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Janicijevic N, Dimovic T, Stajic D, Djonovic N, Vasiljevic D, Tepavcevic M, Stepovic M, Delic S, Petrovic M, Jovanovic K, Fetahovic E, Manojlovic K, Petrovic I, Filipovic M, Sekulic M. Correlation between the Oral and Mental Health of University Students in Serbia-A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1431. [PMID: 39057574 PMCID: PMC11276084 DOI: 10.3390/healthcare12141431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/01/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND This cross-sectional study aimed to assess the correlation between subjective oral health status and mental health in a group of university students in Serbia. METHODS The study included 948 students, aged between 18 and 27, from the Faculty of Medical Sciences, University of Kragujevac, Serbia, and was conducted in 2020. The World Health Organization's Oral Health Questionnaire for Adults was utilized to evaluate the respondents' self-perceived oral health and oral hygiene practices. The existence of depressive symptoms was evaluated using the Beck Depression Inventory-II (BDI-II), and the Zung self-rating anxiety scale (SAS) was used for determining anxiety symptoms. RESULTS It is observed that 28.9% of respondents exhibit symptoms of depression and 42.3% showed symptoms of anxiety. Results show that students with severe depression and anxiety symptoms very often reported lower self-perceived oral health and oral health problems. Although the nature of this relationship has not been thoroughly evaluated, several studies have shown a mutually dependent connection between oral health and mental health. CONCLUSIONS The results suggest that some aspects of oral health are associated with higher risks of developing symptoms of depression or anxiety, and vice versa.
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Affiliation(s)
- Nikoleta Janicijevic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (N.J.); (D.S.); (N.D.); (D.V.); (M.S.)
| | - Tamara Dimovic
- Doctoral Academic Studies—Medical Sciences, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Dalibor Stajic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (N.J.); (D.S.); (N.D.); (D.V.); (M.S.)
| | - Nela Djonovic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (N.J.); (D.S.); (N.D.); (D.V.); (M.S.)
| | - Dragan Vasiljevic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (N.J.); (D.S.); (N.D.); (D.V.); (M.S.)
| | - Melanija Tepavcevic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.T.); (M.S.); (S.D.); (K.J.)
| | - Milos Stepovic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.T.); (M.S.); (S.D.); (K.J.)
| | - Simonida Delic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.T.); (M.S.); (S.D.); (K.J.)
| | - Marko Petrovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Kristijan Jovanovic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.T.); (M.S.); (S.D.); (K.J.)
| | - Ermin Fetahovic
- Department of Communication Skills with Information Technologies, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Katarina Manojlovic
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Ivica Petrovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Milos Filipovic
- Doctoral Academic Studies—Medical Sciences, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Marija Sekulic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (N.J.); (D.S.); (N.D.); (D.V.); (M.S.)
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Bafageeh F, Loux T. Depression Symptoms Linked to Multiple Oral Health Outcomes in US Adults. JDR Clin Trans Res 2024:23800844241246225. [PMID: 38733119 DOI: 10.1177/23800844241246225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Individuals with mental illness have poor oral health compared to those without mental health conditions. However, the literature is still lacking regarding the specifics of this relationship. OBJECTIVE This study aims at examining the relationship between depression and oral health problems such as oral conditions, access to dental care, and oral hygiene measures. METHODS A cross-sectional study using a secondary data analysis of 9,693 participants from the 2017 to March 2020 prepandemic National Health and Nutrition Examination Survey (NHANES). The independent variable was severity of depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9). Proportional odds and binary logistic regression were used to calculate crude and adjusted odds ratios (AORs) between depression and 8 oral health outcomes and oral hygiene-related behaviors. RESULTS After adjusting for sociodemographics, health conditions, and behaviors, individuals with depression were significantly more likely to have dental aches in the past year (AOR = 1.70; 95% confidence interval [CI], 1.13-2.56), difficulty getting dental care when needed (AOR = 1.93; 95% CI, 1.45-2.58), and difficulty at their jobs due to a problem in their mouth (AOR = 1.63; 95% CI, 1.07-2.49) compared to individuals without depression. CONCLUSION Individuals with depressive symptoms often neglect oral hygiene and self-care practices and are less likely to seek medical care for oral health problems, making them at increased risk of poor oral health outcomes. These findings can be applied by dentists, psychologists, and therapists to increase awareness of links between depression and oral health and to encourage patients with depression to seek oral hygiene preventative care. KNOWLEDGE TRANSFER STATEMENT Health care professionals can be on the frontline in creating awareness in the general public about the links between depression and oral health and hygiene. Applying the findings from this study can help communicate about the relationship between depression and poor oral health and relieve some burden on the American health care sector, which often struggles to provide medical care to patients with depression and oral health issues.
