Changes in Oral Health Status in Volunteers on Psychiatric Medications

Objectives: The purpose of this study is to compare changes in oral health status over a 9 month period in a group taking psychiatric medications (P) to a group (NP) taking known xerogenic medications and to examine the associated risk factors.

Methods: Calibrated examiners recorded dental caries and periodontal status at baseline and at a 9 month follow-up visit on 653 Boston area volunteers, aged 40-80, who were taking at least one xerogenic or psychiatric medication, with demonstrated salivary hypofunction. Periodontal and caries increments, dental care, oral hygiene habits and smoking were factored in. A binary logistic regression model was used for statistical analysis.

Results: The P group (n=173) had a mean unstimulated salivary flow of 0.056ml/min, a mean age of 60, 65% female, 89.6% Caucasian, 59% under $35,000 and mean of 24 teeth, whereas the NPgroup(n=480) had a mean unstimulated salivary flow of 0.067ml/min, mean number of 23 teeth, was 55% female , 86% Caucasian with a mean age of 67, 54% under $35,000 and a significantly higher SS ( 1.62 vs. 1.37 (p≤.007)) and less perceived dryness (p≤0.0001). The NP had a significantly higher increase in attachment loss( NP 1.76± 0.696 vs.P 1.59±0.674 (p≤0.043) and recession (NP 0.519±0.389 vs. P 0.400 ±.323, ≤.006)than the P group.

The mean annualized caries increment for the P group was 0.947±2.910 vs NP 0.4472±1.385 (p≤0.009). The number of medications was higher in the P group 4.5 vs 3.1 (p≤0.0001). The number of teeth at baseline was higher in the P group, 24 vs 23 (p≤0.010) in the NP group, yet the increment in missing surfaces was significantly higher (p≤.006).

Conclusion:People taking psychiatric medications are at significantly higher risk for developing dental caries and losing teeth, despite acceptable oral hygiene habits and regular dental visit. The use of multiple psychiatric medications may induce even greater deleterious effects on teeth. Longitudinal studies are needed to confirm the effects of xerogenic medications. (Funded by Procter and Gamble)