Mind the gap: an administrative data analysis of dental treatment outcomes and severe mental illness

Oral health of people with severe mental illness (SMI) remains an important public health issue, despite evidence pointing suboptimal dental health outcomes in this population.

We test the hypotheses that individuals with SMI have lower contact with dental services and higher levels of fillings and extractions. We also examine effect modification by age-group.

We used linked administrative data from general practitioner (GP), hospital and dental records to examine dental service use and treatments (extractions, fillings, crowns and x-rays) among the Northern Ireland hospital population between January 2015 and November 2019 (N = 798,564).

After adjusting for available socio-demographic characteristics, analysis indicated lower levels of dental service use (OR = 0.80, 95% CI = 0.77, 0.84), including lower likelihood of fillings (OR = 0.81, 0.77, 0.84) and x-rays (OR = 0.77, 0.74, 0.81), but higher levels of extractions (OR = 1.23, 1.18, 1.29) among patients with SMI. We also found effect modification by age-group, with older individuals with SMI less likely to have each of the four dental treatments.

We suggest that in the general area of physical healthcare for people with SMI, oral healthcare is neglected. There is a need for improved understanding of the barriers to routine care and treatment, and development of psychoeducational interventions.