Research Article
A Therapeutic Educational Program in Oral Health for
Persons with Schizophrenia: A Qualitative Feasibility Study
Audrey Peteuil,
1
Corinne Rat,
2
Sahar Moussa-Badran,
3
Maud Carpentier,
4
Jean-François Pelletier,
5
and Frederic Denis
2,3,6
1
Instance R´ egionale d’
´
Education et de Promotion de la Sant´ e, 21000 Dijon, France
2
Clinical Research Unit, La Chartreuse Psychiatric Centre, 21033 Dijon, France
3
UFR Odontology and Public Health Department, 1 Avenue du Mar´echal Juin, F-51095 Reims, France
4
Direction de la Recherche Clinique, University Hospital of Dijon, 21079 Dijon, France
5
Department of Psychiatry, Montreal University, Yale Program for Recovery and Community Health, Montreal, Canada
6
EA 75-05 Education, Ethique, Sant´ e, Universit´e François-Rabelais Tours, Facult´e de M´ edecine, 37032 Tours, France
Correspondence should be addressed to Frederic Denis; f.f.denis@orange.fr
Received 9 June 2018; Revised 7 August 2018; Accepted 15 August 2018; Published 24 September 2018
Academic Editor: Maha El Tantawi
Copyright©2018AudreyPeteuiletal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. e aim of this study was to test the feasibility of a therapeutic educational program in oral health (TEPOH) for
persons with schizophrenia (PWS). Design. In a qualitative study, we explored the representation of oral health before and after
a TEPOH. Clinical Setting: PWS are at greater risk of decayed and missing teeth and periodontal diseases. In a previous
publication, we described the different steps in building a TEPOH by taking into account the experiences of PWS concerning
oral health quality of life. is TEPOH aimed at promoting a global health approach. Participants: Voluntary PWS and their
caregivers were recruited during face-to-face interviews at “Les Boisseaux” (a psychiatric outpatient centre) in Auxerre
(France) and were included in the study between November and December 2016. Intervention: We explored the experiences of
participants and their perceptions of oral health before and after the TEPOH with focus group meetings. Results. Four females
and three males participated in the study, and the mean age was 29.4 ± 5. Before the TEPOH, the PWS produced 28 ideas about
oral health perception and 37 after the TEPOH. After the TEPOH, elements relating to the determinants of oral health
(smoking and poor diet) emerged. Conclusions. ese results show an evolution in oral health representation, and after some
adjustments to the TEPOH, the second step will be to test this program in a large sample to generate a high level of evidence of
the impact of TEPOH in the long term.
1. Background
Analysis of the literature shows a gap in health between
persons with severe mental illnesses, such as schizophrenia,
and the general population. e life expectancy of people
with severe mental illnesses is 15 to 20 years shorter than that
of the general population, and they are more prone to excess
morbidity [1]. In oral health, descriptive studies indicated
that this population is also at a greater risk of developing
tooth decay, missing teeth, and periodontal diseases [2]. Oral
health as part of the general health of persons with
schizophrenia (PWS) involves complex interactions between
their mental illness, the social and medical support systems
in which these people live, and the health care they receive
[3]. PWS frequently do not recognize their health need along
with the adverse effects of the different psychiatric treat-
ments, like hyposalivation induced by antipsychotics [4] or
hypersalivation with clozapine [5]. Other side effects do
occur. First-generation antipsychotics can induce neuro-
logical effects (e.g., dystonia and dyskinesia), especially
shaking, which prevents effective tooth brushing and im-
pairs chewing and swallowing [6]. Second-generation an-
tipsychotics tend to induce metabolic side effects, such as
obesity or diabetes, rather than neurological effects [7].
Periodontal disease is associated with metabolic side effects
[8], and it is now generally accepted that poor oral health is
Hindawi
International Journal of Dentistry
Volume 2018, Article ID 6403063, 5 pages
https://doi.org/10.1155/2018/6403063