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Affiliation(s)
- F Bafageeh
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA
| | - T Loux
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA
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Isailă OM, Drima E, Hostiuc S. An Ethical Analysis Regarding the COVID-19 Pandemic Impact on Oral Healthcare in Patients with Mental Disorders. Healthcare (Basel) 2023; 11:2585. [PMID: 37761783 PMCID: PMC10530757 DOI: 10.3390/healthcare11182585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
During the COVID-19 pandemic, restrictive measures were imposed that significantly impacted the healthcare system in general, and the dental healthcare system in particular. The literature cites a possible association between mental and oral health, as psychiatric patients have decreased awareness of their oral health and, therefore, poor dental status. Moreover, several studies have found a positive association between SARS-CoV-2 infection and oral health conditions, as well as between SARS-CoV-2 infection and mental health status. This context generated multiple ethical dilemmas in the case of persons with mental health disorders who require dental treatment because they are more vulnerable in this respect. This article aims to analyze the ethical issues in dental care for patients with mental disorders concerning the COVID-19 restrictive measures. The ethical aspects involved here are the basic principles of bioethics and the related elements of accessibility, equity, consent, and confidentiality.
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Affiliation(s)
- Oana-Maria Isailă
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Eduard Drima
- Medical Clinical Department, Dunărea de Jos University, 800201 Galați, Romania
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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Patterson-Norrie T, Ramjan L, Sousa MS, George A. Oral health and individuals with a lived experience of an eating disorder: a qualitative study. J Eat Disord 2023; 11:121. [PMID: 37461052 DOI: 10.1186/s40337-023-00841-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Limited evidence exists describing the impact to oral health when living with an eating disorder and the availability of information or access to oral health services. This study investigated the perceptions of individuals with a lived experience of an eating disorder specifically to understand their needs and recommendations for improving access to early intervention and oral health promotion. METHODS Using purposive sampling a total of 12 semi-structured interviews were conducted with participants across Australia who had a lived experience of an eating disorder. A hybrid inductive and deductive approach to thematic analysis was used to construct salient themes and subthemes. RESULTS Most participants had experienced some oral health manifestation as part of their eating disorder hence, many felt quite knowledgeable on the topic. Following their eating disorder many participants felt confident in engaging with dental services, although, barriers including embarrassment, shame, and cost compromised access at times. Participants felt strongly that greater emphasis on oral health promotion during an eating disorder was important and this may be achieved by increasing the availability of resources and using trusted non-dental health professionals like dietitians. CONCLUSIONS The need for oral health promotion while experiencing an eating disorder was evident, however, dentists can often be a costly option. Non-dental health professionals like dietitians working with clients with an eating disorder may be an acceptable alternative for closing this gap.
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Affiliation(s)
- Tiffany Patterson-Norrie
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, 2751, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Lucie Ramjan
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, 2751, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Translational Health Research Institute, Campbelltown, NSW, 2560, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Mariana S Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, 2751, 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 (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, 2751, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia
- Translational Health Research Institute, Campbelltown, NSW, 2560, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
- South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Jiang X, Liu G, Xu J, Li H, Wang J, Pang M, Li S, Xu L, Guo X, Kong F. The relationship between oral health status, loneliness, and sleep quality among the migrant elderly following children in Weifang, Shandong Province, China: A comparative analysis on different migration types. Front Public Health 2023; 10:1053690. [PMID: 36845346 PMCID: PMC9945269 DOI: 10.3389/fpubh.2022.1053690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/30/2022] [Indexed: 02/10/2023] Open
Abstract
Background The migrant elderly following children (MEFC) are a vulnerable group that emerged during fast urbanization in China. The MEFC faced physical and psychological discomfort upon their arrival in the inflow city, particularly those who came from rural areas. Objective This study aimed to explore the relationship between oral health status, loneliness, and sleep quality among the MEFC in China and to clarify the disparities in the above mentioned relationship by migration type. Methods In 2021, a cross-sectional survey was conducted in Weifang, Shandong Province, using multistage cluster random sampling to collect data from the MEFC aged 60 years and over. In total, 613 respondents [525 rural-to-urban (RTU) and 88 urban-to-urban (UTU)] were included in the final database. The chi-square test, t-test, and structural equation modeling (SEM) were used to investigate the relationship between oral health status, loneliness, and sleep quality among the RTU and UTU MEFC. Results Total scores [mean ± standard deviation (SD)] for oral health status, loneliness, and sleep quality were 54.95 ± 6.47, 8.58 ± 3.03, and 4.47 ± 3.60, respectively. SEM revealed that, among the RTU and UTU MEFC, oral health status was positively and significantly related to sleep quality; however, the correlation was slightly stronger in the UTU MEFC. In both groups, there was a significant negative correlation between oral health status and loneliness, which was stronger in the UTU MEFC. In the RTU MEFC, a significant negative correlation between loneliness and sleep quality was observed, and in the UTU MEFC, no significant association between loneliness and sleep quality was observed. Conclusion The sleep quality among the MEFC in this study was higher compared to previous studies. Oral health status was negatively correlated with loneliness and positively associated with sleep quality, whereas loneliness was negatively correlated with sleep quality. These three associations differed significantly between the UTU and RTU MEFC. The government, society, and families should take measures to improve oral health and reduce loneliness among the MEFC to improve their sleep quality.
