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Molina G, Zar M, Dougall A, McGrath C. Management of dental caries lesions in patients with disabilities: Update of a systematic review. FRONTIERS IN ORAL HEALTH 2022; 3:980048. [PMID: 36389277 PMCID: PMC9650433 DOI: 10.3389/froh.2022.980048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/07/2022] [Indexed: 07/21/2023] Open
Abstract
The aim of this systematic review was to update an existing review on the management of dental caries lesions in patients with disabilities so as to provide an up-to-date summary of the evidence. Randomized clinical trials and cohort studies related to preventive and restorative programmes for dental caries among people requiring special care, published in English, Spanish, Portuguese, French and German languages from February 1st 2011 to April 1st 2022, were retrieved from three databases ("updated review"). From the 1,105 titles identified using the search topic "Caries AND Disability", 17 papers informed in the analyses: 6 referring to caries preventive strategies and 11 related to restorative care strategies. Most of these studies targeted children and adults with intellectual/physical disability, although preventive and therapeutic strategies were also reported for frail older adults and onchohematological patients. Fluorides in tablets, gels or varnishes forms and the use of xylitol as a sugar substitute were reported as effective approach to prevent the onset of caries in high-risk groups. Minimally intervention treatment options such as the Hall technique, the ART approach and the use of SDF for arresting caries, were deemed suitable and effective strategies for treating existing lesions in-office. In conclusion, in the past decade (2011-2022) an increased number of articles reported strategies to prevent and manage caries among people requiring special care. Although an array of preventive and therapeutic strategies for dental caries exists, more and better-quality clinical evidence is needed to offer guidance to inform policy and practice for special care dentistry.
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Affiliation(s)
- Gustavo Molina
- Division of Restorative Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Special Care Dentistry, The Dental School, Universidad Católica de Córdoba, Córdoba, Argentina
| | - Mariana Zar
- Department of Special Care Dentistry, The Dental School, Universidad Católica de Córdoba, Córdoba, Argentina
| | - Alison Dougall
- Special Care Dentistry, Dublin Dental Hospital, Trinity College, Dublin, Ireland
| | - Colman McGrath
- Applied Oral Sciences and Biomaterials, Faculty of Dentistry, Hong Kong University, Sai Ying Pun, Hong Kong SAR, China
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Mishu MP, Faisal MR, Macnamara A, Sabbah W, Peckham E, Newbronner L, Gilbody S, Gega L. Exploring the contextual factors, behaviour change techniques, barriers and facilitators of interventions to improve oral health in people with severe mental illness: A qualitative study. Front Psychiatry 2022; 13:971328. [PMID: 36304558 PMCID: PMC9592713 DOI: 10.3389/fpsyt.2022.971328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
People with severe mental illness (SMI) have significantly poorer oral health compared to people without SMI and interventions targetted to improve oral health in this population failed to show any long-term improvement. Interventions are influenced by many contextual factors ranging from individual to systems level. This study aimed to understand the contextual factors, behaviour change techniques of the available oral health interventions and explore the barriers to and facilitators for engagement with these interventions from the perspectives of people with SMI (service users) and related service providers. Intervention details were extracted from 12 intervention studies identified from a previous systematic review using the template for intervention description and replication checklist (TIDieR) and behaviour change techniques (BCTs) were coded using the behaviour change technique taxonomy v1. Sixteen individual BCTs were identified and out of which "4.1 instructions on how to perform the behaviour" (n = 9) and "6.1 demonstration of behaviour" (n = 6) were most frequently used BCTs. Video vignettes prepared from the different intervention components identified from existing studies were shown to service users and service providers in dyadic or one-to-one interview format to elicit their views on barriers and facilitators for engagement with the intervention components. Interviews were analysed using Framework analysis and were guided by theoretical domains framework (TDF); and capability, opportunity and motivation (COM-B) model of behaviour change. Main facilitators identified to increase capability, opportunity and motivation of service users were the involvement of carers/care coordinators and integration of dental and mental health care, provision of oral health/hygiene information/products at an appropriate level and provision of tailored support according to individual needs and preferences. Barriers identified were related to lack of communication skills of the service providers, provision of coordinated care, lack of support in visiting a dentist and navigating the payment system and long follow up times. Appropriate training was considered as a facilitator, and staff turnovers and workload were considered as main barriers by the service providers. The findings suggest that comprehensive interventions that target barriers and enhance facilitators from individual to systems level are needed to improve oral health outcomes of people with SMI.
