Oral health self-care behaviours in serious mental illness: A systematic review and meta-analysis.

Abstract

AIM\nTo understand the relationship between serious mental illness and oral health self-care behaviours using meta-analytic methods and a narrative synthesis of available literature.\n\n\nMETHOD\nThe review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines [PROSPERO reference: CRD42020176779]. Search terms pertaining to serious mental illness and oral health were entered into EMBASE, PsycINFO, Medline and CINAHL. Eligible studies included a sample of people with a serious mental illness and a quantitative measure of an oral health self-care behaviour (e.g. dental visits, toothbrushing). The Effective Public Health Practice Project tool was utilised to appraise the quality of the literature. Studies in the meta-analysis contained a non-clinical or general population comparator sample.\n\n\nRESULTS\nPeople with a serious mental illness were significantly less likely to visit the dentist (OR 0.46, 95% CI 0.32-.065, p>0.001) or brush their teeth (OR 0.19, 95% CI 0.08-0.42, p<0.001) when compared to non-clinical comparator samples. Few studies explored other oral health self-care behaviours (e.g. flossing, mouth-washing etc.), but uptake was generally low in people with a serious mental illness. The study quality of included studies was variable.\n\n\nCONCLUSIONS\nThe research showed a reduced uptake of oral health self-care behaviours in people with a serious mental illness. Sub-optimal oral health can negatively impact on physical, social and psychological functioning. Further research is needed to understand the reasons for low rates of oral health self-care behaviours in this population.