Journals / Journal of Health Sciences and Medicine / 2026 / Volume: 8 Issue: 5

Oral health status and risk of potentially malignant lesions in patients with severe mental illnesses: a cross-sectional study

Şiddetli ruhsal bozukluğu olan hastalarda ağız sağlığı durumu ve potansiyel malign lezyon riski: kesitsel bir çalışma

Melisa Öçbe(KOCAELİ SAĞLIK VE TEKNOLOJİ ÜNİVERSİTESİ)0000-0003-1609-610X
Hülya Çerçi Akçay(KOCAELİ SAĞLIK VE TEKNOLOJİ ÜNİVERSİTESİ)0000-0002-3589-7511
Çetin Batuhan Öçbe(Ministry of Health, Kocaeli Kartepe District Health Directorate, Ataşehir Family Medicine Center,)0000-0001-7894-2290
Pages
—
Publication Date
2025-09-16
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The findings emphasize the need for interdisciplinary care models incorporating routine dental screening, preventive interventions, and education within mental health services.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Individuals with severe mental illness (SMI) experience disproportionately poor oral health due to behavioral, pharmacological, and systemic challenges.
📊
Key Findings & Data:Methods: A cross-sectional study was conducted with 60 patients registered at the Community Mental Health Center in Kocaeli, Turkiye.
💡
Conclusion & Impact:The findings emphasize the need for interdisciplinary care models incorporating routine dental screening, preventive interventions, and education within mental health services.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Oral health · severe mental illness · oral potentially malignant lesions

Abstract

Aims: Individuals with severe mental illness (SMI) experience disproportionately poor oral health due to behavioral, pharmacological, and systemic challenges. This study aimed to assess the oral health status of patients with SMI using the oral health assessment tool (OHAT) and the Decayed, Missing, and Filled Teeth (DMFT) Index, and to screen for oral potentially malignant lesions (OPMLs). Methods: A cross-sectional study was conducted with 60 patients registered at the Community Mental Health Center in Kocaeli, Turkiye. Comprehensive clinical examinations were performed using the Turkish version of the OHAT and the DMFT Index. The presence of OPMLs was also recorded. Statistical analyses included descriptive statistics, independent t-tests for gender comparisons, and Pearson correlation analyses to explore associations between age, OHAT, and DMFT scores. Results: Participants (mean age: 47.6±11.5 years; 65% female) had a mean OHAT score of 9.15±2.39 and a mean DMFT score of 13.5±7.00. No significant gender differences were observed in total OHAT or DMFT scores. However, females had significantly more filled teeth than males (3.08±2.04 vs. 1.57±1.80; p=0.006). Age was moderately correlated with OHAT (r=0.318, p=0.013) and strongly correlated with DMFT (r=0.449, p<0.001). OHAT and DMFT scores were also significantly correlated (r=0.502, p<0.001). Fifteen soft tissue lesions were detected, including leukoplakia, lichen planus, and angular cheilitis. Discussion: This study showed a high burden of oral disease and soft tissue lesions among patients with SMI, exceeding levels reported in non-psychiatric and geriatric populations. The findings emphasize the need for interdisciplinary care models incorporating routine dental screening, preventive interventions, and education within mental health services.

Özet

Amaç: Şiddetli ruhsal bozukluk (ŞRB) yaşayan bireyler, davranışsal, farmakolojik ve sistemik zorluklar nedeniyle orantısız şekilde kötü ağız sağlığına sahiptir. Bu çalışmada, ŞRB’li hastaların ağız sağlığı durumu Oral Sağlık Değerlendirme Aracı (OHAT) ve Çürük, Eksik ve Dolgulu Diş (DMFT) indeksi kullanılarak değerlendirilmiş, ayrıca oral potansiyel malign lezyonlar (OPML) açısından tarama yapılmıştır. Yöntem: Çalışma, Türkiye’nin Kocaeli ilinde yer alan Toplum Ruh Sağlığı Merkezi’ne kayıtlı 60 hasta ile kesitsel olarak gerçekleştirilmiştir. Katılımcılara Türkçe versiyonu doğrulanmış OHAT ve DMFT indeksleri ile kapsamlı ağız muayenesi yapılmıştır. OPML varlığı da kaydedilmiştir. İstatistiksel analizler kapsamında tanımlayıcı istatistikler, cinsiyete göre karşılaştırmalar için bağımsız örneklem t-testi ve yaş, OHAT ve DMFT skorları arasındaki ilişkileri incelemek için Pearson korelasyon analizleri kullanılmıştır. Bulgular: Katılımcıların (ortalama yaş: 47,6 ± 11,5 yıl; %65 kadın) ortalama OHAT skoru 9,15 ± 2,39, ortalama DMFT skoru ise 13,5 ± 7,00 olarak bulunmuştur. Toplam OHAT ve DMFT skorlarında cinsiyetler arasında anlamlı bir fark saptanmamıştır. Ancak kadınların erkeklere kıyasla anlamlı derecede daha fazla dolgulu dişi olduğu belirlenmiştir (3,08 ± 2,04 vs. 1,57 ± 1,80; p = 0,006). Yaş, OHAT skoru ile orta düzeyde (r = 0,318; p = 0,013) ve DMFT skoru ile güçlü düzeyde (r = 0,449; p < 0,001) pozitif korelasyon göstermiştir. OHAT ve DMFT skorları arasında da anlamlı bir ilişki bulunmuştur (r = 0,502; p < 0,001). On beş hastada yumuşak doku lezyonu saptanmış olup bunlar arasında lökoplaki, liken planus ve açısal keilit gibi lezyonlar yer almıştır. Tartışma: Bu çalışma, ŞRB’li hastalar arasında non-psikiyatrik ve geriatrik popülasyonlarda bildirilen düzeylerin ötesinde, yüksek ağız hastalığı ve yumuşak doku lezyonu yükü olduğunu ortaya koymuştur. Bulgular, ruh sağlığı hizmetlerine entegre edilmiş rutin diş taraması, önleyici müdahaleler ve eğitimi içeren disiplinler arası bakım modellerine duyulan gereksinimi vurgulamaktadır.

