Oral lesions in patients with psychiatric disorders

Abstract

Introduction. Oral diseases in psychiatric patients are usually a result of bad oral hygiene and psychopharmaceutical side-effects. Objective. The aim of this study was to detect oral lesions in patients hospitalized in psychiatric institutions with the confirmed diagnosis of psychiatric illness and mood disorder with psychotic characteristics, as well as to discover the factors that can influence these oral lesions. Methods. Cross-section study consisted of 186 hospitalized patients with psychiatric disorders in the experimental group, out of whom 87 were males and 99 females. Patients were aged from 18 to 59 years, mean age 46.0±8.0 years. The control group consisted of 186 healthy persons matched for age and gender. Data on oral lesions were obtained within history and clinical examination of the oral cavity. Other medical data were collected from medical documentation. Statistical analysis was performed by Student's t-test, chi-square test and logistic regression. Results. Dry mouth was registered in 78.5% of patients. The difference in tongue and lip lesions, burning and stinging symptoms, bruxism, facial pain, low saliva rates, halitosis, taste changes and swallowing difficulties between the patients and healthy persons was highly statistically significant (p lt 0.001). Age and gender, as well as the factors of main disease, influence burning and stinging, bruxism, low saliva rates, swallowing difficulties, taste changes and facial pain of the psychiatric patients. Conclusion. Results imply that psychiatric patients are more frequently involved with oral lesions than healthy persons. It is necessary to organize specific preventive and educational oral health programmes with these patients, as well as with doctors who treat the basic illness.

Uvod. Promene u usnoj duplji osoba s psihijatrijskim oboljenjima najčešće su posledica loše oralne higijene i neželjenog dejstva psihofarmaka. Cilj rada. Cilj rada je bio da se utvrde oralne promene kod osoba bolnički lečenih u psihijatrijskim ustanovama od psihotičnih i poremećaja raspoloženja sa psihotičnim karakteristikama, kao i činioci koji na njih mogu da utiču. Metode rada. Studijom preseka obuhvaćeno je 186 bolesnika s psihijatrijskim oboljenjima (87 muškaraca i 99 žena), starih od 18 do 59 godina (prosečno 46,0±8,0 godina), koji su činili eksperimentalnu grupu. Kontrolnu grupu činilo je 186 zdravih ispitanika iste starosti i pola. Podaci o oralnim promenama ispitanika dobijeni su anamnezom i kliničkim pregledom usne duplje. Ostali podaci prikupljeni su iz medicinske dokumentacije. Za statističku analizu podataka korišćeni su Studentov t-test, χ2-test i logistička regresija. Rezultati. Suvoća usta je zabeležena kod 78,5% bolesnika. Razlika u promenama na jeziku i usnama, žarenju i peckanju u usnoj duplji, škrgutanju zubima, facijalnom bolu, smanjenom lučenju pljuvačke, neprijatnom zadahu iz usta, poremećaju čula ukusa i smetnji pri gutanju između bolesnika i zdravih osoba bila je visoko statistički značajna (p lt 0,001). Pol i starost ispitanika i činioci osnovne bolesti utiču na žarenje i peckanje u usnoj duplji, škrgutanje zubima, smanjeno lučenje pljuvačke, smetnje pri gutanju, poremećaj čula ukusa i facijalni bol psihijatrijskih bolesnika. Zaključak. Rezultati istraživanja pokazuju da osobe s psihijatrijskim oboljenjima imaju češće oralne promene od zdravih osoba. Neophodno je organizovati specifične preventivne zdravstveno-vaspitne stomatološke programe s ovim osobama, kao i sa lekarima koji leče osnovno oboljenje.