Vol.:(0123456789) 1 3 Community Mental Health Journal https://doi.org/10.1007/s10597-020-00657-w ORIGINAL PAPER The Efects of Oral Health Instruction, and the Use of a Battery‑Operated Toothbrush on Oral Health of Persons with Serious Mental Illness: A Quasi‑Experimental Study Vaishali Singhal 1  · Albert J. Heuer 2  · Jill York 3  · Kenneth J. Gill 4 Received: 11 September 2019 / Accepted: 5 June 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract People with a diagnosis of serious mental illness (SMI) have a greater incidence of poorer oral health as compared to the general population. The aim of this quasi-experimental study was to determine the efect that a combination of the use of a battery-operated toothbrush and a related educational intervention may have on the oral health of individuals with serious mental illness. Key fndings include that the battery-operated toothbrush resulted in a signifcant improvement in the mean change in gingival index, a common indicator of oral health. The study also found that oral home care instructions, smoking and level of negative symptoms did not have an efect on the mean change in plaque or gingival indices. This project sug- gests that the implementation of a relatively simple, cost efective measures such as a battery-operated toothbrush may have a positive impact on the oral health in this population. Keywords Oral health · Mental illness · Oral home care · Battery toothbrush · Gingival index Introduction It is estimated that 14% of the “global burden of disease has been attributed to mental illness, mostly due to the persis- tently disabling nature of common mental disorders such as depression, substance abuse disorders and psychoses” (Edward et al. 2012, p. 423). Among such health conditions which are more prevalent in those with serious mental illness (SMI) are diseases related to oral health. For the individual, the negative stigmas and lower self-esteem associated with SMI may be compounded by the poor cosmetic appearance of the dentition of many individuals. At the same time, stig- mas related to the diagnosis of serious mental illness may result in a delay or avoidance of seeking dental care. This delay or avoidance can lead to further deterioration of oral health (Brondani et al. 2017). Several factors are believed to contribute to the poor oral health in people with schizophrenia, a major form of SMI. The negative symptoms of schizophrenia rarely correlated with the person’s “ability and desire to perform oral hygiene procedures” (Almomani et al. 2006, p. 275). People who sufer more from the negative symptoms of schizophrenia are at greater risk of poor general and oral health (Almom- ani et al. 2006). Additionally, “these factors are aggravated by stigmatization and discrimination” (Siu-Parades et al. 2018, p. 78). This population often does not maintain oral hygiene regularly during hospitalizations, use a proper tooth- brushing technique, or have needed oral care aids at home (Đorđević et al. 2016). Psychotropic medications also nega- tively impact the mouth because these cause xerostomia (dry mouth) and oral dyskinesias, involuntary and uncontrollable movements of the tongue, lips, and jaws that result in dif- fculty in performing oral care. Xerostomia may lead to the frequent use of sugar-laden candies and drinks to counteract the efects of a dry mouth. In general, oral dyskinesias and xerostomia lead to rapid deterioration in oral health (Arnaiz et al. 2011). * Vaishali Singhal singhava@shp.rutgers.edu 1 Rutgers School of Health Professions, 65 Bergen Street, Newark, NJ 07107, USA 2 Rutgers School of Health Professions, 65 Bergen Street, Newark, NJ 07107, USA 3 Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA 4 Rutgers School of Health Professions, 675 Hoes Lane West, Piscataway, NJ 08854, USA