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Poudel P, Kong A, Hocking S, Whitton G, Srinivas R, Borgnakke WS, George A. Oral health-care needs among clients receiving alcohol and other drugs treatment-A scoping review. Drug Alcohol Rev 2023; 42:346-366. [PMID: 36529982 PMCID: PMC10107646 DOI: 10.1111/dar.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
ISSUES Poor oral health is a significant problem among people who access alcohol and other drugs (AOD) health services, yet little is known about their oral health-care needs and whether any interventions and guidelines are implemented within AOD treatment services. APPROACH A scoping review was conducted to identify scientific literature in three focus areas: oral health knowledge, attitudes and practices of clients and clinicians at AOD-related services; oral health guidelines for AOD clinicians; and interventions that describe clinicians promoting oral health among clients. KEY FINDINGS Thirty-two reports were identified. Twenty-three studies focused on the oral health knowledge, attitudes and practices of AOD clients, but none of the studies explored perspectives of clinicians. Seven clinical practice guidelines were identified but recommendations varied. Only two interventions in which an AOD clinician promoted oral health were identified. IMPLICATIONS Most reports provided insight into the perspectives of clients accessing AOD treatment services. Little evidence demonstrated that clinical practice guidelines were being implemented into practice, or that oral health promotion was part of the tasks of AOD clinicians. CONCLUSION This review identified oral health knowledge gaps and perceived poor attitudes that appeared to be reflected in certain oral health practices among clients. This finding indicates a need to educate clients about oral health while receiving AOD treatment. There was an absence of research about the needs for AOD clinicians to advocate for good oral health, and little evidence exists about effective interventions that could enhance integrating oral health care into AOD treatment services.
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Affiliation(s)
- Prakash Poudel
- eHealth New South Wales, Sydney, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Ariana Kong
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | | | - Gilbert Whitton
- Drug Health Services, South Western Sydney Local Health District, Sydney, Australia
| | - Ravi Srinivas
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- Oral Health Services, South Western Sydney Local Health District, Sydney, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, The University of Michigan, Ann Arbor, USA
| | - Ajesh George
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Patterson-Norrie T, Ramjan L, Sousa MS, George A. Dietitians' Experiences of Providing Oral Health Promotion to Clients with an Eating Disorder: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14193. [PMID: 36361071 PMCID: PMC9654250 DOI: 10.3390/ijerph192114193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Eating disorders (EDs) can seriously impact oral health, leading to irreversible dental damage. Dietitians play a key role in the care of people with an ED and are well-placed to promote oral health. However, there is currently little understanding of how dietitians perceive their role in this space. This study aimed to explore the perceptions and role of dietitians in providing oral health promotion to their clients in an ED clinical setting. (2) Methods: This descriptive qualitative study used semi-structured interviews to explore the perceptions of 14 registered dietitians practicing across seven states in Australia. Participants were recruited using a combination of purposive and snowball sampling. A hybrid thematic analysis approach was undertaken to identify and describe the key themes generated from the data. (3) Results: Generally, dietitians were insightful and knowledgeable of the oral health issues that clients with an ED may be experiencing. However, dietitians' practices across education, screening, and referrals were inconsistent. Challenges such as inadequate training, unknown referral pathways, and clear guidelines were cited as significant barriers to practice. (4) Conclusions: The results reinforce the need for education and the development of targeted strategies that address challenges to oral health promotion in dietetic practice.