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Affiliation(s)
- Xiaoxu Jiang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Guangwen Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Hexian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Brigg N, Patterson S, Pradhan A. Enabling people with severe mental illness to overcome barriers to access dental treatment: a qualitative study applying COM-B framework analysis. J Ment Health 2022; 31:765-773. [PMID: 32780601 DOI: 10.1080/09638237.2020.1803230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The oral health of people with severe mental illness is severely compromised. Rates of premature total tooth loss and tooth decay are substantially higher than in the general population. Causation is complex, restricted access to treatment a major contributing factor. AIMS To examine factors enabling people with complex problems related to severe mental illness to attend scheduled dental appointments. METHOD Qualitative semi-structured interviews were conducted with 15 service users who attended no-cost treatment at a university clinic, following oral health screening at an inner-city community mental health service. Analysis used a framework approach informed by a theoretical model of behaviour (COM-B). RESULTS Complex individual motivations, related variously to function, pain and/or self or social appraisal, were also influenced by expectations of treatment. Capabilities included managing "messy" life circumstances; participants overcame various psychological and physical challenges to attend treatment, enabled by opportunities of social and instrumental support. CONCLUSIONS Genuine partnerships between agencies to provide access opportunities, in addition to individual support responsive to personal motivators and adapted to capabilities can enable access to services and improve the lives of people with severe mental illness.
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Affiliation(s)
- Nicole Brigg
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sue Patterson
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia.,School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Archana Pradhan
- School of Dentistry, The University of Queensland, Brisbane, Australia.,Metro North Oral Health Service, Brisbane, Australia
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Tiwari T, Kelly A, Randall CL, Tranby E, Franstve-Hawley J. Association Between Mental Health and Oral Health Status and Care Utilization. FRONTIERS IN ORAL HEALTH 2022; 2:732882. [PMID: 35199101 PMCID: PMC8859414 DOI: 10.3389/froh.2021.732882] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Studies have shown that mental health and oral health may be correlated, with associations demonstrated between mental health problems and tooth loss, periodontal disease, and tooth decay. The COVID-19 pandemic had alarming implications for individuals' and communities' mental and emotional health. This study examined the associations between mental health status, oral health status, and oral healthcare utilization and highlighted the impact of COVID-19 on mental health. Additionally, this study examines specific sociodemographic factors that may amplify oral health disparities. A nationally representative survey was conducted to capture attitudes, experiences, and behaviors related to oral health, mental health, and unmet oral health needs. Eighteen percent of respondents were categorized as having poor mental health. Visiting the dentist in the last year was more common amongst individuals with good mental health. From the logistic regression model, mental health status, age group, race/ethnicity, education, and last dental visit were all significantly associated with of oral health status. Mental health status, age group, and income groups were all significantly associated with unmet oral health need. Future work should focus on the mental-oral health association, including determining ways to improve oral healthcare utilization and oral health status among people with poorer mental health.
