Oral health status and risk of potentially malignant lesions in patients with severe mental illnesses: a cross-sectional study

Aims: Individuals with severe mental illness (SMI) experience disproportionately poor oral health due to behavioral, pharmacological, and systemic challenges. This study aimed to assess the oral health status of patients with SMI using the oral health assessment tool (OHAT) and the Decayed, Missing, and Filled Teeth (DMFT) Index, and to screen for oral potentially malignant lesions (OPMLs). Methods: A cross-sectional study was conducted with 60 patients registered at the Community Mental Health Center in Kocaeli, Turkiye. Comprehensive clinical examinations were performed using the Turkish version of the OHAT and the DMFT Index. The presence of OPMLs was also recorded. Statistical analyses included descriptive statistics, independent t-tests for gender comparisons, and Pearson correlation analyses to explore associations between age, OHAT, and DMFT scores. Results: Participants (mean age: 47.6±11.5 years; 65% female) had a mean OHAT score of 9.15±2.39 and a mean DMFT score of 13.5±7.00. No significant gender differences were observed in total OHAT or DMFT scores. However, females had significantly more filled teeth than males (3.08±2.04 vs. 1.57±1.80; p=0.006). Age was moderately correlated with OHAT (r=0.318, p=0.013) and strongly correlated with DMFT (r=0.449, p<0.001). OHAT and DMFT scores were also significantly correlated (r=0.502, p<0.001). Fifteen soft tissue lesions were detected, including leukoplakia, lichen planus, and angular cheilitis. Discussion: This study showed a high burden of oral disease and soft tissue lesions among patients with SMI, exceeding levels reported in non-psychiatric and geriatric populations. The findings emphasize the need for interdisciplinary care models incorporating routine dental screening, preventive interventions, and education within mental health services.