Oral health status and treatment needs among psychiatric inpatients in Rennes, France: a cross-sectional study
Identifieur interne : 002341 ( Main/Exploration ); précédent : 002340; suivant : 002342Oral health status and treatment needs among psychiatric inpatients in Rennes, France: a cross-sectional study
Auteurs : Valerie Bertaud-Gounot [France] ; Viviane Kovess-Masfety [France] ; Catherine Perrus [France] ; Gilda Trohel [France] ; Frederique Richard [France]Source :
- BMC Psychiatry [ 1471-244X ] ; 2013.
Abstract
Severe mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality and oral health is critical for overall systemic health. But general health care needs in this population are often neglected. Some studies have aimed at determining the oral health status of psychiatric in-patients but to date, no emphasis has been placed on oral health of psychiatric patients in France. The goal of this study was to assess the oral health and treatment needs of institutionalized patients in a large psychiatric hospital, where a dental service was available and free, to compare it with the average population, with psychiatric in-patients in other countries and to provide recommendations for psychiatrists and care-giving staff.
The dental status (DMFT), the oral hygiene (OHIS: Simplified Oral Hygiene Index), the saliva flow rate were recorded on a randomized patient sample. Demographic and medical data were retrieved from the institutional clinical files.
Among the 161 examined patients, 95 (59.0%) were men and 66 (41.0%) were women. The mean age was 46.9 ± 17.5 years. The majority was diagnosed schizophrenia (36.6%) or mood disorders (21.1%). The mean OHIS was 1.7 ± 1.1. Among the 147 patients who agreed to carry out the salivary examination, the average saliva flow rate was 0.3 g ± 0.3 g/min. Saliva flow under the average rest saliva flow (0.52 mg/min) was found for 80.3% of the patient. The mean DMFT was 15.8 ± 8.8 (D = 3.7 ± 4.4, M = 7.3 ± 9.4, F = 4.7 ± 4.9) and significantly increased with age (p < 0.001) and degree of disability (p = 0.003) (stepwise linear regression). Eighteen patients (11.2%) were edentulous.
The DMFT was similar to low income French population but psychiatric patients had almost 4 times more decayed teeth, slightly less missing teeth and 1.5 times less filled teeth. Oral health appeared to be better than in most other countries. But compared to general population, the still unmet dental and prosthetic needs indicated the major need of enhanced access to dental care and specific preventive programs.
Url:
DOI: 10.1186/1471-244X-13-227
PubMed: 24053587
PubMed Central: 3856526
Affiliations:
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France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EHESP School of Public Health, Epidemiology and Biostatistics Department, Avenue Professor Leon Bernard, CS 74312, 35043 Rennes</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I3">University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9, France</nlm:aff><country 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type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Perrus, Catherine" sort="Perrus, Catherine" uniqKey="Perrus C" first="Catherine" last="Perrus">Catherine Perrus</name><affiliation wicri:level="3"><nlm:aff id="I4">Guillaume Régnier Psychiatric Center, 108, av. du Général Leclerc, BP 60321-35703 Rennes, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Guillaume Régnier Psychiatric Center, 108, av. du Général Leclerc, BP 60321-35703 Rennes</wicri:regionArea><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Picardie</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Trohel, Gilda" sort="Trohel, Gilda" uniqKey="Trohel G" first="Gilda" last="Trohel">Gilda Trohel</name><affiliation wicri:level="3"><nlm:aff id="I2">University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I3">University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">RENNES</settlement></placeName></affiliation></author><author><name sortKey="Richard, Frederique" sort="Richard, Frederique" uniqKey="Richard F" first="Frederique" last="Richard">Frederique Richard</name><affiliation wicri:level="3"><nlm:aff id="I2">University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Rennes1, Faculty of Dentistry, 2 Avenue du Professeur Léon Bernard (Bât 15), 35043 Rennes cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I3">University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University Hospital of Rennes, 2 rue Henri Le Guilloux, 35033 RENNES cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">RENNES</settlement></placeName></affiliation></author></analytic><series><title level="j">BMC Psychiatry</title><idno type="eISSN">1471-244X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Severe mental disorders have a chronic course associated with a high risk for co-morbid somatic illnesses and premature mortality and oral health is critical for overall systemic health. But general health care needs in this population are often neglected. Some studies have aimed at determining the oral health status of psychiatric in-patients but to date, no emphasis has been placed on oral health of psychiatric patients in France. The goal of this study was to assess the oral health and treatment needs of institutionalized patients in a large psychiatric hospital, where a dental service was available and free, to compare it with the average population, with psychiatric in-patients in other countries and to provide recommendations for psychiatrists and care-giving staff.</p></sec><sec><title>Methods</title><p>The dental status (DMFT), the oral hygiene (OHIS: Simplified Oral Hygiene Index), the saliva flow rate were recorded on a randomized patient sample. Demographic and medical data were retrieved from the institutional clinical files.