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

Abstract

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.

A special needs dentistry study of institutionalized individuals with intellectual disability in West Sumatra Indonesia

“…Dentists need to be equipped with adequate knowledge and skills to address the special needs of these patients. Treatment and admission protocols that do not accommodate these individuals and an unfriendly environment lower the quality of care for these individuals 41 . Therefore, a special training course for people involved in dental care should be established where special needs dentistry units are lacking, to train dentists who will devote themselves to dental care of individuals with special needs.…”

“…People with ID have impaired intellectual and adaptive functioning with an intelligence quotient (IQ) below 70. The American Association on Intellectual and Developmental Disabilities (AAIDD) divides ID into four categories according to IQ: mild (55-69), moderate (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54), severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), and profound (<20). People with ID have difficulty in understanding, learning, and applying new or complex skills.…”

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

“…Authors [22,36,43,44] have highlighted a lack of evidence on the effectiveness of oral health interventions for people with mental disorders. There have been calls for the training of mental health professionals and closer collaboration between all health professionals [48,49]. Recommendations for further research include studies focused on oral health education and promotion within mental health service settings (including inpatient and community settings) [23,49].…”

Dental care for drug users in Norway: dental professionals’ attitudes to treatment and experiences with interprofessional collaboration

“…In general health care, increased effectiveness, better quality of care, and reduction of health disparities have been associated with successful inter-professional collaboration [ 17 – 19 ]. Collaboration between dental practitioners and non-dental primary care providers has been pointed out as a potential factor to improve oral health care among patients with mental health problems [ 20 ]. However, the dental health care delivery system in Norway is separated from the general health care system, hence collaboration can be challenging [ 21 , 22 ].…”