Stato della salute orale in pazienti istituzionalizzati affetti da patologie neuropsichiatriche

The caries prevalence (DMFT, SIC) and oral hygiene status (OHI-S) were assessed in a group of 103 (72 males, 31 females, mean age 51) of the 216 neuropsychiatric institutionalized living in a long-term care institution close to Milan. Comparison with a control group of healthy patients of the same age was evaluated. In order to focus on the decision-making process of choosing need of pharmacological sedation, set of codes of the International Classification of Functioning, Disability and Health (ICF) and Frankl scale can be useful. Participants were divided into two groups depending on their tolerability of dental treatment. The results of these groups for codes were then compared using the Mann-Whitney test. Nurses' assessments of barriers to oral hygiene improvement were detected using a questionnaire on 97 caregivers. Evaluation showed overall DMFT of 16,14 and SIC of 23,8. The stepwise linear regression analysis showed that the mean DMFT index did not increase with age. Comparison with controls showed significant differences in M and F component. Mean OHI-S score was 3,46 and the stepwise linear regression analysis showed that it increased with time since previous dental examination. Significant differences with controls were detected. The tolerable group showed lower disability levels in regard to d110 Watching, d330 Speaking and e340 Personal Care Provider. Nurses' questionnaire results showed lack of nurses' education in oral hygiene issues. The findings of this study demonstrate high caries prevalence, poor oral hygiene and needs for dental treatment. The ICF was raised as a more suitable possibility for considering the application of pharmacological sedation for dental treatment on patients with neuropsychiatric disease. Coordinated strategies between the caregivers and dental office must be improved in order to overcome barrier of nurses' education.