Poor oral health in patients with schizophrenia: A systematic review and meta-analysis

Abstract

Increased rates of comorbid physical illness have been commonly reported in patients with schizophrenia. However, there are fewer data on dental disease in these patients. We systematically evaluated existing data on the oral health survey of schizophrenia patients through meta-analysis. Using the available databases, we performed a systematic search to identify the studies examining the oral health in schizophrenia patients from January 1997 to June 2017, based on the inclusion and exclusion criteria. Two investigators extracted the related data independently. The meta-analysis was performed by using the RevMan 5.3 software after data extraction and quality assessment. We compared the oral health results between the schizophrenia patients and the general population, including the following measures: the mean number of decayed, missing and filled teeth (DMFT). Eight studies comprising 2640 patients with schizophrenia and 19,698 healthy controls were included in the meta-analysis. The patients with schizophrenia had significantly higher scores of dental caries (mean difference [MD] = 7.77, 95% confidence interval [CI] = 3.27 to 12.27), missing teeth (MD = 7.61, 95% CI = 3.44 to 11.77), and decayed teeth (MD = 3.44, 95% CI = 2.06 to 4.82) compared to controls (all p < 0.01). By contrast, the schizophrenia patients had fewer score of filled teeth (MD = −3.06, 95% CI, −4.82 to −1.30) than the controls (p < 0.01), indicating decreased access to dental care. Our systematic review suggests that patients with schizophrenia have worse oral health than the general population, but have received less dental care services. Hence, the oral health services should be taken into account in the patients with schizophrenia.