Furthermore, lack of communication between psychiatrists and dentists, lack of knowledge of psychiatrists regarding oral health, and the reluctance of dentists to provide care to patients with mental illness are additional barriers ( 18, 19). Additional barriers, including the oral health team’s attitudes toward and knowledge of mental illness and the severity of mental illness, also impede access to care among persons with mental illness ( 13, 17). Previous studies have reported barriers to oral health care, such as the cost of care, lack of insurance, transportation barriers, lack of time to seek dental services, and dental anxiety ( 14– 16). Individuals with mental illness experience several risk factors that increase the prevalence of oral health problems, including adverse effects of prescribed psychotropic medications comorbid substance use, including tobacco use and poor diet ( 12, 13). Increased dental decay and tooth loss are common among persons with anxiety and depressive disorders, and those with eating disorders often have significantly more dental erosion and decay than those without eating disorders ( 8, 11). A systematic review found that individuals with serious mental illness are 2.8 times more likely than those in the general public to lose teeth and to have more decayed, missing, and filled teeth ( 1). ![]() Additionally, persons with mental illness are more likely than those in the general population to experience adverse oral health and to require more dental interventions ( 8). Poor oral health negatively affects social functioning because of its effect on smiling, eating, speaking, psychological well-being, self-esteem, self-confidence, and quality of life ( 9, 10). Poor oral health status among patients with mental illness is an important cause of the 25-year lower life expectancy for people with mental illness, compared with the general population ( 4– 6).Įvidence suggests a bidirectional relationship between oral health and mental health ( 7, 8). Oral diseases have been associated with numerous inflammatory and infectious diseases and may directly lead to bacterial colonization, which may cause bacteremia and chronic inflammation of multiple organ systems ( 3). Emerging data correlate poor oral health with systemic medical comorbid conditions and associated increased mortality rates ( 2). Populations with mental illness remain at a considerable disadvantage in oral health outcomes across the world ( 1). Supportive public policies that improve access to dental services and integration of mental health with oral health may help improve the oral health of patients with mental illness. Qualitative interviews with patients with mental illness, psychiatrists, and dentists were conducted to study the challenges that the patients face in accessing dental care.Īll participants identified cost and fear of dental care services as patients’ top two barriers to receiving care.
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