Periodontal health and treatment needs among hospitalized chronic psychiatric patients in Istanbul, Turkey.

OBJECTIVE: The aim of the study was to evaluate the periodontal health and treatment needs of chronically hospitalized psychiatric patients in Istanbul, Turkey. METHOD: The subjects' periodontal health was recorded by the CPI (Community Periodontal Index) method. RESULTS: Of the 330 patients examined, 179 (52.5%) were males and 151 (47.5%) females. The mean age of the patients was 49.2 +/- 11.7 years. The majority (61.8%) was diagnosed with schizophrenia and 30.6% diagnosed with mental retardation. The mean length of hospitalization was 16.0 +/- 10.9 years. Healthy periodontal tissues (CPI 0) were found in 8.8% of the subjects. Bleeding on probing (CPI 1) was recorded in 6.3%, and dental calculus (CPI 2) in 51.8% of the subjects. These were determined as the worst findings. Altogether, 33% of the subjects had deep periodontal pockets, 14.2% with at least one 4- to 5-mm pocket (CPI 3), and 18.8% with at least one 6-mm pocket (CPI 4). The stepwise logistic regression analysis, between the final CPI score and seven variables including age, gender, psychiatric diagnosis, length of hospitalization, degree of helplessness, tooth brushing habits and smoking, showed that irregular tooth brushing habits and male gender were significant contributors to having a final CPI score of 2 or more. The regression analysis also showed that tooth brushing habits remained as an explanatory variable in CPI 0 coded subjects; helplessness and psychiatric diagnosis (mental retardation) in CPI 2; tooth brushing habits and psychiatric diagnosis (schizophrenia) in CPI 3; and only helplessness in CPI 4. CONCLUSION: The present study underlines a considerable need for prevention and treatment of periodontal disease among chronic psychiatric patients in Istanbul. Efforts need to be focused above all on raising this population's awareness of the importance of oral hygiene and on early diagnosis of periodontal problems.

Oral health and treatment needs of institutionalized chronic psychiatric patients in Istanbul, Turkey.

OBJECTIVE: To assess the oral health status and treatment needs in a group of hospitalized chronic psychiatric patients. METHOD: The dental status was assessed using the DMFT index. Demographic and medical data were retrieved from the institutional clinical files. RESULTS: 491 patients were examined in the study. 258 (52.5%) of the patients were males. The mean age was 52.3 +/- 12.3 years and the average length of hospitalization was 17.5 years. The majority of the patients (69%) were diagnosed with schizophrenia. The mean DMFT was 19.25 +/- 7.85. Missing teeth (81.4%) comprised the largest proportion of the DMFT while filled teeth (0.5%) the smallest. 18.1% of the DMFT consisted of decayed teeth. Stepwise logistic regression analysis showed that the DMFT significantly increased with age (p < 0.001) and was significantly higher in schizophrenia patients than those with mental retardation (p < 0.01). Males had significantly higher decayed teeth (p < 0.01) and fewer missing teeth (p < 0.01) than females. 58 dentate subjects (14.4%) were caries free. Two hundred and thirty five patients (58.5%) required restorative care, the mean number of treatments required per patient was 1.42 +/- 1.82. Eighty-nine subjects (18.1%) were found to be completely edentulous with only 17 wearing complete dentures. 70.6% of dentate patients needed tooth extraction for caries and 36.1% for periodontal disease. CONCLUSION: The findings of this study demonstrate poor oral health status with extensive unmet dental and prosthetic needs. These underline the urgent need for specific preventive oral health programme to improve the dental care of these chronic psychiatric inpatients.

The prevalence of temporomandibular disorder signs in people with mental retardation.

The purpose of this study was to determine the prevalence of temporomandibular disorder (TMD) signs and tooth wear levels in a group of hospitalised patients with mental retardation (MR). A total of 118 patients with MR and 104 mentally healthy individuals (control) were included in this study. The groups consisted of equal numbers of male and female patients. TMD signs were evaluated according to the Research Diagnostic Criteria to assess the limitation in maximum mouth opening, the alterations in the mouth opening pathway and temporomandibular joint sounds. In addition, tooth wear was recorded. The frequency of at least one sign of TMD observed in patients with MR (79·7%) was significantly higher than in controls (69·2%) (P=0.03). In addition, 43.2% of the patients with MR had more than one sign of TMD compared with 28.8% of the control group (P = 0·02). Prevalence of each sign exhibited in the MR and control groups was as follows: limitation in mouth opening, 24·6% vs. 13·5% (P=0·02); deviation, 18·6% vs. 26·9% (P=0·001); deflection, 29·7% vs. 10·6% (P=0·001); TMJ sounds, 46·6% vs. 41·1% (P=0·43); bilateral joint sounds 28·8% vs. 16·3% (P=0·05) respectively. Prevalences of TMD signs were not different between genders in both groups (P>0·05). Severe tooth wear was evident in 43·2% of the patients with MR compared with 20·6% of the controls (P=0·001). In conclusion, patients with MR seem to be more prone to having TMD signs compared with the control population.

Prevalence of temporomandibular disorder signs in patients with schizophrenia.

The aim of this study was to determine the prevalence of temporomandibular disorder (TMD) signs in a group of institutionalized patients with schizophrenia. Three hundred thirty-nine patients with schizophrenia were examined and compared with 107 age-matched and gender-matched control subjects. TMD signs were evaluated according to the Research Diagnostic Criteria to assess temporomandibular joint pain to palpation, limitation of maximum mouth opening, alteration of mouth opening pathway (deviation/deflection) and temporomandibular joint noises. In addition, tooth wear was recorded for the assessment of bruxism. The prevalence of any TMD signs was observed higher (P = 0.001) in the patients with schizophrenia (284/339, 83.7%) than in the controls (72/107, 67.3%). The prevalence of more than one TMD sign was also significantly higher (P = 0.03) in the patients with schizophrenia (131/339, 38.6%) than in the controls (29/107, 27.1%). Significant differences between the two groups were apparent for joint pain on palpation (P = 0.006), deflection (P = 0.006) and joint sounds (P = 0.002). Severe tooth wear was evident in 39.2% of the patients with schizophrenia compared with 21.2% in the control group (P = 0.001). The finding of the present study showed that, compared to control population, chronically hospitalized patients with schizophrenia seem to be more prone to the development of TMD signs and severe tooth wear and bruxism.

The effect of uterine volume on uterine artery Doppler velocimetry in the myomatous state.

This study aimed at testing the hypothesis that lower uterine arterial (UA) Doppler indices are caused by increased uterine volume rather than the presence of myoma. Uterine volumes were calculated and uterine and/or myomal arterial pulsatility index (PI) and resistance index (RI) were obtained by transvaginal color Doppler ultrasonography. The mean uterine volume in the myomatous group (276.2 cm3; range 65-928 cm3, n = 100) was significantly greater than that of the control group (101.4 cm3; range 36-171 cm3; n = 60; p = 0.00). The mean UA PI and RI values in the study group were significantly lower than their corresponding values in the control group (0.77 +/- 0.08 and 1.69 +/- 0.47 vs. 0.82 +/- 0.06 and 1.97 +/- 0.49, respectively, p = 0.01). When the myomatous uterine volumes of the study group were categorized into two subgroups (< 200 and > or = 200 cm2) the UA PI and RI values were lower in the latter group (p = 0.006 and p = 0.015, respectively). However, after analysis of receiver-operator-characteristic curves, none of the UA Doppler indices could differentiate the myomatous uterus from the normal uterus.