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Affiliation(s)
- Tamanna Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Abigail Kelly
- CareQuest Institute for Oral Health, Boston, MA, United States
| | - Cameron L. Randall
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, WA, United States
| | - Eric Tranby
- CareQuest Institute for Oral Health, Boston, MA, United States
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Poirier BF, Hedges J, Smithers LG, Moskos M, Jamieson LM. Aspirations and Worries: The Role of Parental Intrinsic Motivation in Establishing Oral Health Practices for Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111695. [PMID: 34770211 PMCID: PMC8582669 DOI: 10.3390/ijerph182111695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 11/26/2022]
Abstract
Aboriginal and Torres Strait Islander (respectfully, subsequently referred to as Indigenous) children in Australia experience oral disease at a higher rate than non-Indigenous children. A history of colonisation, government-enforced assimilation, racism, and cultural annihilation has had profound impacts on Indigenous health, reflected in oral health inequities sustained by Indigenous communities. Motivational interviewing was one of four components utilised in this project, which aimed to identify factors related to the increased occurrence of early childhood caries in Indigenous children. This qualitative analysis represents motivational interviews with 226 participants and explores parents’ motivations for establishing oral health and nutrition practices for their children. Findings suggest that parental aspirations and worries underscored motivations to establish oral health and nutrition behaviours for children in this project. Within aspirations, parents desired for children to ‘keep their teeth’ and avoid false teeth, have a positive appearance, and preserve self-esteem. Parental worries related to child pain, negative appearance, sugar consumption, poor community oral health and rotten teeth. A discussion of findings results in the following recommendations: (1) consideration of the whole self, including mental health, in future oral health programming and research; (2) implementation of community-wide oral health programming, beyond parent-child dyads; and (3) prioritisation of community knowledge and traditions in oral health programming.
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Affiliation(s)
- Brianna F. Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
- Correspondence: ; Tel.: +61-8-8313-5208
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
| | - Lisa G. Smithers
- School of Public Health and the Robinson Research Institute, University of Adelaide, Adelaide 5000, Australia;
- School of Health and Society, University of Wollongong, Wollongong 2522, Australia
| | - Megan Moskos
- Future of Employment and Skills Research Centre, School of Economic and Public Policy, Faculty of the Professions, University of Adelaide, Adelaide 5000, Australia;
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
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McGrath R, Marino R, Satur J. Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey. BMC Oral Health 2021; 21:85. [PMID: 33632192 PMCID: PMC7908706 DOI: 10.1186/s12903-021-01438-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI). METHODS An anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants' self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher's exact and Mann-Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers. RESULTS A total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed ('Agreed' or 'Strongly agreed') that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, 'lack of consumer interest' was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25-9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629-10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77-8.65, p = 0.001). CONCLUSION The results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.
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Affiliation(s)
- Roisin McGrath
- The Melbourne Dental School, The University of Melbourne, Melbourne, VIC, 3053, Australia.
| | - Rodrigo Marino
- The Melbourne Dental School, The University of Melbourne, Melbourne, VIC, 3053, Australia
| | - Julie Satur
- The Melbourne Dental School, The University of Melbourne, Melbourne, VIC, 3053, Australia
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Wright WG, Averett PE, Benjamin J, Nowlin JP, Lee JGL, Anand V. Barriers to and Facilitators of Oral Health Among Persons Living With Mental Illness: A Qualitative Study. Psychiatr Serv 2021; 72:156-162. [PMID: 33234051 DOI: 10.1176/appi.ps.201900535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Persons with mental illness have poorer oral health and are less likely to receive oral health care than those in the general population. A comprehensive understanding of barriers to and facilitators of accessing oral health care from a multidisciplinary perspective is lacking. The authors of this qualitative study sought to explore barriers and facilitators in addressing the oral health needs of individuals with mental illness from the perspectives of patients, psychiatrists, and dentists. METHODS A thematic content analysis approach was used to triangulate the perspectives of the three groups. Face-to-face semistructured interviews were conducted in 2018-2019 with patients with mental illness (N=20), psychiatrists (N=20), and dentists (N=25) at an academic medical campus in rural eastern North Carolina. Participants were recruited until thematic saturation for each group was reached. RESULTS Reported barriers to oral health care were categorized under emerging themes: access to dental care, fear of dental care, characteristics of mental illness, lack of oral health screening by psychiatrists, lack of education and training, stigma of mental illness, and lack of communication. Facilitators of oral health care were linked to the reported need for education and training, financial support, dentists' chairside manner, community support, and interprofessional communication. CONCLUSIONS The findings highlight health system gaps between oral health and mental health. The barriers and facilitators identified can help inform the development of interventions to improve oral health of patients with mental illness. Interventions should include interdisciplinary education and training, improved communication, and strategies to reduce financial barriers and anxiety in dental practice.
