title: An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel.
abstract: Many institutionalized patients with psychiatric disease have been discharged into the community and the patients who remain hospitalized are at a particularly high risk for dental disease. This study assessed the oral health and treatment needs of chronically hospitalized patients with psychiatric disease in Israel. A random sample of 301 patients hospitalized for more than 1 year in 14 of 18 psychiatric institutions in Israel was drawn from the National Psychiatric Hospitalization Registry, and 84.4% of them were examined. Their dental status was evaluated using decayed, missing, filled teeth (DMF-T) index and demographic and medical data were retrieved from the patients' files. Of the 254 patients examined, 4 (1.6%) were caries-free, 176 (69%) patients had only a partial natural dentition, while 66 (26%) were edentulous. The average DMF-T score was 23.8. The caries component accounted for 2.7 of the DMF-T, the missing teeth component was 20, and the restored teeth component was only 1.1. There was a negative correlation between age and treated caries, and a positive correlation between age and missing teeth. Not all edentulous patients had dentures. These findings confirm the need to improve the oral health of chronic psychiatric inpatients and the need for dental treatment. The existing policy should be adjusted to integrate the currently separated delivery of the dental services for institutions and community settings. Dental professionals in the health service should be rewarded to restore teeth in this population rather than just to extract them.
authors.affiliation: Ministry of Health, Dental Health Division, Jerusalem, Israel. shlomo.zusman@moh.health.gov.il
authors.forename: Shlomo Paul
authors.initials: SP
authors.lastname: Zusman
authors.forename: Alexander Michael
authors.initials: AM
authors.lastname: Ponizovsky
authors.forename: Dan
authors.initials: D
authors.lastname: Dekel
authors.forename: Abd-El-Samia
authors.initials: AE
authors.lastname: Masarwa
authors.forename: Tirza
authors.initials: T
authors.lastname: Ramon
authors.forename: Lena
authors.initials: L
authors.lastname: Natapov
authors.forename: Alexander
authors.initials: A
authors.lastname: Grinshpoon
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004245:DMF Index; D017742:Dental Care for Chronically Ill / Q000706:statistics & numerical data; D003731:Dental Caries / Q000453:epidemiology; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D003778:Dentures / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D007576:Jaw, Edentulous, Partially / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000453:epidemiology; D020380:Needs Assessment / Q000706:statistics & numerical data; D019965:Neurocognitive Disorders / Q000453:epidemiology; D009909:Oral Health; D012559:Schizophrenia / Q000453:epidemiology; D012737:Sex Factors; D016388:Tooth Loss / Q000453:epidemiology; D055815:Young Adult