Periodontal microbiome in patients with mental disorders residing in psychiatric long-term care facilities

Relevance. According to the World Health Organization, periodontitis and gingivitis are among the eleven most prevalent conditions globally. A major contributing factor in the development of these diseases is the presence of periodontal pathogens. This study is based on the premise that differences in the periodontal microbiome between individuals with and without mental disorders may play a meaningful role in understanding the connection between mental and oral health.

Objective. To identify and evaluate the periodontal microbial profile in patients with mental disorders residing in psychiatric long-term care facilities.

Materials and methods. This cross-sectional study analyzed the periodontal microbial profiles of 135 patients with mental disorders living in psychiatric long-term care facilities in Arkhangelsk and 96 individuals without diagnosed mental disorders. The assessment included evaluation of periodontal status and microbial composition. Statistical analyses were performed using Stata 17.0 software. The Shapiro–Wilk test was applied to assess the normality of quantitative data. Pairwise comparisons were conducted using the Mann–Whitney U test, and multiple comparisons using the Kruskal–Wallis test. Associations between categorical variables were evaluated using Pearson’s chi-squared (χ²) test, while correlations between quantitative variables were analyzed using Spearman’s rank correlation.

Results. The prevalence of periodontal pathogens was 90.8% in the main group and 49.4% in the control group. The Mann–Whitney U test revealed statistically significant differences in the detection rates of periodontal pathogens between patients with mental disorders and those without (P. gingivalis, P. intermedia, T. forsythia, T. denticola, A. actinomycetemcomitans – p < 0.001; C. albicans – p = 0.009). An association was observed between the presence of a mental disorder and the detection of periodontal pathogens (Pearson’s χ², p < 0.001).

Conclusion. Patients with mental disorders showed a significantly higher prevalence and colonization of periodontal tissues by periodontal pathogens compared to controls. Furthermore, the presence of mental disorders and the associated use of antipsychotic medications were linked to a higher risk of harboring these bacteria in the periodontal microbiome.

1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–1259. doi: 10.1016/S0140-6736(18)32279-7

2. Jain N, Dutt U, Radenkov I, Jain S. WHO's global oral health status report 2022: Actions, discussion and implementation. Oral Dis. 2024 Mar;30(2):73-79. doi: 10.1111/odi.14516

3. Sanz M. European workshop in periodontal health and cardiovascular disease. European Heart Journal Supplements. 2010;12(B):B2-B2. doi: 10.1093/eurheartj/suq002

4. Reynolds I, Duane B. Periodontal disease has an impact on patients’ quality of life. Evidence-Based Dentistry. 2018;19(1):14–15. doi: 10.1038/sj.ebd.6401287

5. Belyaev VS, Chervinets VM, Chervinets YuV, Grigoryants EO, Leontʼeva AV, Stulov NM. Microbiota of oral cavity isolated from healthy people and patients with chronical generalizated periodontitis. Problems in medical mycology. 2020;(3):49 (In Russ.). Available from: https://elibrary.ru/item.asp?id=44271623

6. Slazhneva ES, Tikhomirova EA, Atrushkevich VG. Periodontopathogens: a new view. Systematic review. Part 1. Pediatric dentistry and dental prophylaxis. 2020;20(1):70-76 (In Russ.). doi: 10.33925/1683-3031-2020-20-1-70-76

7. Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. Journal of Clinical Periodontology. 2017;44(5):456–462. doi: 10.1111/jcpe.12732

8. Tonetti MS., Bottenberg P, Conrads G. Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing – consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries be. Journal of Clinical Periodontology. 2017;44(18):135–144. doi: 10.1111/jcpe.12681

9. Torshin IYu, Gromova OA, Vanchakova NP, Semyonov VA. Comparative analysis of microbiome indicators in patients with mental disorders and in healthy volunteers. Experimental and Clinical Gastroenterology. 2022;(8):92-105 (In Russ.). doi: 10.31146/1682-8658-ecg-204-8-92-105

10. Said-Sadier N, Sayegh B, Farah R, Abbas LA, Dweik R, Tang N et al. Association between Periodontal Disease and Cognitive Impairment in Adults. International Journal of Environmental Research and Public Health. 2023;20(6):4707. doi: 10.3390/ijerph20064707

11. Kriauciunas A, Gedvilaite G, Bruzaite A, Zekonis G, Razukevicius D, Liutkeviciene R. Generalised Periodontitis: Examining TAS2R16 Serum Levels and Common Gene Polymorphisms (rs860170, rs978739, rs1357949). Biomedicines. 2024;12(2):319. doi: 10.3390/biomedicines12020319

12. Choi J, Price J, Ryder S, Siskind D, Solmi M, Kisely S. Prevalence of dental disorders among people with mental illness: An umbrella review. The Australian & New Zealand Journal of Psychiatry. 2022;56(8):949-963. doi: 10.1177/00048674211042239

13. Iushchuk MV, Balmasova IP, Nikolaeva EN, Arutyunov SD, Tsarev VN. Relations of associations of periodontal-pathogenic bacteria and gingivitis development among students of medical higher educational institution suffering academic stress. Clinical Dentistry(Russia). 2017;(2):18–24 (In Russ.). Available from: https://kstom.ru/ks/article/view/0082-04?locale=ru_RU

14. Yanushevich OO, Tsarev VN, Nikolaeva EN, Balmasova IP, Ippolitov EV, Tsareva TV, et al. The first domestic experience of detecting the association of anaerobic bacteria Filifactor Alocis and Porphyromonas Gingivalis by molecular biological methods in periodontal diseases and comorbid pathology (comparative research). Annals of the Russian academy of medical sciences. 2023;77(6):437-446 (In Russ.). doi: 10.15690/vramn2262

15. Tsarev VN, Nikolaeva EN, Ippolitov EV. Periodontophatogenic bacteria of the main factors of emergence and development of periodontitis. Journal of microbiology. 2017;(5):22-34 (In Russ.). doi: 10.36233/0372-9311-2017-5-101-112

16. Cockburn N, Pradhan A, Taing MW, Kisely S, Ford PJ. Oral health impacts of medications used to treat mental illness. Journal of Affective Disorders. 2017;223:184-193. doi: 10.1016/j.jad.2017.07.037

17. Teoh CXW, Thng M, Lau S, Taing MW, Chaw SY, Siskind D et al. Dry mouth effects from drugs used for depression, anxiety, schizophrenia and bipolar mood disorder in adults: systematic review. BJPsych Open. 2023;9(2):e53. doi: 10.1192/bjo.2023.15

18. Qiao Y, Wu M, Feng Y, Zhou Z, Chen L, Chen F. Alterations of oral microbiota distinguish children with autism spectrum disorders from healthy controls. Scientific Reports. 2018;8:1597. doi: 10.1038/s41598-018-19982-y

19. Hashioka S, Inoue K, Miyaoka T, Hayashida M, Wake R, Oh-Nishi A et al. The possible causal link of periodontitis to neuropsychiatric disorders: More than psychosocial mechanisms. International Journal of Molecular Sciences. 2019;20:3723. doi: 10.3390/ijms20153723

20. Martin S, Foulon A, El Hage W, Dufour-Rainfray D, Denis F. Is There a Link between Oropharyngeal Microbiome and Schizophrenia? A Narrative Review. International Journal of Molecular Sciences. 2022;23(2):846. doi: 10.3390/ijms23020846