Evaluation of the Concurrent Validity of the Oral Health Screening Tool (OHS) in the Mental Health Care Setting: A Pilot Study

The prevalence of oral health problems in people with mental health disorders and addictions is significantly higher than in the general population. Timely and regular assessment of their oral health is therefore important to prevent or stop their oral health deterioration. The aim of this study is to evaluate whether the Oral Health Screener for use within interRAI (OHS) accurately detects oral health care needs people in the mental health care setting in Brazil compared to the gold standard instrument for assessing oral health, the SB BRASIL 2020. This is a cross-sectional pilot study performed at the Mental Health unit of the University Hospital of the University Hospital of Canoas, Rio Grande do Sul, in the South of Brazil. Admitted patients with severe mental disorders and addictions were included, according to the inclusion criteria. First the OHS was translated and adapted to the Brazilian mental health care context. Secondly, the patients' oral health was screened by a dentist using the OHS as well as the SB BRASIL 2020. Scores of the OHS were compared with the scores of selected corresponding items of the SB BRASIL 2020 to calculate sensitivity, specificity, predictive validity and ROC analysis of the OHS. A total of 44 participants were included (mean age 37.5 ± 14.2, 54.6% female), of which 39% had addiction problems, 16% had bipolar disorder, and 14% depression disorder as their primary diagnosis. The items' pain and oral hygiene showed large predictive accuracy with respectively 0.82 ±0.06 and 0.85 ± 0.08. The pain item showed the best results for sensitivity (90.9%), followed by the item oral hygiene (89.47%), and condition of the teeth (75.8%). No conclusive results were found for the items palate and tongue problems, as these conditions were barely present in the sample. The OHS presented high sensitivity and specificity and the application of this tool in the mental health care setting can bring an added value to clinical practice, as it is much shorter and hence more feasible to be used in the daily care for people with mental disorders and addictions. A valid screening tool for oral health in the mental health care setting can help caregivers detect people with oral disease or at risk for oral health problems. This allows targeted preventive measures, such as better oral hygiene practices and referrals to dental professionals.