Oral health in Veterans Affairs patients diagnosed with serious mental illness.
OBJECTIVE
We evaluated patient and medication treatment factors associated with self-reported oral health status in patients diagnosed with serious mental illness (SMI) in a large, national sample of patients in the Veterans Affairs (VA) health system.


METHODS
4,769 patients (mean age = 55, 7.8 percent women) were included from the VA's 1999 National Psychosis Registry (NPR) for whom the oral health information gathered by the VA's Large Health Survey of Veterans was available. Current (1999) psychotropic medication data were ascertained from the NPR. Multivariable logistic regression analyses were used to determine the patient factors (e.g., sociodemographic, enabling, and treatment factors) associated with poor or fair overall dental health, and with having tooth or mouth problems that made it difficult to eat.


RESULTS
While 61.0 percent of persons with SMI self-reported fair to poor dental health, 34.1 percent reported that oral health problems made it difficult for them to eat. Patients who were not employed, experiencing financial strain, who smoked, who were prescribed tricyclic antidepressants, or prescribed selective serotonin reuptake inhibitors were more likely to report poor or fair dental health. These variables were also associated with having tooth or mouth problems.


CONCLUSIONS
Suboptimal oral health was self-reported with substantial prevalence among patients with SMI, a problematic finding given its consequences for general health, social functioning, and quality of life. Greater efforts are needed to improve oral health outcomes among patients with SMI by facilitating access to dental care and addressing mutable factors such as smoking and medication side effects.
Kilbourne
Amy M
AM
VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI 48105, USA. Amy.Kilbourne@va.gov
Horvitz-Lennon
Marcela
M
Post
Edward P
EP
McCarthy
John F
JF
Cruz
Mario
M
Welsh
Deborah
D
Blow
Frederic C
FC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003753:Dental Health Surveys; D005260:Female; D006801:Humans; D007057:Ichthyosis / Q000139:chemically induced; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010510:Periodontal Diseases / Q000150:complications*; D011619:Psychotropic Drugs / Q000009:adverse effects; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D014076:Tooth Diseases / Q000150:complications* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*
D011619:Psychotropic Drugs