Article metrics

  • citations in SCindeks: [1]
  • citations in CrossRef:0
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:11
  • full-text downloads in 30 days:6
article: 1 from 152  
Back back to result list
Balkan Journal of Dental Medicine
2016, vol. 20, iss. 1, pp. 15-21
article language: English
document type: Review Paper
published on: 21/01/2017
doi: 10.1515/bjdm-2016-0002
Schizophrenia and oral health: Review of the literature
aClinical Center of Serbia, Clinic for Psychiatry, Belgrade
bClinical Center of Serbia, Clinic for Psychiatry, Belgrade + University of Kragujevac, Faculty of Medicine
cUniversity of Belgrade, Faculty of Dental Medicine
dMedical Academy of the Serbian Medial Society



Patients with schizophrenia, especially during period of their hospitalization, are likely to constitute a high-risk group of individuals with respect to prevalence of oral diseases. Several factors are mentioned in the manuscript that may contribute to the finding of increased prevalence of oral diseases in patients with schizophrenia. Unfortunately, some of these can be attributed to dental profession; these patients are sometimes deprived of dental service as they cannot afford the treatment due to its cost and they are even neglected sometimes by dental professionals. The idea of providing oral health care in the environment of specialized health care institutions, such as psychiatric hospitals, during periods of hospitalization, is especially emphasized.



Adeniyi, A.A., Ola, B.A., Edeh, C.E., Ogunbanjo, B. O., Adewuya, A.O. (2011) Dental status of patients with mental disorders in a Nigerian teaching hospital: a preliminary survey. Special Care in Dentistry, 31(4): 134-137
Al-Mobeeriek, A. (2012) Oral Health Status among Psychiatric Patients in Riyadh, Saudi Arabia. West Indian Medical Journal, 61(5): 549-554
American Psychiatric Association (2000) Diagnostic and Statistical Manual for Mental Disorders. Washington, DC, 4th ed
Angelillo, I.F., Grasso, G.M., Sagliocco, G., Villari, P., d`Errico Marcello, M. (1991) Dental health in a group of drug addicts in Italy. Community Dentistry and Oral Epidemiology, 19(1): 36-37
Arnaiz, A., Zumárraga, M., Díez-Altuna, I., Uriarte, J.J., Moro, J., Pérez-Ansorena, M.A. (2011) Oral health and the symptoms of schizophrenia. Psychiatry Research, 188(1): 24-28
Aurer, A. (2003) Risk factors of systematic diseases and periodontitis. Medix, 50, 117-118
Bardow, A., Nyvad, B., Nauntofte, B. (2001) Relationships between medication intake, complaints of dry mouth, salivary flow rate and composition, and the rate of tooth demineralization in situ. Archives of oral biology, 46(5): 413-23
Barnes, G.P., Allen, E.H., Parker, W.A., Lyon, T.C., Armentrout, W., Cole, J.S. (1988) Dental treatment needs among hospitalized adult mental patients. Spec Care Dentist, 8(4): 173-7
Beloica, D., i dr. (2003) Paediatric dentistry. Belgrade: Elit Medica
Bertaud-Gounot, V., Kovess-Masfety, V., Perrus, C., Trohel, G., Richard, F. (2013) Oral health status and treatment needs among psychiatric inpatients in Rennes, France: a cross-sectional study. BMC Psychiatry, 13(1)
Brand, H. S., Gonggrijp, S., Blanksma, C. J. (2008) Cocaine and oral health. BDJ, 204(7): 365-369
Brand, H.S., Dun, S.N. (2008) Ecstasy (MDMA) and oral health. BDJ, 204(2): 77
Bühler, B., Hambrecht, M., Löffler, W., Heiden, W., Häfner, H. (2002) Precipitation and determination of the onset and course of schizophrenia by substance abuse--a retrospective and prospective study of 232 population-based first illness episodes. Schizophrenia research, 54(3): 243-51