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Affiliation(s)
- Masuma Pervin Mishu
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, United Kingdom.,Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Mehreen Riaz Faisal
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, United Kingdom
| | | | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Emily Peckham
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, United Kingdom
| | - Liz Newbronner
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, United Kingdom
| | - Simon Gilbody
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, United Kingdom.,Hull York Medical School, University of York, Heslington, United Kingdom
| | - Lina Gega
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, United Kingdom.,Hull York Medical School, University of York, Heslington, United Kingdom
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Macnamara A, Mishu MP, Faisal MR, Islam M, Peckham E. Improving oral health in people with severe mental illness (SMI): A systematic review. PLoS One 2021; 16:e0260766. [PMID: 34852003 PMCID: PMC8635332 DOI: 10.1371/journal.pone.0260766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Those with severe mental illness (SMI) are at greater risk of having poor oral health, which can have an impact on daily activities such as eating, socialising and working. There is currently a lack of evidence to suggest which oral health interventions are effective for improving oral health outcomes for people with SMI. AIMS This systematic review aims to examine the effectiveness of oral health interventions in improving oral health outcomes for those with SMI. METHODS The review protocol was registered with PROSPERO (ID CRD42020187663). Medline, EMBASE, PsycINFO, AMED, HMIC, CINAHL, Scopus and the Cochrane Library were searched for studies, along with conference proceedings and grey literature sources. Titles and abstracts were dual screened by two reviewers. Two reviewers also independently performed full text screening, data extraction and risk of bias assessments. Due to heterogeneity between studies, a narrative synthesis was undertaken. RESULTS In total, 1462 abstracts from the database search and three abstracts from grey literature sources were identified. Following screening, 12 studies were included in the review. Five broad categories of intervention were identified: dental education, motivational interviewing, dental checklist, dietary change and incentives. Despite statistically significant changes in plaque indices and oral health behaviours as a result of interventions using dental education, motivational interviewing and incentives, it is unclear if these changes are clinically significant. CONCLUSION Although some positive results in this review demonstrate that dental education shows promise as an intervention for those with SMI, the quality of evidence was graded as very low to moderate quality. Further research is in this area is required to provide more conclusive evidence.
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Affiliation(s)
- Alexandra Macnamara
- The University of York and Hull York Medical School, Castle Hill Hospital, York, United Kingdom
| | | | | | - Mohammed Islam
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Emily Peckham
- Department of Health Sciences, The University of York, York, United Kingdom
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Kuo MW, Yeh SH, Chang HM, Teng PR. Effectiveness of oral health promotion program for persons with severe mental illness: a cluster randomized controlled study. BMC Oral Health 2020; 20:290. [PMID: 33109148 PMCID: PMC7590455 DOI: 10.1186/s12903-020-01280-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/09/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a composite oral health promotion program designed to reduce dental plaque among persons with severe mental illness in a psychiatric institution. METHODS A cluster randomized controlled study was carried out in chronic psychiatric wards of a general hospital in central Taiwan. Sixty-eight eligible male individuals admitted to 2 wards were randomly assigned to an experimental and a control group. Participants in the experimental group underwent an oral health promotion program that consisted of biweekly group education sessions, and a 12-week individual behavioral modification for oral hygiene course. The participants in the control group received usual care only. Dental plaque (measured by the Plaque Control Index) was examined by a single dentist before and after the experiment. Each participant responded to a questionnaire regarding oral health knowledge, attitude and behavior before and after the experiment. RESULTS Fifty-eight individuals completed the study. Before the experiment, the plaque index was similar between the intervention group (68.9; N = 27) and the control group (69.8; N = 31). After the experiment, the plaque index was significantly better in the intervention group than in the control group (42.6 vs. 61.8; P < 0.001). Participants in the intervention group also demonstrated better oral health knowledge, attitude and behavior than those in the control group after the experiment. CONCLUSIONS A composite oral health promotion program using both group education and individual behavioral methods over a 12-week period was effective in both reducing dental plaque and improving the oral health knowledge of persons with severe mental illness in the institution. TRIAL REGISTRATION This study was retrospectively registered in Clinicaltrials.gov, with number NCT04464941, dated 7/7/2020. https://register.clinicaltrials.gov/RD103035018 .
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Affiliation(s)
- Mei-Wen Kuo
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, No. 6, Lugong Rd., Lugang Township, Changhua County, 505, Taiwan, ROC.,Department of Nursing, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan, ROC
| | - Shu-Hui Yeh
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan, ROC
| | - Heng-Ming Chang
- Orthodontic and Dental Department, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan, ROC
| | - Po-Ren Teng
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, No. 6, Lugong Rd., Lugang Township, Changhua County, 505, Taiwan, ROC.
