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精神病与口腔健康的关联:病例对照研究。

Association of psychosis and oral health: case-control study.

作者信息

Wölfle Uta Christine, Beck Franziska, Werner Nils, Pitchika Vinay, Heck Katrin, Folwaczny Matthias, Schwendicke Falk, Boudriot Emanuel, Greiner Sophie-Kathrin, Hasan Alkomiet, Falkai Peter, Löhrs Lisa, Bumm Caspar Victor

机构信息

Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestraße 70, Munich, 80336, Germany.

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

出版信息

Clin Oral Investig. 2025 Aug 6;29(9):397. doi: 10.1007/s00784-025-06463-6.

Abstract

OBJECTIVES

Roughly one in eight individuals presents with psychiatric disorders which were proposed to significantly affect oral health. This study compared oral health of 112 patients (mean 28 years), 31 with schizophrenia spectrum disorders (SSD) or 33 with major depression/bipolar disorders (MDD/BD) to 52 healthy controls (HCG).

MATERIALS AND METHODS

Oral health parameters, including caries experience (decayed-missed-filled teeth/surfaces-index DMFT/DMFS), the presence of plaque (plaque-index PI) and periodontal health (bleeding on probing BOP, periodontal probing depths PPD%), were evaluated by examiners blinded to psychiatric diagnoses. Descriptive statistics summarized demographic and clinical data. Group differences and associations with dental outcomes were analyzed using Chi-square or Mann-Whitney-U tests. Logistic regression identified predictors of oral health.

RESULTS

Patients with SSD or MDD/BD resented with significantly oorer oral health than HCG regarding DMFT (SSD = 9; MDD/BD = 10; HCG = 2), DMFS (SSD = 10; MDD/BD = 12; HCG = 1), PI (SSD = 2; MDD/BD = 2; HCG = 1), BOP (SSD = 20%; MDD/BD = 17%; HCG = 3)% and PPD% (SSD = 1%; MDD/BD = 0%; HCG = 0%) and smoked more often. Differences regarding dental anxiety were not significant (p = 0.112). Subgroup analysis showed no differences between SSD and MDD/BD.

CONCLUSIONS

SSD and MDD/BD and smoking are key contributors to poor dental health shown by significantly worse DMFT, DMFS and PI, BOP. Probably this might additionally be enhanced by concomitant medication, with multiple psychiatric medication being associated with poorer oral health regarding DMFT, PI and BOP.

CLINICAL RELEVANCE

Routine dental care and personalized oral hygiene training to address disease-specific risks are desirable for individuals with SSD or MDD/BD.

摘要

目的

约八分之一的人患有精神疾病,这些疾病被认为会显著影响口腔健康。本研究比较了112例患者(平均年龄28岁)的口腔健康状况,其中31例患有精神分裂症谱系障碍(SSD)或33例患有重度抑郁症/双相情感障碍(MDD/BD),并与52名健康对照者(HCG)进行对比。

材料与方法

口腔健康参数,包括龋病经历(龋失补牙数/面指数DMFT/DMFS)、牙菌斑的存在情况(菌斑指数PI)和牙周健康状况(探诊出血BOP、牙周探诊深度PPD%),由对精神疾病诊断不知情的检查者进行评估。描述性统计总结了人口统计学和临床数据。使用卡方检验或曼-惠特尼-U检验分析组间差异以及与牙科结果的关联。逻辑回归确定口腔健康的预测因素。

结果

与HCG相比,患有SSD或MDD/BD的患者在DMFT(SSD = 9;MDD/BD = 10;HCG = 2)、DMFS(SSD = 10;MDD/BD = 12;HCG = 1)、PI(SSD = 2;MDD/BD = 2;HCG = 1)、BOP(SSD = 20%;MDD/BD = 17%;HCG = 3%)和PPD%(SSD = 1%;MDD/BD = 0%;HCG = 0%)方面的口腔健康明显较差,且吸烟频率更高。在牙科焦虑方面的差异不显著(p = 0.112)。亚组分析显示SSD和MDD/BD之间没有差异。

结论

SSD和MDD/BD以及吸烟是导致牙齿健康状况不佳的关键因素,表现为DMFT、DMFS以及PI、BOP明显更差。可能同时使用的药物会进一步加剧这种情况,多种精神科药物与DMFT、PI和BOP方面更差的口腔健康状况相关。

临床意义

对于患有SSD或MDD/BD的个体,进行常规牙科护理和针对特定疾病风险的个性化口腔卫生培训是很有必要的。

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