Cantwell, R., Brewin, J., Glazebrook, C., Dalkin, T., Fox, R., Medley, I., Harrison, G. (1999) Prevalence of substance misuse in first-episode psychosis. British Journal of Psychiatry, 174(2): 150-153
Carney, C.P., Jones, L., Woolson, R.F. (2006) Medical comorbidity in women and men with schizophrenia: a population-based controlled study. Journal of general internal medicine, 21(11): 1133-7
Chambers, R.A., Krystal, J.H., Self, D.W. (2001) A neurobiological basis for substance abuse comorbidity in schizophrenia. Biol Psychiatry, 50(2): 71-83
Chu, K., Yang, N., Chou, P., Chiu, H., Chi, L. (2012) Comparison of oral health between inpatients with schizophrenia and disabled people or the general population. Journal of the Formosan Medical Association = Taiwan yi zhi, 111(4): 214-9
Clark, D.B. (2003) Dental care for the patient with bipolar disorder. Journal of Canadian Dental Association, 69(1): 20-4
Cormac, I., Jenkins, P. (1999) Understanding the Importance of Oral Health in Psychiatric Patients. Advances in Psychiatric Treatment, 5(1): 53-60
Dangore-Khasbage, S., Khairkar, P.H., Degwekar, S.S., Bhowate, R.R., Bhake, A.S., Singh, A., Lohe, V.K. (2012) Prevalence of oral mucosal disorders in institutionalized and non-institutionalized psychiatric patients: a study from AVBR Hospital in central India. Journal of Oral Science, 54(1): 85-91
Dejanovic-Đukic, S. (2006) Psychiatry. Kragujevac: University of Kragujevac
Dervaux, A. (2002) Substance misuse among people with schizophrenia: similarities and differences between the UK and France. British Journal of Psychiatry, 180(4): 381-a-381
Dimicpotic, J. (2000) Basics of Psychiatry for Dental Medical Students. Beograd: Zavod za udžbenike i nastavna sredstva
Dimitrijević, B., i dr. (2010) Clinical periodontology. Belgrade: Zavod za udzbenike i nastavna sredstva, in Serb
Đajić, D., i dr. (2001) Atlas of mouth diseases and periodontology. Belgrade: Elit Medica, in Serb
Enberg, N., Wolf, J., Ainamo, A., Alho, H., Heinälä, P., Lenander-Lumikari, M. (2001) Dental diseases and loss of teeth in a group of Finnish alcoholics: a radiological study. Acta odontologica Scandinavica, 59(6): 341-7
Evans, C.A., Kleinman, D.V. (2000) The Surgeon General's report on America's oral health: Opportunities for the dental profession. J Am Dent Assoc, 131(12): 1721-8
Farhadmollashahi, L., Lashkaripour, K., Bakhshani, N., Faghihinia, M. (2014) Dental Health Status in Hospitalized Psychiatric Patients in Sistan and Baluchestan Province, Iran. Health Scope, 3(4)
Fowler, I. L., Carr, V. J., Carter, N. T., Lewin, T. J. (1998) Patterns of Current and Lifetime Substance Use in Schizophrenia. Schizophrenia Bulletin, 24(3): 443-455
Friedlander, A.H., Liberman, R.P. (1991) Oral health care for the patient with schizophrenia. Special care in dentistry, 11(5): 179-83
Friedlander, A.H., Norman, D.C. (2002) Late-life depression: Psychopathology, medical interventions, and dental implications. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 94(4): 404-412
Friedlander, A.H., Marder, S.R. (2002) The psychopathology, medical management and dental implications of schizophrenia. Journal of the American Dental Association, 133(5): 603-10; quiz 624-5
Gopalakrishnapillai, A.C., Iyer, R.R., Kalantharakath, T. (2012) Prevalence of periodontal disease among inpatients in a psychiatric hospital in India. Special Care in Dentistry, 32(5): 196-204
Gowda, E., Bhat, P., Swamy, M. (2007) Dental Health Requirements for Psychiatric Patients. Medical Journal Armed Forces India, 63(4): 328-330