🔖

Cite This Article

Öçbe, M., Akçay, H. Ç., Öçbe, Ç. B. (2025). Oral health status and risk of potentially malignant lesions in patients with severe mental illnesses: a cross-sectional study. Journal of Health Sciences and Medicine, Volume: 8 Issue: 5. https://doi.org/10.32322/jhsm.1757914

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (21)

  1. Macnamara A, Mishu MP, Faisal MR, Islam M, Peckham E. Improving oral health in people with severe mental illness (SMI): a systematic review. PLoS One. 2021;16(12):e0260766. doi:10.1371/journal.pone.0260766
  2. Turner E, Berry K, Aggarwal VR, Quinlivan L, Villanueva T, Palmier-Claus J. Oral health self-care behaviours in serious mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand. 2022;145(1):29-41. doi:10.1111/acps.13308
  3. Choi J, Price J, Ryder S, Siskind D, Solmi M, Kisely S. Prevalence of dental disorders among people with mental illness: an umbrella review. Aust N Z J Psychiatry. 2022;56(8):949-963. doi:10.1177/00048674211042239
  4. Kisely S. No mental health without oral health. Can J Psychiatry. 2016;61(5):277-282. doi:10.1177/0706743716632523
  5. Sharma D, Higgins O, Sawicki A, et al. Oral health in individuals with severe mental illness on second-generation antipsychotics-a scoping review. J Oral Pathol Med. 2025;54(6):401-412. doi:10.1111/jop.13639
  6. Skallevold HE, Rokaya N, Wongsirichat N, Rokaya D. Importance of oral health in mental health disorders: an updated review. J Oral Biol Craniofac Res. 2023;13(5):544-552. doi:10.1016/j.jobcr.2023.06.003
  7. Kisely S, Quek LH, Pais J, Lalloo R, Johnson NW, Lawrence D. Advanced dental disease in people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry. 2011;199(3):187-193. doi:10.1192/bjp.bp.110.081695
  8. Sharma A, Blakemore A, Byrne M, et al. Oral health primary preventive interventions for individuals with serious mental illness in low- and middle-income nations: scoping review. Glob Public Health. 2024;19(1):2408597. doi:10.1080/17441692.2024.2408597
  9. Kuipers S, Boonstra N, Kronenberg L, Keuning-Plantinga A, Castelein S. Oral health interventions in patients with a mental health disorder: a scoping review with critical appraisal of the literature. Int J Environ Res Public Health. 2021;18(15):8113. doi:10.3390/ijerph18158113
  10. Ercan Şahin N, Jablonski RA. Psychometric properties of the oral health assessment tool Turkish version. Cukurova Med J. 2019;44(Suppl 1):513-520. doi:10.17826/cumj.567995
  11. Kalaigian A, Chaffee BW. Mental health and oral health in a nationally representative cohort. J Dent Res. 2023;102(9):1007-1014. doi:10.1177/00220345231171108
  12. Torales J, Barrios I, González I. Oral and dental health issues in people with mental disorders. Medwave. 2017;17(8):e7045. doi:10.5867/medwave.2017.08.7045
  13. Mishu MP, Faisal MR, Macnamara A, et al. A qualitative study exploring the barriers and facilitators for maintaining oral health and using dental service in people with severe mental illness. Int J Environ Res Public Health. 2022;19(7):4344. doi:10.3390/ijerph19074344
  14. Cross AF, Balanoff WL, Schayes B, Jayne W. Oral rehabilitation and mental health: effects of the renew procedure on depression scores. Cureus. 2025;17(6):e85843. doi:10.7759/cureus.85843
  15. Tabaoka H. Oral health assessment tool (OHAT). Nihon Ronen Igakkai Zasshi. 2023;60(4):400-405. doi:10.3143/geriatrics.60.400
  16. Tanaka K, Tominaga T, Kikutani T, et al. Oral status of older adults receiving home medical care: a cross-sectional study. Geriatr Gerontol Int. 2024;24(7):706-714. doi:10.1111/ggi.14917
  17. Maeda K, Mori N. Poor oral health and mortality in geriatric patients admitted to an acute hospital: an observational study. BMC Geriatr. 2020;20(1):26. doi:10.1186/s12877-020-1429-z
  18. Bokhari AM, Quadri MFA. What factors contribute to the self-reported oral health status of Arab adolescents? BMC Oral Health. 2020;20(1):21. doi:10.1186/s12903-020-1018-8
  19. Warnakulasuriya S. Oral potentially malignant disorders: a comprehensive review on clinical aspects and management. Oral Oncol. 2020;102:104550. doi:10.1016/j.oraloncology.2019.104550
  20. Wang YY, Tail YH, Wang WC, et al. Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders. BMC Oral Health. 2014;14:99. doi:10.1186/1472-6831-14-99
  21. Warnakulasuriya S, Kovacevic T, Madden P, et al. Factors predicting malignant transformation in oral potentially malignant disorders. J Oral Pathol Med. 2011;40(9):677-683. doi:10.1111/j.1600-0714.2011.01054.x