DENTAL-HEALTH AND TREATMENT NEEDS IN INSTITUTIONALIZED PSYCHIATRIC-PATIENTS IN ITALY

The caries prevalence, oral hygiene status, periodontal health and the treatment needs were assessed in a group of institutionalized psychia tric patients in Catanzaro, Italy. Of the total sample of 297 subjects , 165 (55.6%) were males, the mean age was 55.1 yr, the gnat majority (90.6%) was able to care for themselves, on average they had been inst itutionalized for 12.9 yr, and almost two-thirds were schizophrenic (6 5%). They did not receive any assistance in daily oral hygiene procedu res, only 7.4% had visited a dentist and exclusively for emergency car e, A total of 33 (11.1%) patients were edentulous, and the multiple lo gistic regression analysis showed a highly significant increase of ede ntulousness with increasing age (P<0.001). No caries-free subjects wer e found and among the dentate the DMFT and DMFS scores for all age gro ups were respectively 15.5 and 88.6. The stepwise linear regression an alysis showed that the mean DMFT index increased with age (t=6.86; P<0 .001), and in the partly or totally helpless patients it was significa ntly higher than in the self-sufficient patients (t=2.78; P=0.006). Of the 264 dentate subjects, only 25 (9.5%) had no need of dental treatm ent; 213 (80.7%) required extractions with a mean number per person of 6.3 and the need for conservative dental care was recorded in 154 (58 .3%) patients with a mean need for patient of 2.8. Mean OHI-S score wa s 4.2 and the stepwise linear regression analysis showed that it incre ased with age (t=5,73; P<0.001) and with the length of institutionaliz ation (t=3.42; P<0.001). Only 0.9% of the entire sample was found with healthy periodontal tissue; bleeding on probing or a higher score was found in 4.6% of examined sextants; calculus in 10.1%; shallow pocket s and deep pockets in 19.6% and 64.8% of all sextants, The results of the multiple logistic regression analysis indicated that the number of subjects with deep pockets as highest score increased with increasing age (P<0.001), and with the increasing length of institutionalization (P=0.005). The findings of this study demonstrate high caries prevale nce, poor oral hygiene and periodontal health, and extensive unmet nee ds for dental treatment. More coordinated efforts between the social a nd dental care sector must be maintained to serve adequately the need of this disadvantaged group.