Oral health care for the patient with schizophrenia

Schizophrenia is a psychiatric disorder affecting 1% of the United States population. Conceptualizing the disorder as consisting of "positive" and "negative" symptoms has led to improved treatment modalities. Medications used in managing the "positive" symptoms have numerous systemic and orofacial adverse side effects that must be recognized by the dentist. Dental treatment strategies for the identification and management of these side effects are described. "Negative" symptoms are responsible for chronicity of the disorder and frequently impede rehabilitation. These symptoms are potentially devastating to oral health as they impair a patient's desire and ability to invoke preventive oral hygiene. Treatment strategies to improve compliance with oral hygiene techniques are outlined. A medication specifically indicated for patients with treatment-sistant ++ disease and marked "negative" symptoms has recently been approved for use in the United States. The systemic and orofacial adverse side effects of this medication and its influence on dental management are reviewed.