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Effectiveness of Knowledge Translation Strategies in Audiovisual Language Compared With Other Languages to Improve Health Outcomes in Individuals and the General Population: Systematic Review. ACTA ACUST UNITED AC 2019; 48:105-126. [PMID: 30981325 DOI: 10.1016/j.rcp.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/24/2017] [Accepted: 07/10/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Knowledge translation (KT) not only encompasses a series of final actions in areas of dissemination, but also the identification of strategies for the implementation of this process. OBJECTIVE To evaluate the effectiveness of KT strategies in audiovisual language compared with other languages to improve health outcomes in the general population. METHODS We performed a search in MEDLINE, CENTRAL, PsycARTICLES, the WHO International Clinical Trials Registry Platform, EMBASE and LILACS. RESULTS We included 63 studies encompassing a broad range of study populations, languages that were compared to audiovisual language and measurement scales for outcomes. These studies presented a high risk of bias and the quality of evidence was not sufficient to draw conclusions about the effectiveness of the evaluated languages for knowledge translation. CONCLUSIONS We identified different languages that could be used in knowledge translation. The knowledge and the effects produced as a result of the strategy diminish as time progresses, regardless of the type of language used. This is an important point to consider when implementing this type of strategy.
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Winston K, Grendarova P, Rabi D. Video-based patient decision aids: A scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:558-578. [PMID: 29102063 DOI: 10.1016/j.pec.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. METHOD The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. RESULTS 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. CONCLUSION Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. PRACTICE IMPLICATIONS Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids.
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Affiliation(s)
- Karin Winston
- Alberta Children's Hospital, 2800 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Petra Grendarova
- University of Calgary, Division of Radiation Oncology, Calgary, Canada
| | - Doreen Rabi
- University of Calgary, Department of Medicine, Calgary, Canada
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Scrine C, Durey A, Slack-Smith L. Enhancing oral health for better mental health: Exploring the views of mental health professionals. Int J Ment Health Nurs 2018; 27:178-186. [PMID: 28345285 DOI: 10.1111/inm.12307] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2016] [Indexed: 11/26/2022]
Abstract
The association between oral health, self-esteem and quality of life is well established yet there is limited research on the impact of addressing the poor oral health of people living with mental health disorders. Greater consideration is warranted on how enhancing oral health in the course of mental healthcare might reduce the burden of a person's ill health. The role of mental health professionals is important in this regard yet uncertainty persists about the role these providers can and should play in promoting oral health care for people with mental health disorders. This qualitative study explored the issue of oral health and mental health with community based mental health professionals in Perth, Western Australia. It examined their views on the oral health status and experiences of their clients, and the different and alternative ways to improve access to care, knowledge and preventative regimens. Findings indicated participants' ambivalence, reluctance and lack of training in raising oral health issues, despite its acknowledged importance, indicating a siloed approach to care. Findings offer an opportunity to reflect on whether a more integrated approach to oral health care for people with mental health disorders would improve health outcomes.
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Affiliation(s)
- Clair Scrine
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia
| | - Angela Durey
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia
| | - Linda Slack-Smith
- School of Dentistry, University of Western Australia, Perth, Western Australia, Australia
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Slack-Smith L, Hearn L, Scrine C, Durey A. Barriers and enablers for oral health care for people affected by mental health disorders. Aust Dent J 2017; 62:6-13. [PMID: 27164018 DOI: 10.1111/adj.12429] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with mental health disorders are reported to have poorer access to dental services and poorer oral health outcomes. The aim of this paper is to analyze current published work regarding barriers and enablers for oral health outcomes and access to dental care for adults with mental health disorders which will be addressed from individual, organizational and systemic perspectives METHODS: A narrative review based on a search of the relevant published work regarding oral health for people with mental health disorders was undertaken using Medline, Web of Science, ERIC and Psychlit. Any relevant systematic reviews were highlighted in this process along with primary studies. RESULTS The published work repeatedly verified poorer oral health and inadequate access to dental services in people with mental health disorders. The published work identified barriers at individual, organizational and systemic levels. Much of the published work focused on barriers with less focus on enablers and interventions. CONCLUSIONS Considerable investigation of barriers had not elucidated options to improve care or outcomes.
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Affiliation(s)
- L Slack-Smith
- School of Dentistry, University of Western Australia, Perth, Australia
| | - L Hearn
- School of Dentistry, University of Western Australia, Perth, Australia
| | - C Scrine
- School of Dentistry, University of Western Australia, Perth, Australia
| | - A Durey
- School of Dentistry, University of Western Australia, Perth, Australia
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