾液腺和感觉功能障碍，这凸显了制定关于常规口腔筛查和预防保健的最新指南的必要性。
