Oral health status of psychiatric patients

Many patients suffering from long-term psychiatric illness are on medication for long periods. These medications frequently cause xerostomia leading to an increased risk of caries, gingivitis, periodontitis and stomatitis. Oral hygiene is therefore of the utmost importance for these patients. Nurses interact with patients on a daily basis, and therefore they are the psychiatric caregivers of choice to support these patients. The main aim of this study was to describe the oral health status of patients in short-term and long-term psychiatric care by means of oral assessment. A second aim was to discover whether the assessment guide used could distinguish any differences between these two groups. A modified version of the Oral Assessment Guide (OAG) developed by Eilers et al. (1988) was used. In addition, new items/categories were developed, forming the Oral Assessment Guide for Psychiatric Care (OAG-PC). A total of 57 patients in psychiatric care, short-term (n = 32) and long-term (n = 25), were assessed by the OAG-PC. Patients in long-term psychiatric care had significantly higher scores on the total OAG-PC compared with those in short-term psychiatric care, indicating a worse oral health status. Statistically significant differences were also found in relation to the following OAG-PC categories: odour from the mouth, mucous membranes, gums, teeth or dentures, calculus on teeth and appearance of teeth. Further research should be focused on the difficulties for nurses in approaching their patients in order to perform oral care and on evaluating the effect of teaching and training psychiatric nurses in oral care, preferably with the assistance of the OAG-PC. This assessment guide may thereby also be valuable for nurses' documentation in estimating, planning, implementing and evaluating their psychiatric patients' oral care needs.