Griffiths, J., Jones, V., Leeman, I., Lewis, D., Patel, K., Wilson, K., Blankenstein, R. (2000) Oral health care for people with mental health problems-guidelines and recommendations. British Society for Disability and Oral Health Work Group, 1-20
Harris, C.K., Kaas, W., Johnson, N.W. (1996) Oral and dental health in alcohol misusers. Community Dental Health, 13: 199-203
Hede, B. (1995) Oral health in Danish hospitalized psychiatric patients. Community Dent Oral Epidemiol, 23(1): 44-8
Herrman, H., Saxena, S., Moodie, R., ur. (2005) Promoting mental health: Concepts, emerging evidence, practice: Report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne. Geneva: World Health Organization
Janardhanan, T., Cohen, C.I., Kim, S., Rizvi, B.F. (2011) Dental care and associated factors among older adults with schizophrenia. Journal of the American Dental Association, 142(1): 57-65
Jankovic, Lj., i dr. (2007) Oral Medicine: practicum. Belgrade: Zavod za udžbenike i nastavna sredstva
Jayakumar, H.L., Jyothi, D., i dr. (2011) Periodontal health among elderly psychiatric patients in Bangalore city-India. Pakistan Oral and Dental Journal, 31(1); 128-136
Jovanovic, S., Milovanovic, S.D., Gajic, I., Mandic, J., Latas, M., Jankovic, L. (2010) Oral health status of psychiatric in-patients in Serbia and implications for their dental care. Croatian medical journal, 51(5): 443-50
Jovanović, S., Gajić, I. (2008) Oral health in individuals with psychotic disorders. Stomatološki glasnik Srbije, vol. 55, br. 3, str. 180-187
Jyoti, B., Muneeshwar, P.D., Srivastava, R., Singh, A.R., Kiran, M., Simlai, J. (2012) Oral Health Status and Treatment Needs of Psychiatric Inpatients in Ranchi, India. Journal of Indian Academy of Oral Medicine and Radiology, 24: 177-181
Katz, G., Durst, R., Shufman, E., Bar-Hamburger, R., Grunhaus, L. (2008) Substance abuse in hospitalized psychiatric patients. Israel Medical Association journal, 10(10): 672-5
Kebede, B., Kemal, T., Abera, S. (2012) Oral Health Status of Patients with Mental Disorders in Southwest Ethiopia. PLoS ONE, 7(6): e39142
Kilbourne, A.M., Horvitz-Lennon, M., Post, E.P., McCarthy, J.F., Cruz, M., Welsh, D., Blow, F.C. (2007) Oral health in Veterans Affairs patients diagnosed with serious mental illness. Journal of public health dentistry, 67(1): 42-8
Kisely, S., Quek, L.-H., Pais, J., Lalloo, R., Johnson, N. W., Lawrence, D. (2011) Advanced dental disease in people with severe mental illness: systematic review and meta-analysis. British Journal of Psychiatry, 199(3): 187-193
Kossioni, A., Kossionis, G.E., Polychronopoulou, A. (2013) Variation in oral health parameters between older people with and without mental disorders. Special Care in Dentistry, 33(5): 232-238
Kossioni, A.E., Kossionis, G.E., Polychronopoulou, A. (2012) Oral health status of elderly hospitalised psychiatric patients. Gerodontology, 29(4): 272-83
Kučukalic, A., i dr. (2006) Guideline for therapy of schizophrenia. Sarajevo, in Bosnian
Kumar, M., Chandu, G.N., Shafiulla, M.D. (2006) Oral health status and treatment needs in institutionalized psychiatric patients: one year descriptive cross sectional study. Indian journal of dental research, 17(4): 171-7
Lewis, S., Jagger, R.G., Treasure, E. (2001) The oral health of psychiatric in-patients in South Wales. Spec Care Dentist, 21(5): 182-6
Manning, V., Betteridge, S., Wanigaratne, S., Best, D., Strang, J., Gossop, M. (2009) Cognitive impairment in dual diagnosis inpatients with schizophrenia and alcohol use disorder. Schizophrenia research, 114(1-3): 98-104
Marić, J. (2005) Clinical psychiatry. Beograd: Megraf