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Affiliation(s)
- Tiffany Patterson-Norrie
- Australian Centre for Integration of Oral Health, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Lucie Ramjan
- Australian Centre for Integration of Oral Health, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 1871, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Mariana S. Sousa
- Australian Centre for Integration of Oral Health, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- IMPACCT—Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, NSW 2007, Australia
| | - Ajesh George
- Australian Centre for Integration of Oral Health, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, NSW 2010, Australia
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Perceptions and practices of general practitioners on providing oral health care to people with diabetes - a qualitative study. BMC FAMILY PRACTICE 2020; 21:34. [PMID: 32054440 PMCID: PMC7020546 DOI: 10.1186/s12875-020-1102-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 01/29/2020] [Indexed: 12/12/2022]
Abstract
Background Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with diabetes, yet little is known about this area of care. This study aimed to explore current practices, perceptions and barriers of GPs towards oral health care for people with diabetes. Methods We employed a qualitative research method utilising telephone interviews. Purposive and snowball sampling were used to recruit 12 GPs from Greater Sydney region. A thematic analysis involving an inductive approach was used to identify and analyse contextual patterns and themes. Results A majority of participants were males (n = 10), working in group practices (n = 11) with a mean ± SD age of 55 ± 11.4 years and 25 ± 13.6 years work experience. Three major themes emerged: oral health care practices in general practice settings; barriers and enablers to oral health care; and role of diabetes care providers in promoting oral health. Most GPs acknowledged the importance of oral health care for people with diabetes, identifying their compromised immune capacity and greater risks of infections as risk factors. GPs reported 20–30% of their patients having oral health problems, however their current oral health care practices relating to education, risk assessment and referrals were reported as very limited. GPs identified several barriers including time constraints, absence of referral pathways, and limited knowledge and training in promoting oral health care. They also reported patient barriers including oral health care costs and lower oral health awareness. GPs perceived that resources such as education/training, a standardised assessment tool and patient education materials could support them in promoting oral health care. GPs also perceived that other diabetes care providers such as diabetes educators could play an important role in promoting oral health. Conclusions Despite current recommendations, GPs’ current oral health care practices among people with diabetes are limited. Further strategies including capacity building GPs by developing appropriate oral health training programs and simple risk assessment tools along with accessible referral pathways are needed to address the current barriers.
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Affiliation(s)
- Prakash Poudel
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, New South Wales (NSW), 2170, Australia. .,School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW, 2560, Australia. .,South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia. .,Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.
| | - Rhonda Griffiths
- School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Vincent W Wong
- South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.,Faculty of Medicine, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University Campbelltown Campus, Campbelltown, NSW, 2751, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia.,Faculty of Medicine, University of New South Wales, Kensington, NSW, 2052, Australia.,Diabetes Centre Bankstown-Lidcombe Hospital, Bankstown, NSW, 2200, Australia.,School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Chee L Khoo
- Health focus Family Practice, Ingleburn, NSW, 2565, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool, New South Wales (NSW), 2170, Australia.,School of Nursing & Midwifery, Western Sydney University, Campbelltown, NSW, 2560, Australia.,South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,University of Sydney, Camperdown, NSW, 2050, Australia
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Sanchez P, Everett B, Salamonson Y, Redfern J, Ajwani S, Bhole S, Bishop J, Lintern K, Nolan S, Rajaratnam R, Sheehan M, Skarligos F, Spencer L, Srinivas R, George A. The oral health status, behaviours and knowledge of patients with cardiovascular disease in Sydney Australia: a cross-sectional survey. BMC Oral Health 2019; 19:12. [PMID: 30634974 PMCID: PMC6329166 DOI: 10.1186/s12903-018-0697-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 12/18/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Periodontal disease is a risk factor for atherosclerotic cardiovascular disease and it is recommended internationally that patients with cardiovascular disease should engage in preventative oral health practices and attend regular dental care visits. This study aimed to explore the oral health status, behaviours and knowledge of patients with cardiovascular disease. METHODS A cross-sectional questionnaire containing 31 items was administered to patients with cardiovascular disease from cardiac rehabilitation and outpatient clinics in Sydney Australia in 2016-2017. RESULTS Of the 318 patients surveyed, 81.1% reported having at least one oral health problem. Over a third (41.2%) of participants had not seen a dentist in the preceding 12 months and 10.7% had received any oral healthcare information in the cardiac setting. Those with valvular conditions were more likely to have received information compared to those with other cardiovascular conditions (40.6% versus 7.4%, p < 0.001). Only half of the participants had adequate oral health knowledge. CONCLUSIONS Despite a high incidence of reported oral health problems, many patients lacked knowledge about oral health, were not receiving oral health information from cardiac care providers and had difficulty accessing dental services. Further research is needed to develop oral health strategies in this area.
