54 Chapter 3 with a severe mental illness (SMI) showed poor oral healthcare, and highlight the importance of paying attention to oral healthcare [8,9]. Poor oral health in patients diagnosed with SMI is associated with chronic diseases, e.g. diabetes or cardiovascular diseases [8]. Moreover, the prevalence of diabetes in patients diagnosed with schizophrenia is two to three times higher than in the general population [8,10,11]. A meta-analysis among studies of patients diagnosed with SMI showed a 53% higher risk of having cardiovascular disease (CVD), a 78% higher risk for developing CVD, and an 85% higher risk of death from CVD, compared to the regionally matched general population [12]. Thus, due to the high risks of developing diabetes and/ or CVD in patients diagnosed with SMI, it is important to gain insight into oral health-related risk factors and OHRQoL in patients diagnosed with a psychotic disorder (first-episode). Risk factors influencing oral health care Risk factors for poor oral health are related to lifestyle in patients diagnosed with a mental health disorder (e.g. smoking, using alcohol or illicit drugs), side effects (e.g., xerostomia) or (anti-psychotic) medication, and consumption of sugary food/ drinks [4,7,13,14]. The Ivory Cross is the Dutch scientific association for the prevention of dental and oral health problems in the Netherlands. They advise brushing two times a day with fluoride toothpaste, for at least two minutes. The use of dental aids (e.g., toothpicks) is also recommended (Ivory Cross, 2011). This advice is substantiated by evidence-based practice or expert opinions. Due to poor oral health habits and risk factors related to lifestyle, the influence on patients’ oral health increases the needs for regular check-ups (e.g., dentist or dental hygienist) [11,14,15]. Young adults are advised to pay preventive visits to the dentist and dental hygienist at least once a year [15]. The accessibility of oral health services and finances (e.g. sufficient money, insurance) have also been determined as risk factors in patients diagnosed with a psychotic disorder (first-episode) or SMI [1,7,9]. A sample of outpatients diagnosed with SMI show that financial barriers remain a major hurdle to reduce the unmet needs (of dental care) [9].
RkJQdWJsaXNoZXIy MTk4NDMw