Alexander Grinshpoon1, Shlomo P Zusman2, Abraham Weizman3, Alexander M Ponizovsky4. 1. Sha'ar Menashe Mental Health Center, Hadera, Israel, and Bruce Rappoport Faculty of Medicine, Technion, Haifa, Israel. 2. Division of Dental Health, Ministry of Health, Jerusalem, Israel. 3. Geha Mental Health Center, Petah Tikva, Israel, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Research Unit, Mental Health Services, Ministry of Health, Jerusalem, Israel.
Abstract
AIM: This study examined the association between dental conditions in hospitalized patients with ICD-10 schizophrenia and type of antipsychotic treatment. Based on the literature suggesting that atypical antipsychotics are thought to be more tolerable than typical antipsychotics, we hypothesized that hospitalized patients with schizophrenia treated with atypicals would have better dental health than those treated with typicals alone or with a combination of both (combined group). METHODS: A representative sample of 348 patients (69% males), aged 51.4 (SD=14.5, range 31-58) years, was assessed on the standardized criteria of the Decayed, Missing and Filled Teeth (DMFT) index and component scores. Data on medication were extracted from patients' electronic medical records. RESULTS: Patients treated with typicals had significantly higher DMFT index scores than those who received atypicals (23.5±9.9 vs. 19.0±10.5; p < 0.05), and higher Missing (20.2±11.6 vs. 13.5±11.2; p < 0.01) and lower Filled (1.0±2.4 vs. 2.1±3.9; p < 0.05) teeth component scores. No between-group differences in Decayed component scores were found (2.3±3.4 and 3.4±5.0, respectively; p > 0.05). The combined treatment group was situated in between the typicals and atypicals groups on all measures. CONCLUSIONS: The results suggest that patients with schizophrenia maintained on atypicals have better dental health than patients treated with typicals or with a combination of both. From an oral health perspective, monotherapy with atypicals is superior to both typical and atypical/typical treatments. Although the choice between typical and atypical antipsychotic agents is based mainly on clinical psychiatric efficacy, the benefit of atypicals with regard to dental health should be taken into consideration in clinician's decision making.
AIM: This study examined the association between dental conditions in hospitalized patients with ICD-10 schizophrenia and type of antipsychotic treatment. Based on the literature suggesting that atypical antipsychotics are thought to be more tolerable than typical antipsychotics, we hypothesized that hospitalized patients with schizophrenia treated with atypicals would have better dental health than those treated with typicals alone or with a combination of both (combined group). METHODS: A representative sample of 348 patients (69% males), aged 51.4 (SD=14.5, range 31-58) years, was assessed on the standardized criteria of the Decayed, Missing and Filled Teeth (DMFT) index and component scores. Data on medication were extracted from patients' electronic medical records. RESULTS:Patients treated with typicals had significantly higher DMFT index scores than those who received atypicals (23.5±9.9 vs. 19.0±10.5; p < 0.05), and higher Missing (20.2±11.6 vs. 13.5±11.2; p < 0.01) and lower Filled (1.0±2.4 vs. 2.1±3.9; p < 0.05) teeth component scores. No between-group differences in Decayed component scores were found (2.3±3.4 and 3.4±5.0, respectively; p > 0.05). The combined treatment group was situated in between the typicals and atypicals groups on all measures. CONCLUSIONS: The results suggest that patients with schizophrenia maintained on atypicals have better dental health than patients treated with typicals or with a combination of both. From an oral health perspective, monotherapy with atypicals is superior to both typical and atypical/typical treatments. Although the choice between typical and atypical antipsychotic agents is based mainly on clinical psychiatric efficacy, the benefit of atypicals with regard to dental health should be taken into consideration in clinician's decision making.