Matevosyan, N.R. (2009) Oral Health of Adults with Serious Mental Illnesses: A Review. Community Mental Health Journal, 46(6): 553-562
McGrath, J., Welham, J., Scott, J., Varghese, D., Degenhardt, L., Hayatbakhsh, M.R., Alati, R., Williams, G.M., Bor, W., Najman, J.M. (2010) Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Archives of general psychiatry, 67(5): 440-7
Ministry of Health, Serbia National guideline of good clinical practice for diagnostics and therapy of schizophrenia. in Serb,
Mirza, I., Day, R., Phelan, M., Wulff-Cochrance, V. (2001) Oral health of psychiatric in-patients. Psychiatric Bulletin, 25(4): 143
Morales-Chavez, MC., Rueda-Delgado, YM., Pena-Orozco, DA. (2014) Prevalence of bucco-dental pathologies in patients with psychiatric disorders. Journal of Clinical and Experimental Dentistry, 6(1):7-11
Morio, K.A., Marshall, T.A., Qian, F., Morgan, T.A. (2008) Comparing diet, oral hygiene and caries status of adult methamphetamine users and nonusers: a pilot study. Journal of the American Dental Association, 139(2): 171-6
Nikfarjam, M., Parvin, N. (2013) Oral Health Status in Three Long Term Care Units of Schizophrenic Patients in Chaharmahal-Bakhtiari Province, Iran. Iranian Red Crescent Medical Journal, 15(4): 371-2
Nikolic-Jakoba, N. (2012) Characterisation of Toxic Activity of Aggregatibacter Actinomycetemcomitans. , PhD thesis
Rai, B. (2008) Oral health in patients with mental illness. Int Dent Sci, 6: 1-7
Ramon, T., Grinshpoon, A., Zusman, S.P., Weizman, A. (2003) Oral health and treatment needs of institutionalized chronic psychiatric patients in Israel. Eur Psychiatry, 18(3): 101-5
Rekha, R., Hiremath, S.S., Bharath, S. (2002) Oral health status and treatment requirements of hospitalized psychiatric patients in Bangalore city: a comparative study. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 20(2): 63-7
Saban, A., Flisher, A.J. (2010) The association between psychopathology and substance use in young people: a review of the literature. Journal of psychoactive drugs, 42(1): 37-47
Sadock, B.J., Sadock, V.A. (2009) Kaplan and Sadocks comprehensive textbook of psychiatry. Lippincott Williams and Williams, 9th edition
Samaranayake, L.P. (2002) Essential Microbiology for Dentistry. Philadelphia: Elsevier
Schmidt, L.M., Hesse, M., Lykke, J. (2011) The impact of substance use disorders on the course of schizophrenia--a 15-year follow-up study: dual diagnosis over 15 years. Schizophrenia research, 130(1-3): 228-33
Selwitz, R.H., Ismail, A.I., Pitts, N.B. (2007) Dental caries. Lancet, Jan 6, 369, (9555), 51-9
Shah, V., Patel, N., Jain, P. (2012) Oral health of psychiatric patients: A cross-sectional comparision study. Dental Research Journal, 9(2): 209
Shetty, S., Bose, A. (2014) Schizophrenia and periodontal disease: An oro-neural connection? A cross-sectional epidemiological study. Journal of Indian Society of Periodontology, 18(1): 69-73
Sjogren, R., Nordstrom, G. (2000) Oral health status of psychiatric patients. Journal of Clinical Nursing, 9(4): 632-638
Sreebny, L.M., Bancozy, J., Edgar, W.M., i dr. (1992) Saliva: Its role in health and disease: Working Group 10 of the Commission on Oral Health, Research and Epidemiology (CORE). Int Dent J, 42(4 Suppl 2): 287-304
Stevens, T., Spoors, J., Hale, R., Bembridge, H. (2010) Perceived oral health needs in psychiatric in-patients: impact of a dedicated dental clinic. Psychiatrist, 34(12): 518-521