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Affiliation(s)
- Wanda G Wright
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Paige E Averett
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Janet Benjamin
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Jonathan P Nowlin
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Joseph G L Lee
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
| | - Vivek Anand
- Department of Foundational Sciences and Division of Dental Public Health, School of Dental Medicine, East Carolina University (ECU), Greenville, North Carolina (Wright, Nowlin); School of Social Work (Averett) and Department of Health Education and Promotion (Lee), College of Health and Human Performance, ECU, Greenville; Department of Psychiatry and Behavioral Medicine (Benjamin, Anand) and Center for Health Disparities (Lee), Brody School of Medicine, ECU, Greenville
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11
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Couatarmanach A, Sherlaw W, Prigent PM, Harpet C, Bertaud V. Dentists' perspectives on barriers to providing oral health care in French psychiatric hospitals with on-site dental clinics. Community Dent Oral Epidemiol 2020; 48:296-301. [PMID: 32212269 DOI: 10.1111/cdoe.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Psychiatric inpatients suffer from poorer oral health than the general population, and difficulties in accessing necessary dental treatment remain even when a dedicated dental service is available within the psychiatric hospital. The aim of this study was to identify barriers to access dental care from the point of view of dentists working within French psychiatric hospitals. METHODS The relatively small number of dentists working in psychiatric hospitals necessitated a qualitative approach. Semi-structured interviews were conducted, recorded, transcribed and coded in a conventional content analysis approach. RESULTS Eight interviews were conducted. Six of the dentists interviewed were men, and two were women. Three of them worked full-time in a psychiatric facility, while the other five worked partly in the hospital and partly in private practice. The average duration for interviews was 54 minutes (minimum 24 min, maximum 89 min). The interviews highlighted three dimensions of barriers to access to dental care. The first dimension was directly related to the patient. This may be linked to the patient's psychiatric disorder but not necessarily. This also encompasses refusal of care. A second dimension regrouped events related to the organization of the hospital (locally), such as communication issues between staff members within the dental office, and with other staff members from the psychiatric ward. A third dimension included difficulties related to the overall organization of the healthcare system, including financial issues and deinstitutionalization. CONCLUSIONS In-site dental consultations appear as an interesting tool to enhance access to oral care for psychiatric inpatients. However, difficulties remain from the dentists' perspective.
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Affiliation(s)
| | - William Sherlaw
- Ecole des Hautes Etudes en Santé Publique (EHESP), UMR 6051, Rennes, France
| | | | - Cyrille Harpet
- Ecole des Hautes Etudes en Santé Publique (EHESP), UMR 6051, Rennes, France
| | - Valérie Bertaud
- Faculty of Dentistry, University of Rennes, LTSI, CHU Rennes, Rennes, France
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12
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Lam PC, John DA, Galfalvy H, Kunzel C, Lewis-Fernández R. Oral Health-Related Quality of Life Among Publicly Insured Mental Health Service Outpatients With Serious Mental Illness. Psychiatr Serv 2019; 70:1101-1109. [PMID: 31522632 DOI: 10.1176/appi.ps.201900111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study investigated factors associated with unmet need for dental care and oral health-related quality of life (OHQoL) among individuals with serious mental illness receiving outpatient care in a public mental health program serving a largely low-income population, mostly from racial-ethnic minority groups. METHODS Cross-sectional interview data were collected from a convenience sample (N=150) of outpatients. Adjusted risk ratios (ARRs) and adjusted risk differences (ARDs) were estimated by logistic regression models to examine the independent contribution of sociodemographic and clinical factors to low OHQoL and past-year unmet dental need, defined as inability to obtain all needed dental care. RESULTS More than half of participants reported low OHQoL (54%) and a past-year dental visit (61%). Over one-third (39%) had past-year unmet dental need. Financial barriers (ARR=3.16) and nonfinancial barriers (ARR=2.18) were associated with greater risk for past-year unmet dental need after control for age, gender, high dental anxiety, and limited English proficiency. ARDs for financial and nonfinancial barriers indicated absolute differences of 40 and 27 percentage points, respectively. Unmet dental need (ARR=1.31), xerostomia severity (ARR=1.20), and a schizophrenia spectrum diagnosis (ARR=1.33) were associated with low OHQoL, after control for age and current smoking, with ARDs ranging from 11 to 15 percentage points. CONCLUSIONS Improving oral health promotion, oral health service access, and the integration of the mental and oral health systems may help reduce the high prevalence of low OHQoL in this population, given that low OHQoL is partly driven by unmet dental need.
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Affiliation(s)
- Peter C Lam
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Dolly A John
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Hanga Galfalvy
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Carol Kunzel
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
| | - Roberto Lewis-Fernández
- New York State Center of Excellence for Cultural Competence (Lam, John, Lewis-Fernández) and Anxiety Disorders Clinic and Hispanic Treatment Program (Lewis-Fernández), New York State Psychiatric Institute, New York; Department of Psychiatry, Vegelos College of Physicians and Surgeons (Galfalvy, Lewis-Fernández), Department of Biostatistics (Galfalvy) and Department of Sociomedical Sciences (Kunzel), Mailman School of Public Health, and Division of Foundational Sciences, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine (Kunzel), all at Columbia University, New York
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