Simona Bida, Teona Tudorici, Daniela Argatu, Magda Calina Barlean, Razvan-Constantin Branzan, Gabriel Rotundu, Andrei Georgescu
ABSTRACT
Schizophrenia is increasingly conceptualized as a disorder of disrupted brain connectivity rather than of isolated neurotransmitter dysfunction. Aberrant communication between cortical and subcortical networks-particularly within frontotemporal, limbic, and default mode circuits—contributes to cognitive impairment, emotional dysregulation, and functional decline. Emerging evidence also indicates that these neural alterations may extend beyond cognition, influencing systemic and oral health behaviours through complex neuroimmune, metabolic, and behavioural pathways. This narrative review aims to synthesize current knowledge on the neuro connectivity model of schizophrenia, highlight its cognitive consequences, and explore potential implications for oral health, including hygiene behaviors, periodontal disease, and inflammatory burden. Functional and structural neuroimaging studies have identified disrupted synchronization between key brain regions, such as reduced frontoparietal connectivity and hyperconnectivity in the salience and limbic networks. These abnormalities underlie deficits in executive function, working memory, and motivation—domains that are directly relevant to self-care and adherence to health-promoting behaviours. Recent clinical studies have shown higher prevalence and severity of periodontitis, caries, and xerostomia in patients with schizophrenia compared to healthy controls, even after adjusting for medication and socioeconomic factors. Dysregulated inflammatory pathways increased oxidative stress, and poor oral hygiene practices may act synergistically, linking neuropsychiatric dysfunction to oral disease progression. Furthermore, antipsychotic medications can induce salivary hypofunction and metabolic disturbances, exacerbating oral pathology.
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