Dental care for the psychiatric patient: chronic schizophrenia

In recent years, there has been a shift in philosophy concerning the overall delivery of mental health services. As a result, the treatment and management of patients with various psychiatric and behavioral disorders have undergone some fundamental changes. Improved diagnostic and treatment modalities have, in many instances, reduced the need for long-term institutionalization for a large number of these patients. Consequently, community-based mental health agencies (e.g., group homes, homes for special care patients, etc.) are now assuming an increasingly important role in the long-term management of these patients, providing, for example, more sophisticated mental health promotion programs and counselling services. A greater positive interaction now exists between these individuals and the surrounding community, thereby encouraging a more favorable integration within society as a whole. Due to this shift from primarily an institutional-based treatment regimen to a more community-oriented approach, the general dental practitioner can expect to see and be requested to treat an increasing number of these patients, many of whom present with significant dental pathology. The purpose of this paper will be to provide an overview of the oral health findings and management protocols for those individuals suffering from one specific form of psychiatric illness--chronic schizophrenia. An attempt will be made to familiarize the practising dentist with the main psychopathological features of this disorder as well as the specific oral health care requirements and management protocols for these patients.(ABSTRACT TRUNCATED AT 250 WORDS)