Assessment of Oral Hygiene, Tooth Brushing Habits, and Mucosal Changes of Non- Institutionalized and Institutionalized Psychiatric Patients in a Tertiary Rehabilitation Center in Bengaluru: A Comparative Study

Background: The study was carried out to estimate the oral hygiene status (decayed, missing, filled index [DMFT], and oral hygiene index simplified [OHI-S]), tooth brushing habits, and mucosal changes if any of institutionalized and noninstitutionalized patients. Furthermore, comparison of the differences in the level of oral hygiene and mucosal changes in both groups was carried out. Materials and Methods: The study consisted 200 psychiatric patients, out of which 100 were institutionalized in a tertiary rehabilitation center in Bangalore, and 100 were noninstitutionalized. Clearance was obtained from the ethical committee, and individual consent was taken. Following this, a complete oral examination was done, and the OHI-S and DMFT were evaluated. The mucosa was examined overall with respect to the following sites: Buccal mucosa, tongue labial mucosa, floor of the mouth, and palate for mucosal changes if any. A history of tooth brushing habits was recorded from each patient. Results: Among the 200 patients evaluated, patients diagnosed and being treated for clinical depression, schizophrenia, substance abuse, and bipolar disorders were considered for the study. The mean DMFT index was calculated to be 4.820 in institutionalized and 5.960 in non-institutionalized subjects. The mean of OHI-S was calculated to be 1.651 in institutionalized patients and 2.220 in non-institutionalized patients. There were no significant mucosal changes observed in both the classes. We also found better oral hygiene practices in the case of institutionalized patients. Conclusion: In this study, we observed a significant increase in DMFT index in non-institutionalized patients. The OHI-S index was also found to be significant in non-institutionalized subjects. This significant increase in the parameters could be attributed to an overall care and maintenance of all aspects of the patient’s health in an institution, as compared to those patients who are noninstitutionalized, whose basic hygiene is often neglected.