Barriers and enablers for oral health care for people affected by mental health disorders

Slack‐Smith, Linda; Hearn, Lydia; Scrine, Clair; Durey, Angela

doi:10.1111/adj.12429

Cited by 50 publications

(80 citation statements)

References 71 publications

(197 reference statements)

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“…Evidence suggests that individuals in Australia with severe MHD are more likely to be edentate or have decayed, missing and filled teeth or surfaces than the general population . Local and international evidence indicates that factors influencing the sub‐optimum oral health status of people with MHD include poor general health, effects of medication and limited access to preventive dentistry . Regular dental care in this group is recommended .…”

Section: Introductionmentioning

confidence: 99%

“…Regular dental care in this group is recommended . Yet, access to and affordability of dental care in Australia have been identified as a significant problem for people with MHD …”

Section: Introductionmentioning

confidence: 99%

“…that factors influencing the sub-optimum oral health status of people with MHD include poor general health, effects of medication and limited access to preventive dentistry. [6][7][8][9] Regular dental care in this group is recommended. 6 Yet, access to and affordability of dental care in Australia have been identified as a significant problem for people with MHD.…”

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confidence: 99%

“…6 Yet, access to and affordability of dental care in Australia have been identified as a significant problem for people with MHD. 5,9 States and territories provide most of the public dental services in Australia, and other services are largely private. Public services are available to those on a concession card (such as age pension, disability support pension or unemployment payments) although a co-payment may be incurred for treatment.…”

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confidence: 99%

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Providing oral care for adults with mental health disorders: Dental professionals’ perceptions and experiences in Perth, Western Australia

Scrine

Durey

Slack‐Smith

2018

Comm Dent Oral Epid

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Objective To explore dental professionals’ perceptions and experiences of providing oral health care for adults with mild to moderate mental health disorders (MHD) in Perth, Western Australia. Methods A grounded theory approach guided this research which comprised semi‐structured interviews with oral health professionals working in private and/or public dental facilities attended by adults with MHD. An iterative analysis of transcripts identified emerging issues that were organized into categories under which key themes were noted, coded, compared, discussed, reviewed and revised independently by two researchers to ensure rigour. Results Sixteen interviews were conducted with six general dentists, three dental specialists, four oral health therapists (OHT) and three dental assistants. Barriers to providing oral health care for adults with MHD included limitations of the current model of care, often focused on treating advanced disease; limited inter‐professional collaboration; an over‐burdened public dental system and the financial constraints of private practice. Personal barriers included perceptions that people with MHD had limited capacity for self‐care and preventing oral disease. Factors that would enable oral health care included training and professional development for dental professionals to work effectively with people with MHD and a more flexible, inter‐professional approach that involved prevention and inviting family to consultations about oral health in primary health care settings. Conclusions Our study reveals structural barriers where services often appear to be inadequately prepared to meet the oral health needs of people with MHD. This suggests the need for strategies to review current models of care and encourage and support dental professionals to provide oral health care that is inclusive, inter‐professional, focused on prevention and sensitive to the social context and lived experience of people with MHD.

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Section: Introductionmentioning

confidence: 99%

“…Regular dental care in this group is recommended . Yet, access to and affordability of dental care in Australia have been identified as a significant problem for people with MHD …”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Providing oral care for adults with mental health disorders: Dental professionals’ perceptions and experiences in Perth, Western Australia

Scrine

Durey

Slack‐Smith

2018

Comm Dent Oral Epid

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“…Lives are negatively impacted, and millions of productive hours are lost annually as a result of poor oral health [13,15,[18][19][20]. People with mental disorders have significantly poorer oral health outcomes than the general population [21][22][23]. Kisely [21] refers to a bi-directional association between oral health and mental health.…”

Section: Introduction/backgroundmentioning

confidence: 99%

Oral health interventions for people living with mental disorders: protocol for a realist systematic review

Kenny

Dickson‐Swift

Gussy

et al. 2020

Int J Ment Health Syst

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Background: The increasing number of people who experience mental disorders is a global problem. People with mental disorders have high rates of co-morbidity and significantly poorer oral health outcomes than the general public. However, their oral health remains largely a hidden and neglected issue. A complex range of factors impact the oral health of this group. These include anxiety and dental phobia, dietary habits, including the heavy consumption of sugary drinks, substance misuse of tobacco, alcohol, and/or psychostimulants, the adverse orofacial side effects of anti-psychotic and anti-depression medications, and financial, geographic, and social barriers to accessing oral health care. Methods:The aim of this realist systematic review is to (a) identify and synthesise evidence that explores oral health interventions for people living with mental disorders; (b) explore the context and mechanisms that have contributed to the success of interventions or the barriers and challenges; (c) produce program theories on causal, contextual and mechanistic factors to facilitate outcomes and (d) produce recommendations and guidelines to guide future oral health interventions for people with mental disorders at both the policy and practice level. Using a five-step process, that incorporates primary data collection from key stakeholders, a beginning theoretical framework will be developed to describe contextual and mechanistic factors and how they might impact on the success or failure of oral health interventions for people with mental disorders. Key database searches will be conducted, with data extraction focused on the factors that might have impacted on intervention implementation and outcomes. Quality appraisal of studies will occur, and the theoretical framework will be populated with extracted data. Stakeholder input will support the development and refinement of a theory on oral health interventions for people with mental disorders.Discussion: This will be the first review to take a realist approach to explore the broad scope of causal factors that impact on the success or failure of oral health interventions for people with mental disorders. The approach includes extensive stakeholder engagement and will advance realist systematic review methodology. Review outcomes will be important in guiding policy and practice to ensure oral health interventions better meet the needs of people with mental disorders. Systematic review registrationThis review protocol is registered with PROSPERO (Number) 155969. © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article' s Creative Commons licence, unless indicated otherwise in a credit l...

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Personalized Dental Caries Management for Frail Older Adults and Persons with Special Needs

Marchini

Ettinger

Hartshorn

2019

Dental Clinics of North America

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Barriers and enablers for oral health care for people affected by mental health disorders

Abstract: Considerable investigation of barriers had not elucidated options to improve care or outcomes.

Cited by 50 publications

References 71 publications

Providing oral care for adults with mental health disorders: Dental professionals’ perceptions and experiences in Perth, Western Australia

Providing oral care for adults with mental health disorders: Dental professionals’ perceptions and experiences in Perth, Western Australia

Oral health interventions for people living with mental disorders: protocol for a realist systematic review

Personalized Dental Caries Management for Frail Older Adults and Persons with Special Needs

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