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First Page

1363

Last Page

1368

Abstract

Patients with severe mental illness (SMI) often have untreated caries, periodontal inflammation, tooth loss, xerostomia-related risk, dental anxiety, and delayed dental attendance. This narrative review aimed to synthesize evidence relevant to dental treatment planning for patients with SMI receiving psychiatric home-visit care and to clarify when domiciliary dental assessment and repeated professional oral care may be indicated. Targeted literature searches and citation tracking were used to identify reviews, epidemiological studies, intervention studies, qualitative syntheses, and special care dentistry guidance. The evidence indicates that oral disease in SMI reflects not only limited knowledge but also avolition, cognitive impairment, psychosis, sedation, medication-induced dry mouth, shame, transport difficulty, and inability to sustain appointments. Domiciliary dental care for selected patients can include brief oral examination, identification of pain, swelling, residual roots, denture trauma and aspiration or nutritional risks, plaque and calculus removal as tolerated, topical or prescription fluoride, xerostomia and diet review, reinforcement of one feasible hygiene action, and referral for radiographs, restorations, extraction, periodontal or prosthetic treatment when clinic or special care settings become possible. In the illustrative home-visit case, severe avolition and somnolence prevented independent toothbrushing; therefore, dentists provided professional oral care every two weeks. During 7 months of follow-up, the patient had no acute dental symptoms, and no obvious clinical deterioration of carious lesions or periodontal inflammation was observed within the limits of domiciliary assessment. Home-visit dentistry should be considered for selected psychiatric home-care patients when self-care and clinic attendance are unreliable, before dental problems deteriorate into emergency-driven treatment.

Publication Date

2026

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