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Affiliation(s)
- Paula Sanchez
- School of Nursing and Midwifery Western Sydney University, Centre for Oral Health Outcomes & Research Translation (COHORT), Ingham Institute Applied Medical Research, Liverpool Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery Western Sydney University, Ingham Institute Applied Medical Research, Centre for Applied Nursing Research (CANR), Parramatta South Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery Western Sydney University, Ingham Institute Applied Medical Research, Centre for Applied Nursing Research (CANR). Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health University of Sydney, PO Box 154, Westmead, NSW 2154 Australia
| | - Shilpi Ajwani
- Sydney Local Health District, Oral Health Services, Sydney Dental Hospital, University of Sydney/ Sydney Research, 2 Chalmers Street, Surry Hills, NSW 2010 Australia
| | - Sameer Bhole
- Sydney Local Health District, Oral Health Services, Sydney Dental Hospital, University of Sydney/ Sydney Research, 2 Chalmers Street, Surry Hills, NSW 2010 Australia
| | - Joshua Bishop
- Balmain Hospital, 29 Booth, St Balmain, NSW 2041 Australia
| | - Karen Lintern
- South Western Sydney Local Health District, Cardiac Ambulatory Services, Liverpool Hospital, 7103 Locked Bag 7103, Liverpool BC, NSW 2170 Australia
| | - Samantha Nolan
- Cardiac Ambulatory Services Cardiac Rehabilitation, Royal Prince Alfred Hospital & Balmain Hospital, 29 Booth St Balmain, Camperdown, NSW 2041 Australia
| | - Rohan Rajaratnam
- South Western Sydney Local Health District, Locked Bag 7103, BC1871, Liverpool, NSW 2170 Australia
| | - Maria Sheehan
- South Western Sydney Local Health District, Cardiac Rehabilitation and Chronic Cardiac Care, Fairfield Hospital, Polding St & Prairie Vale Rd, Prairiewood, NSW 2176 Australia
| | - Fiona Skarligos
- Cardiac Ambulatory Services, Cardiac Rehabilitation, Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW 2050 Australia
| | - Lissa Spencer
- Chronic Disease Rehabilitation, Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW 2050 Australia
| | - Ravi Srinivas
- South Western Sydney Local Health District Oral Health Services, Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, University of Sydney, Ingham Institute Applied Medical Research, 59 Cumberland Rd, Ingleburn, NSW 2565 Australia
| | - Ajesh George
- Centre of Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Level 3, 1 Campbell, St Liverpool, NSW 2170 Australia
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Perceptions and Practices of Diabetes Educators in Providing Oral Health Care: A Qualitative Study. DIABETES EDUCATOR 2018; 44:454-464. [PMID: 30141382 DOI: 10.1177/0145721718796055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose The purpose of this study was to explore the current perceptions and practices of diabetes educators (DEs) in providing oral health care to people with diabetes. Methods A qualitative study design involving focus groups was used to gather data. Purposive sampling was used to recruit DEs working across 3 metropolitan hospitals in South Western Sydney, Australia. Results Fourteen DEs participated in 3 focus groups. Participants had a mean ± SD age of 44.4 ± 9.2 years and 5.2 ± 5.3 years of work experience in diabetes care. Four main themes were identified: perceptions about oral health care and diabetes current oral health care practices, perceptions on incorporating oral health, and suggested model of care. DEs agreed that promoting oral health in diabetes clinics is important, and they reported seeing patients frequently with oral health problems. However, the majority do not include oral health care in consultations, primarily because they have limited knowledge in this area and have not received any formal oral health education or training. Additional barriers were the lack of referral pathways and resources for patient education. DEs were receptive to incorporating oral health provided that the current barriers were addressed. DEs also suggested a multidisciplinary team care approach to promote oral health. Conclusions Current practices of DEs in oral health care are limited, but they are willing to address oral health. A suggested model of oral health care should include capacity building of diabetes care providers, appropriate dental referral pathways, and a team approach within multidisciplinary diabetes care.
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Affiliation(s)
- Prakash Poudel
- COHORT Research Group (Centre for Oral Health Outcomes and Research Translation), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Rhonda Griffiths
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Vincent W Wong
- South Western Sydney Local Health District, South Western Clinical School, University of New South Wales, Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, Penrith, Australia
- Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, South Western Clinical School, University of New South Wales, Liverpool, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Chee L Khoo
- Health Focus Family Practice, Ingleburn, Australia
| | - Ajesh George
- COHORT Research Group (Centre for Oral Health Outcomes and Research Translation), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, Australia
- School of Dentistry, University of Sydney, Camperdown, Australia
- Translational Health Research Institute, Penrith, Australia
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