</p></sec><sec><title>Results</title><p>Among the 161 examined patients, 95 (59.0%) were men and 66 (41.0%) were women. The mean age was 46.9 ± 17.5 years. The majority was diagnosed schizophrenia (36.6%) or mood disorders (21.1%). The mean OHIS was 1.7 ± 1.1. Among the 147 patients who agreed to carry out the salivary examination, the average saliva flow rate was 0.3 g ± 0.3 g/min. Saliva flow under the average rest saliva flow (0.52 mg/min) was found for 80.3% of the patient. The mean DMFT was 15.8 ± 8.8 (D = 3.7 ± 4.4, M = 7.3 ± 9.4, F = 4.7 ± 4.9) and significantly increased with age (p < 0.001) and degree of disability (p = 0.003) (stepwise linear regression). Eighteen patients (11.2%) were edentulous.</p></sec><sec><title>Conclusions</title><p>The DMFT was similar to low income French population but psychiatric patients had almost 4 times more decayed teeth, slightly less missing teeth and 1.5 times less filled teeth. Oral health appeared to be better than in most other countries. But compared to general population, the still unmet dental and prosthetic needs indicated the major need of enhanced access to dental care and specific preventive programs.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="De Hert, M" uniqKey="De Hert M">M De Hert</name></author><author><name sortKey="Van Winkel, R" uniqKey="Van Winkel R">R van Winkel</name></author><author><name sortKey="Silic, A" uniqKey="Silic A">A Silic</name></author><author><name sortKey="Van Eyck, D" uniqKey="Van Eyck D">D Van Eyck</name></author><author><name sortKey="Peuskens, J" uniqKey="Peuskens J">J Peuskens</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fleischhacker, W" uniqKey="Fleischhacker W">W Fleischhacker</name></author><author><name sortKey="Cetkovich Bakmas, M" uniqKey="Cetkovich Bakmas M">M Cetkovich-Bakmas</name></author><author><name sortKey="De Hert, M" uniqKey="De Hert M">M De 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Cabaret</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ponizovsky, A" uniqKey="Ponizovsky A">A Ponizovsky</name></author><author><name sortKey="Zusman, S" uniqKey="Zusman S">S Zusman</name></author><author><name sortKey="Dekel, D" uniqKey="Dekel D">D Dekel</name></author><author><name sortKey="Masarwa, A" uniqKey="Masarwa A">A Masarwa</name></author><author><name sortKey="Ramon, T" uniqKey="Ramon T">T Ramon</name></author><author><name sortKey="Natapov, L" uniqKey="Natapov L">L Natapov</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Greene, J" uniqKey="Greene J">J Greene</name></author><author><name sortKey="Vermillion, J" uniqKey="Vermillion J">J Vermillion</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Navazesh, M" uniqKey="Navazesh M">M Navazesh</name></author><author><name sortKey="Christensen, C" uniqKey="Christensen C">C Christensen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Greene, J" uniqKey="Greene J">J Greene</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Angelillo, I" uniqKey="Angelillo I">I Angelillo</name></author><author><name sortKey="Nobile, C" uniqKey="Nobile C">C Nobile</name></author><author><name sortKey="Pavia, M" uniqKey="Pavia M">M Pavia</name></author><author><name sortKey="De Fazio, P" uniqKey="De Fazio P">P De Fazio</name></author><author><name sortKey="Puca, M" uniqKey="Puca M">M Puca</name></author><author><name sortKey="Amati, A" uniqKey="Amati A">A Amati</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hescot, P" uniqKey="Hescot P">P Hescot</name></author><author><name sortKey="Bourgeois, D" uniqKey="Bourgeois D">D Bourgeois</name></author><author><name sortKey="Doury, J" uniqKey="Doury J">J Doury</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bourgeois, D" uniqKey="Bourgeois D">D Bourgeois</name></author><author><name sortKey="Berger, P" uniqKey="Berger P">P Berger</name></author><author><name sortKey="Hescot, P" uniqKey="Hescot P">P Hescot</name></author><author><name sortKey="Leclercq, M" uniqKey="Leclercq M">M Leclercq</name></author><author><name sortKey="Doury, J" uniqKey="Doury J">J Doury</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Almomani, F" uniqKey="Almomani F">F Almomani</name></author><author><name sortKey="Brown, C" uniqKey="Brown C">C Brown</name></author><author><name sortKey="Williams, K" uniqKey="Williams K">K Williams</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Hauts-de-France</li><li>Picardie</li><li>Région Bretagne</li></region><settlement><li>RENNES</li><li>Rennes</li></settlement></list><tree><country name="France"><region name="Région Bretagne"><name sortKey="Bertaud Gounot, Valerie" sort="Bertaud Gounot, Valerie" uniqKey="Bertaud Gounot V" first="Valerie" last="Bertaud-Gounot">Valerie Bertaud-Gounot</name></region><name sortKey="Bertaud Gounot, Valerie" sort="Bertaud Gounot, Valerie" uniqKey="Bertaud Gounot V" first="Valerie" last="Bertaud-Gounot">Valerie Bertaud-Gounot</name><name sortKey="Bertaud Gounot, Valerie" sort="Bertaud Gounot, Valerie" uniqKey="Bertaud Gounot V" first="Valerie" last="Bertaud-Gounot">Valerie Bertaud-Gounot</name><name sortKey="Kovess Masfety, Viviane" sort="Kovess Masfety, Viviane" uniqKey="Kovess Masfety V" first="Viviane" last="Kovess-Masfety">Viviane Kovess-Masfety</name><name sortKey="Perrus, Catherine" sort="Perrus, Catherine" uniqKey="Perrus C" first="Catherine" last="Perrus">Catherine Perrus</name><name sortKey="Richard, Frederique" sort="Richard, Frederique" uniqKey="Richard F" first="Frederique" last="Richard">Frederique Richard</name><name sortKey="Richard, Frederique" sort="Richard, Frederique" uniqKey="Richard F" first="Frederique" last="Richard">Frederique Richard</name><name sortKey="Trohel, Gilda" sort="Trohel, Gilda" uniqKey="Trohel G" first="Gilda" last="Trohel">Gilda Trohel</name><name sortKey="Trohel, Gilda" sort="Trohel, Gilda" uniqKey="Trohel G" first="Gilda" last="Trohel">Gilda Trohel</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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