The aim of this systematic review from the Cochrane Schizophrenia Group was to assess the effectiveness of oral health advice in reducing morbidity, mortality and preserving the quality of life in people with serious mental illness.

A number of studies have found links between mental health problems and poor oral health and we have highlighted some more recent studies here on the Mental Elf:

• Study suggests people with depression and anxiety have lower use of oral health services and greater tooth loss
• Tooth loss three times higher in people with serious mental illness

Unfortunately the new Cochrane Review did not identify any randomised controlled trials focusing on oral health advice versus standard care or comparing oral health advice with other more focused methods of delivering care or information:

• Khokhar WA, Clifton A, Jones H, Tosh G. Oral health advice for people with serious mental illness. Cochrane Database of Systematic Reviews 2011, Issue 11. Art. No.: CD008802. DOI: 10.1002/14651858.CD008802.pub2

However, it’s clearly important that people experiencing mental health problems have appropriate oral health care advice in line with other population groups. There have been a number of reviews looking at the effectiveness of oral health promotion suggesting that this can change behaviour and improve oral health e.g.

• Sprod A J, Anderson R, Treasure E T. Effective oral health promotion: literature review. Dental Public Health Unit, Health Promotion Wales, 1996:67.
• Kay E, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dental Health.1998;15(3):132‐144.

While recently it has been suggested that motivational interviewing may be an effective approach:

• Yevlahova D, Satur J. Models for individual oral health promotion and their effectiveness: a systematic review. Aust Dent J. 2009 Sep;54(3):190-7. Review. PubMed PMID: 19709105. [PubMed abstract]

And a more tailored approach may be more suitable for this population group. Overall the majority of reviews evaluating oral health promotion have criticised the original studies as being of poor quality and Watt et al have argued for the need for higher quality outcome measures:

• Watt RG, Harnett R, Daly B, Fuller SS, Kay E, Morgan A, Munday P, Nowjack-Raymer R, Treasure ET. Evaluating oral health promotion: need for quality outcome measures. Community Dent Oral Epidemiol. 2006 Feb;34(1):11-7. PubMedPMID: 16423026. [PubMed abstract]