ArticleEpidemiology and psychiatric sciences2026
Oral health in people with schizophrenia: associations with behavioural and pharmacological factors.
Article in Epidemiology and psychiatric sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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8 authors.
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Abstract
aimThis study aimed to assess the oral health status of individuals with schizophrenia and explore its association with behavioural and pharmacological factors, with particular focus on long-term antipsychotic treatment and cumulative anticholinergic burden.
methodsA total of 153 adults with schizophrenia (18-65 years) from the Mental Health Network of Bizkaia (Spain), all under antipsychotic treatment for ≥12 months, were evaluated and compared with 153 controls from the general population. Data on socio-demographic variables, tobacco use and oral hygiene habits were collected. Oral health was assessed using the Decayed, Missing and Filled Teeth (DMFT) index and the Community Periodontal Index of Treatment Needs (CPITN). Unstimulated salivary flow was measured, and subjective xerostomia symptoms were recorded. Cumulative anticholinergic burden was estimated using the Drug Burden Index, considering both psychotropic and non-psychotropic medications. The association between dental health and clinical, behavioural and pharmacological variables was analysed in patients with schizophrenia.
resultsPatients with schizophrenia exhibited significantly poorer oral health than controls, with higher mean DMFT scores (15.3 vs. 10.9;
conclusionsOral health is substantially compromised in individuals with schizophrenia, reflecting a multifactorial interplay of behavioural, systemic and pharmacological factors. Both cumulative anticholinergic burden and reduced salivary flow independently contribute to poorer dental health, while periodontal disease appears to result from more complex influences not fully captured with studied variables. These findings underscore the importance of proactive clinical strategies, including regular dental assessments, targeted oral hygiene interventions, interdisciplinary collaboration between mental health and dental care providers and careful review of psychopharmacological regimens to minimize unnecessary anticholinergic exposure. Such integrated approaches are essential to preserve oral health, enhance quality of life and improve long-term outcomes in this vulnerable population.
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