Understanding the oral health status and factors affecting poor oral health in people living with severe mental illness: a cross-sectional study

Objectives: To assess the oral health status of patients with severe mental illness visiting the Collaborative Centre for Cardiometabolic Health in Psychosis clinics and examine the effect of demographic, medical and social factors on Oral Health (OH). Methods: The cross-sectional study included adults aged 18–65 years with severe mental illness who attended the clinics in Sydney, Australia between June 2016 and December 2020. As part of the OH assessment, information about their oral hygiene behaviours was recorded and participants underwent dental examination to assess their dental status. Results: The majority of the 845 patients were male (63%), with a mean age of 43.4 years and a diagnosis of Schizophrenia (61%). Co-morbidities included dyslipidaemia (93.3%), overweight/obesity (81%), and hypertension (47%). Gingival inflammation was noticed in 80% of participants. Caries experience was high, with 44% having active tooth decay requiring restoration or extraction. Age, smoking, schizophrenia, depression and cardiometabolic conditions like diabetes and hypertension were significantly associated with caries. Gingival inflammation was significantly associated with psychiatric diagnosis and antipsychotic medications, male gender, smoking and diabetes. Conclusions: People with severe mental illness have a high prevalence of dental caries and gingival inflammation. A strong association between dental diseases and demographics as well as cardiometabolic conditions emphasises the need for a multipronged approach to improve the overall health outcomes of people with severe mental illness.