Oral health and treatment needs in institutionalized psychiatric patients in India

The caries prevalence, oral hygiene status, periodontal health and treatment needs were evaluated in a group of institutionalized psychiatric patients in Goa, India. Of the total 153 inmates, males constituted 59 percent, the mean age was 25 years, 96 percent were self sufficient and the response rate was 84 percent. 63 percent were diagnosed with schizophrenia. They did not receive any assistance in daily self-care activities including oral hygiene maintenance. None of the 5 edentulous patients had dentures, 5% had been referred for emergency dental care during the period of institutionalization. 15 subjects (12%) were caries-free, the stepwise linear regression analysis showed that the mean DMFT index significantly increased with age (t = 2-819, PL 0.05). Two third of the study population (88%) were in need of conservative dental treatment. The stepwise linear regression analysis showed that the mean OHI-S index significantly increased with age (t = 2.412, P < 0.01). Only 5.4% reported a healthy periodontium whereas 16.27% required complex periodontal therapy. Soft tissue lesions included dorsal lingual depapillation/heavily coated areas and angular cheilitis in addition to incidental observations such as mucosal hyperpigmentation, gingival hyperplasia, and leucoedema. Bruxism and factitious injuries were also noted. The onus of meeting the oral health needs of this marginalized patient population therefore depends on the effectiveness of community dentistry programs vis a vis the efforts of the staff of the institution to provide such services on a regular basis.