Severe dental disease has been reported for patients receiving psychiatric treatment. This study compared the oral status of non‐institutionalized adults with chronic mental illness with a similar group without such history, and evaluated relative risk factors, for example, xerostomia, diet, hygiene, and poverty. A sample of 37 subjects with chronic mental illness (CMI) and 29 control subjects without mental illness were assessed for dental, medical and social history; head, neck, and oral soft tissue pathology; salivary flow; DMFS, gingivitis, loss of periodontal attachment, plaque, and calculus. The groups were equivalent in socioeconomic level, education, dental history, and home care. All subjects with CMI received psychotropic medications (mean of 3.8 drugs for 10.3 years). The CMI group had significantly higher incidence in the following variables: self‐reported dry mouth; consumption of carbonated beverages (P<.001); mucosal, lip, and tongue lesions (P<.01); coronal smooth surface caries (P<.001); severity of plaque (P<.001) and calculus (P<.01); and salivary flow (P<.05). No significant differences were evident in the M and F components of DMFS, in gingivitis or loss of attachment. The results indicate significant increases in risk factors and increased oral pathosis in persons with mental illness who live in community settings compared with a control group that showed dental negl