Purpose Prisoners have poorer oral health than the general population. Good oral health is essential for both social and physical well-being. For prisoners, poor oral health is also related to drug use after release, whereas good oral health is related to successful reintegration into society. The purpose of this study was twofold: to examine the effect of an intervention based on motivational interviewing (MI) on prisoners’ oral health-related behavior and to assess if the intervention is a good fit for this population. Design/methodology/approach In total, 16 prisoners in a Norwegian prison were offered a brief MI-based intervention focusing on changing their oral health-related behavior. An oral examination was also performed and the prisoners received a small package containing oral hygiene aids. Two weeks later, a second oral examination and a semi-structured interview were conducted to explore the effect of the intervention and examine the prisoners’ responses to the intervention. Qualitative data analyzes were guided by thematic analysis. Findings The findings indicate that the intervention had positive effects on both the prisoners’ motivation to use oral health-related behavior and their performance of oral health-related behavior. The findings also indicate that the intervention was well adapted to the target population. Originality/value This is one of the first studies that explore the effect of an intervention in improving prisoners’ oral health and bridges a knowledge gap in the literature. The findings may increase the understanding of how dental services should be organized and offered to provide dental health care to this vulnerable group.
Patients with dental phobia or a history of trauma tend to avoid dental services, which may, over time, lead to poor oral health. In Norway, a specific service targets these patients by providing exposure therapy to treat their fear of attendance and subsequently enable oral restoration. Dental practitioners deliver the exposure therapy, which requires a role change that deviates from their traditional practice. This paper explores how -and under what circumstances -dental practitioners manage this new role of alleviating dental anxiety for patients with a history of trauma or dental phobia. Using a realist evaluation approach, this paper develops theory describing which contexts promote mechanisms that allow practitioners to alleviate dental anxiety for patients with trauma or dental phobia. A multi-method approach, comprising service documents (n = 13) and stakeholder interviews (n = 12), was applied. The data were then analysed through a content analysis and context-mechanism-outcome heuristic tool. Our findings reveal that dental practitioners must adopt roles that enable trust, a safe space, and gradual desensitisation of the patient to their fear triggers. Adopting these roles requires time and resources to develop practitioners' skills -enabling them to adopt an appropriate communication style and exposure pace for each patient.
This study aimed to explore the factors associated with oral health‐related quality of life (OHRQoL) in a sample with high dental anxiety. Data were obtained from 107 patients attending a therapeutic treatment program for people who have experienced abuse and for those with dental phobia in Norway. Patients completed questionnaires, including the Index of Dental Anxiety and Fear, the Anxiety subscale of the Hospital Anxiety and Depression Scale, and the Oral Impacts on Daily Performance scale, measuring OHRQoL prior to treatment. The various measurement instruments were evaluated psychometrically, and the variables associated with OHRQoL were explored using hierarchical multiple regression. Symptoms of dental anxiety and general anxiety were high, while OHRQoL was poor. Dental anxiety, higher age, higher number of years since the last dental treatment, and higher general anxiety were discernibly associated with lower OHRQoL. The strongest association was found between general anxiety and OHRQoL. In conclusion, several factors were associated with OHRQoL in a sample with high dental anxiety, suggesting a complex picture of dental anxiety. When treating patients with high dental anxiety, dental practitioners should be aware that there may be factors complicating the therapeutic setting, such as general anxiety.
Patients with a trauma history, whether sexual abuse or torture, or dental phobia, tend to avoid dental services due to severe dental anxiety. Subsequently, they experience poor oral health, lower quality of life, and poorer general health. In Norway, a specific service (torture, abuse, and dental anxiety [TADA]) targets these patients’ dental anxiety through cognitive behavioural therapy (CBT) prior to dental restoration. By exploring patients’ experiences with TADA services using a realist evaluation approach, this paper aims to increase our understanding of how this type of service addresses patients’ dental anxiety in terms of its mechanisms and contextual factors. Interviews with TADA patients (n = 15) were analysed through a template analysis driven by context‐mechanism‐outcome heuristics. The analysis revealed that patients value a dental practitioner who provides a calm and holistic approach, positive judgements and predictability elements that lean towards a person‐centred care approach. Provided this, patients felt understood and cared for, their shame was reduced, self‐esteem emerged, and control was gained, which led to alleviation of dental anxiety. Therefore, our findings suggest that combining CBT with a person‐centred care approach helps alleviate patients’ dental anxiety. This provides insights into how dental services could be executed for these patients.
Purpose Prisoners’ oral health is an often overseen, yet important aspect of the general health of prisoners. To develop effective measures to improve the situation, it is important to get an overview of existing research. The purpose of this study is to examine and analyse existing research on oral health of prisoners and provide a thorough understanding of prisoners’ oral health and related factors. Design/methodology/approach Due to relatively few scientific papers on prisoners’ oral health, an integrative review was chosen. Integrative reviews allow for the inclusion of diverse methodologies. A literature search was conducted, followed by an assessment of the quality of the studies by using the Mixed Methods Appraisal Tool. Thematic analysis was used to analyse the studies. Findings The few studies addressing European prisoners’ oral health in the last 21 years differ in design and methodology. The results from this review indicate that prisoners’ oral health is a complex phenomenon and should be understood from both individual and organisational perspectives. More research is needed to bridge the gap in the literature on prisoners’ oral health. Originality/value To the best of the authors’ knowledge, this is the first literature review on European prisoners’ oral health.
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