Oral health related quality of life and reasons for non‐dental attendance among patients with substance use disorders in withdrawal rehabilitation

Abstract

No study has assessed the socio‐behavioral distribution of oral health related quality of life (OHRQoL) among patients with substance use disorders receiving medically assisted rehabilitation therapy (MAR) in Norway. Objectives To examine the prevalence of oral impacts on daily performances (OIDP) and its distribution among MAR patients in western Norway. We also examined whether oral impacts discriminate with different reasons for non‐dental attendance. Material and Methods A cross‐sectional study focusing OHRQoL was nested to the INTRO‐HCV study and implemented in six rehabilitation clinics for people with substance use disorders. A total of 167 MAR patients completed personal interviews and oral clinical examination upon entering the clinic for their MAR medication. Results The prevalence of oral impacts (OIDP > 0) was 61%. Logistic regression, adjusted for sex and age presented with odds ratios (OR) with 95% confidence intervals (CI) revealed that less than 20 remaining teeth (OR = 5.3 95% CI: 1.6–23.3) and dissatisfaction with dental care (OR = 5.1 95% CI: 1.3–19.0) increased the odds of having OIDP > 0. OIDP > 0 was also associated with insufficient dental follow‐up due to dental anxiety and poor experiences with perceived attitudes of dental workers. Means OIDP among people with negative experiences with attitudes of dental care workers were 3.1 (SD 0.8) compared to 1.4 (SD 0.7) among those without negative experiences, and 2.8 (SD) for those with dental anxiety compared to 1.8 (SD) among those without. Conclusion OHRQoL among MAR patients was generally poor. To reach those with a need for dental care, modification of the existing rehabilitation approach toward closer collaboration between dental health care workers and others in contact with drug users might be necessary.

Oral health‐care needs among clients receiving alcohol and other drugs treatment—A scoping review

“…In the first focus area, 23 studies were identified that included 3611 participants with a mean age ranging from 27.9 to 44 years [ 19 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. The studies were conducted in Australia ( n = 2), Brazil ( n = 3), India ( n = 2), Indonesia ( n = 1), Iran ( n = 1), Ireland ( n = 2), Italy ( n = 2), Lithuania ( n = 1), Norway ( n = 1), Portugal ( n = 1), Serbia ( n = 1), South Africa ( n = 1), United Kingdom ( n = 1) and the United States ( n = 4).…”

“…The studies were conducted in Australia ( n = 2), Brazil ( n = 3), India ( n = 2), Indonesia ( n = 1), Iran ( n = 1), Ireland ( n = 2), Italy ( n = 2), Lithuania ( n = 1), Norway ( n = 1), Portugal ( n = 1), Serbia ( n = 1), South Africa ( n = 1), United Kingdom ( n = 1) and the United States ( n = 4). About half of the studies were of cross‐sectional design ( n = 14) [ 32 , 33 , 35 , 36 , 39 , 40 , 41 , 43 , 46 , 47 , 48 , 50 , 51 , 52 ]; few studies used a qualitative design ( n = 3) [ 19 , 38 , 53 ]; and the designs of remaining six studies were cohort ( n = 3) [ 42 , 44 , 45 ], case–control ( n = 1) [ 34 ], prospective longitudinal ( n = 1) [ 49 ] and pre‐post quasi‐experimental ( n = 1) [ 37 ]. In the second focus area, the guidelines identified were developed for application in Australia ( n = 2), Canada ( n = 2), Ireland ( n = 1), United Kingdom ( n = 1) and the United States ( n = 1).…”

“…None of the papers reported on oral health knowledge, attitudes or practices of AOD clinicians. Of the 23 studies [ 19 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ], 5 reported on their oral health knowledge [ 19 , 38 , 40 , 46 , 53 ]; 5 explored their oral health attitudes [ 19 , 35 , 40 , 46 , 53 ] and all reported on oral health practices [ 19 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ...…”

“…In the study by Robinson et al [ 19 ] in the United Kingdom, participants highlighted that low self‐esteem and lifestyle adversely affected their prioritisation of oral health. Two studies also reported that some clients feared accessing the dentist [ 19 , 53 ] and two found that some people experienced being stigmatised by their dentist [ 19 , 35 ]. The study conducted in Norway found that most participants (78%) were dissatisfied with their oral health as well as their dental care, but dental anxiety or lack of perceived need were barriers to obtaining a dental visit [ 35 ].…”

“…Two studies also reported that some clients feared accessing the dentist [ 19 , 53 ] and two found that some people experienced being stigmatised by their dentist [ 19 , 35 ]. The study conducted in Norway found that most participants (78%) were dissatisfied with their oral health as well as their dental care, but dental anxiety or lack of perceived need were barriers to obtaining a dental visit [ 35 ]. However, one of the Irish studies reported that participants who were parents were motivated to pass on good oral hygiene practices to their children, including routine dental visits and daily personal oral health measures [ 53 ].…”