Schizophrenia is a thought disorder characterized by episodes psychosis, i.e., impairment of reality testing. Patients manifest disorders of perception, thinking, speech, emotion, and/or physical activity. The model that is most often cited to explain the pathogenesis of schizophrenia is the dopamine hypothesis, which states that the abnormal motor and mood states are caused by excess (or dysregulated) central dopaminergic neurotransmission.7,9

Schizophrenia is characterized by symptoms such as delusions, hallucinations, disorganized speech, and catatonic behavior; and reduction or loss of normal functions such as affective flattening (decreased emotional expression), alogia (decrease in fluency of speech), and avolition (decrease in goal-oriented behavior).18,19 Schizophrenia can cause marked, clinically significant impairment of social and occupational functioning, and reduced self-care.

Over the past decades dopamine D2-receptor antagonist (Table 3) and atypical antipsychotic agents (Table 3) have emerged as first-line therapies for schizophrenia.2,18,19 The term “atypical antipsychotic” refers to newer antipsychotic drugs that confer less risk of extrapyramidal ADEs than traditional, first generation “neuroleptics.” Nonadherence, which often leads to relapse of symptoms, is a significant problem with schizophrenia.

When providing oral healthcare to patients with schizophrenia, the goals are to develop and implement timely preventive and therapeutic strategies. Confirm adherence, relapse can cause clinically significant distress or impairment in the patient’s ability to perform optimal oral self-care, to participate in oral healthcare-related decision-making, to cooperate in his/her treatment, and may perceive the dental setting as threatening.