Oral health knowledge, beliefs and experiences among outpatients with schizophrenia: a qualitative study

Oral health is a crucial but often neglected component of general health in individuals with schizophrenia. Previous studies have suggested that cognitive, medication-related, motivational, and access-related factors may contribute to poor oral health in this population. This study aimed to explore, through a qualitative approach, the oral health knowledge, beliefs, daily oral hygiene practices, dental anxiety, and care-seeking experiences of outpatients with schizophrenia. This qualitative descriptive study was conducted at the Community Mental Health Center of Ege University Faculty of Medicine. Thirty adult outpatients with schizophrenia were recruited through purposive sampling. Data were collected via semi-structured, face-to-face interviews lasting 7–25 min, recorded and transcribed verbatim. Data were analyzed using an inductive thematic analysis approach. Four themes were identified: (1) level of knowledge and awareness, (2) brushing habits, (3) dental anxiety, and (4) accessing care. Participants reported no structured oral health education, and knowledge was primarily derived from family members, personal experience, or online sources. Dental caries was frequently perceived as genetic and largely unavoidable. Although most participants stated that toothbrushing is important, only a few reported consistent daily brushing. Brushing behaviors ranged from complete avoidance to highly structured or repetitive routines, reflecting a marked knowledge–behavior gap. Dental anxiety was commonly described in relation to previous painful or poorly explained treatments, and sensory stimuli within dental settings were also described in relation to avoidance. Access to dental services was hindered by multiple factors, including long waiting times in public hospitals, limitations of the centralized appointment system, and the use of informal or online sources for oral health information. Oral health experiences among outpatients with schizophrenia in this study appear to be shaped by interconnected informational, motivational, experiential, and structural factors. Interventions may benefit from extending beyond education alone to incorporate individualized behavioral support, anxiety-sensitive communication, and improved coordination between dental and mental health services to promote preventive and sustained engagement with oral health care. These findings provide context-specific insights that may inform the development of tailored approaches for similar outpatient populations. This study was approved by the Ege University Scientific Research and Publication Ethics Committee (approval date: 01 September 2025; decision no: 12/04; protocol no: 3009).