Swartz, M.S., Wagner, H., Swanson, J.W., Stroup, T., McEvoy, J.P., McGee, M., Miller, D.D., Reimherr, F., Khan, A., Cañive, J.M., Lieberman, J.A. (2006) Substance use and psychosocial functioning in schizophrenia among new enrollees in the NIMH CATIE study. Psychiatric services (Washington, D.C.), 57(8): 1110-6
Tandon, R., Nasrallah, H.A., Keshavan, M.S. (2009) Schizophrenia, “just the facts” 4. Clinical features and conceptualization. Schizophrenia Research, 110(1-3): 1-23
Tang, W.K., Sun, F.C., Ungvari, G.S., o`Donnell D. (2004) Oral health of psychiatric in-patients in Hong Kong. International Journal of Social Psychiatry, 50(2): 186
Tani, H., Uchida, H., Suzuki, T., Shibuya, Y., Shimanuki, H., Watanabe, K., Den, R., Nishimoto, M., Hirano, J., Takeuchi, H., Nio, S., Nakajima, S., Kitahata, R., Tsuboi, T., Tsunoda, K. (2012) Dental conditions in inpatients with schizophrenia: A large-scale multi-site survey. BMC Oral Health, 12(1): 32
Teng, P., Su, J., Chang, W., Lai, T. (2011) Oral health of psychiatric inpatients: a survey of central Taiwan hospitals. General Hospital Psychiatry, 33(3): 253-259
Thomas, A., Lavrentzou, E., Karouzos, C., Kontis, C. (1996) Factors which influence the oral condition of chronic schizophrenia patients. Special Care in Dentistry, 16(2): 84-86
Turkington, A., Mulholland, C. C., Rushe, T. M., Anderson, R., McCaul, R., Barrett, S. L., Barr, R. S., Cooper, S. J. (2009) Impact of persistent substance misuse on 1-year outcome in first-episode psychosis. British Journal of Psychiatry, 195(3): 242-248
Ujaoney, S., Motwani, M.B., Khairkar, P.H., Dewgekar, S.S., Bang, G. (2010) Oral health status and dental treatment needs in institutionalized versus non-institutionalized psychiatric patients. Journal of Disability and Oral Health, 11(4); 163-170
Velasco, E., Bullon, P. (1999) Periodontal status and treatment needs among Spanish hospitalized psychiatric patients. Spec Care Dentist, 19(6): 254-8
Velasco, E., Machuca, G., Martinez-Sahuquillo, A., Rios, V., Lacalle, J., Bulloan, P. (1997) Dental health among institutionalized psychiatric patients in Spain. Special Care in Dentistry, 17(6): 203-206
Velasco-Ortega, E., Segura-Egea, JJ., Cordoba-Arenas, S., Jimenez-Guerra, A., Monsalve-Guil, L., Lopez-Lopez, J. (2013) A comparison of the dental status and treatment needs of older adults with and without chronic mental illness in Sevilla, Spain. Medicina Oral Patología Oral y Cirugia Bucal, : e71-e75
Veling, W., Mackenbach, J.P., van Os, J., Hoek, H.W. (2008) Cannabis use and genetic predisposition for schizophrenia: a case-control study. Psychological medicine, 38(9): 1251-6
Vulovic, M., i dr. (2002) Preventive Dentistry. Belgrade: Elit Medica
World Health Organization (2010) International statistical classification of diseases and related health problems. 10th revision
World Health Organization (2003) Investing in mental health: Evidence for action. Geneva
World Health Organization (2002) World health report: Reducing risks, promoting healthy life. Geneva
Yang, J., Chen, T., Sun, L., Zhao, Z., Qi, X., Zhou, K., Cao, Y., Wang, X., Qiu, Y., Su, M., Zhao, A., Wang, P., Yang, P., Wu, J., Feng, G., He, L., Jia, W., Wan, C. (2011) Potential metabolite markers of schizophrenia. Molecular Psychiatry, 18(1): 67-78
Zengin, A., Yanik, K., Celenk, P., Unal-Erzurumlu, Z., Yilmaz, H., Bulut, N. (2015) Oral hygiene and oral flora evaluation in psychiatric patients in nursing homes in Turkey. Nigerian Journal of Clinical Practice, 18(6): 751
Zusman, S.P., Ponizovsky, A.M., Dekel, D., Masarwa, A., Ramon, T., Natapov, L., Grinshpoon, A. (2010) An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel. Special Care in Dentistry, 30(1): 18-22