在宅精神科訪問診療患者における未治療のむし歯と口腔衛生不良の実態~無料の訪問歯科健診が明らかにした「歯科につながらない」実態と支援の鍵~

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2026-02-09 東京科学大学

東京科学大学(Science Tokyo)大学院医歯学総合研究科の豊福明教授らは、東京都内で在宅精神科訪問診療を受ける患者を対象に、精神科訪問に歯科医師が同行する無料の訪問歯科健診を実施し、口腔内の実態と未充足の歯科ニーズを調査した。22人の参加者では、未治療のむし歯や残根、口腔衛生不良が多く、数年単位で歯科受診歴のない人が多数確認された。健診後には8割以上が治療や口腔ケアを希望した一方、公的扶助を受けていない患者では、訪問歯科診療の自己負担(約2,000~6,000円/回)が受診の障壁となる可能性が示された。本研究は、在宅精神科医療の現場で口腔問題が見過ごされやすい実態を明らかにするとともに、口腔スクリーニングの導入や、費用支援・家族支援を含む医療・福祉連携の重要性を示した。成果はScientific Reportsに掲載された。

在宅精神科訪問診療患者における未治療のむし歯と口腔衛生不良の実態~無料の訪問歯科健診が明らかにした「歯科につながらない」実態と支援の鍵~
図. 本研究の概要

<関連情報>

在宅精神科サービスを受けている患者の口腔の健康状態と満たされていない歯科ニーズに関する予備研究 A preliminary study on oral health status and unmet dental needs in patients with home-based psychiatric services

Takayuki Suga,Trang Thi Huyen Tu,Yuji Gamo,Takafumi Asakura,Shigeru Iida,Yoko Iwase & Akira Toyofuku
Scientific Reports  Published:09 January 2026
DOI:https://doi.org/10.1038/s41598-026-35661-9

Abstract

To investigate the oral health status and unmet dental needs of patients receiving home-based psychiatric care in Tokyo. This preliminary study aimed to assess the extent of dental problems and identify the proportion of patients requiring urgent or comprehensive dental treatment to inform more effective integrated care strategies. This study involved 22 patients receiving psychiatric care at home from a Tokyo-based clinic. A single dentist conducted free, in-home dental examinations during psychiatric home visits. Oral health was evaluated using the decayed, missing, and filled teeth (DMFT) index, Oral Health Assessment Tool (OHAT), Oral Hygiene Index (OHI), Plaque Index (PI), and Tongue Coating Index (TCI). Patient demographic and clinical data were also analyzed. The findings revealed a high prevalence of untreated caries (elevated DT scores), residual roots, and poor oral hygiene across multiple indices. Many patients had not visited a dentist for several years. A significant majority (68.18%) of participants were recipients of public assistance, and financial constraints were identified as a critical barrier to accessing care for those ineligible. For 40.91% of participants, the examination was prompted by caregiver concern rather than patient initiative. Patients receiving home-based psychiatric care demonstrate significant unmet dental needs and poor oral hygiene, exacerbated by financial, motivational, and logistical barriers. The study highlights an urgent need for enhanced home dental services, improved financial support systems, and stronger collaboration among medical, dental, and social welfare sectors to provide continuous and accessible oral healthcare for this vulnerable population.

医療・健康
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