Plain English Summary
Background and study aims
Oral health is an important factor in the quality of life and overall health and well-being. People with mental health disorders are reported to have poorer oral health and poorer access to dental health services as compared to the general population. That is, there are barriers to oral health in adults with mental disorders. Little is known about why this patient group misses necessary dental treatment.
This study explores different aspects of oral health and dental health services use among persons with severe or long term mental illness.
We wanted to explore the experiences and views of patients with SMI regarding oral health care services and particularly to explore perceived barriers to obtaining optimal dental health care. Further, we wanted to identify possible facilitators to provide true access to dental health services for this population. The ultimate goal of our study was to develop and improve adequate oral health services for persons with SMI.
Who can participate?
Adults over 18 years who receive support from the Community Mental Health Services in a Norwegian municipality and live at home.
What does the study involve?
Participants were recruited by the Community mental health services. At the onset of the research project, all service users receiving individual support from the Community mental health team were informed and asked to participate by their individually assigned contact person in the team. Participation was based on informed and written consent. Participation in the study involved an intake interview by a clinical psychologist, and a dental examination by a dentist. When treatment needs were identified in the oral examination, dental treatment was offered and performed to all patients. As far as possible, dental treatment was arranged and carried out according to the patient’s own preferences.
What are the possible benefits and risks of participating?
Benefits: The participants were offered free oral examination and dental treatment from a highly competent dentist and were invited to bring about their own experiences of barriers and facilitators for dental care.
Risks: Telling your story about oral and mental health might be challenging for some and there could possibly be a risk for symptom increase. At the same time, a conversation like this can also be experienced as supportive. Interviewers and support persons has to take responsibility and be aware of this possible dilemma, and follow up participants when needed. The participants had ongoing contact with the Community mental health services during data collection.
Where is the study run from?
Stord Community Mental Health Centre (Norway)
When is the study starting and how long is it expected to run for?
October 2015 to December 2021
Who is funding the study?
1. Oral Health Centre of Expertise in Western Norway
2. Directorate of Health in Norway
Who is the main contact?
Jofrid Bjørkvik, jofrid.bjorkvik@gmail.com
Trial website
Contact information
Type
Scientific
Primary contact
Mrs Jofrid Bjørkvik
ORCID ID
http://orcid.org/0000-0002-0270-3856
Contact details
Pb 2354
Møllendal
Bergen
5867
Norway
+47 41201631
jofrid.bjorkvik@vlfk.no
Additional identifiers
EudraCT number
Nil known
ClinicalTrials.gov number
Nil known
Protocol/serial number
2015/1724-1
Study information
Scientific title
Oral health and dental treatment for persons with severe or long term mental illness
Acronym
Study hypothesis
The main goal of this study was to develop and improve adequate oral health services for persons with severe or long term mental illness (SMI). This study has three sub-objectives:
1. To study dental status and oral health for people affected by severe or long term mental health disorders
2. To explore perceived barriers to obtain optimal dental health care for patients with severe or long term mental illness, and to identify possible facilitators to provide true access to dental services for this population
3. To explore possibilities and obstacles to cooperation between dental health services and other health services that are relevant for this patient group
Ethics approval
Approved 22/10/2015, Regional Ethics Committee for Medical and Health Research in Western Norway (REK vest: Rogaland, Vestland, Norway; +47 55 97 50 00; rek-vest@uib.no), ref: 2015/1724-1
Study design
Longitudinal mixed-methods
Primary study design
Observational
Secondary study design
Longitudinal study
Trial setting
Other
Trial type
Quality of life
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
Condition
In need of long term psychosocial support
Intervention
Participants were recruited by the Community mental health services. At the onset of the research project, all service users receiving individual support from the Community mental health team were informed and asked to participate by their individually assigned contact person in the team (all psychiatric nurses). Participants have different psychiatric conditions, but are in need of long term psychosocial support.
Participation in the study involved an intake interview by the first author (JB, clinical psychologist PhD), a dental examination by the second author (DH, dentist), and a number of questionnaires comprising issues relevant for oral health. When treatment needs were identified in the oral examination, dental treatment was offered and performed to all patients. As far as possible, dental treatment was arranged and carried out according to the patient’s own preferences. There was a follow-up interview after completion of dental treatment in order to validate the content of the first interview and to provide the participants with an opportunity to add new information.
Intervention type
Mixed
Phase
Drug names
Primary outcome measure
At baseline and follow up (after treatment end):
1. Dental anxiety measured using Modified Dental Anxiety Scale (MDA) and Index of Dental Anxiety and Fear (IDAF)
2. Oral quality of life measured using Oral Impact on Daily Performance (OIDP) questionnaire
3. Dry Mouth measured using the Xerostomy inventory
4. Dental hygiene measured using scale with four categories of never or rarely twice a day to questions about how often they brush their teeth, use dental floss or toothpicks, use mouthwash or fluoride
5. Smoking status (yes/no)
6. Mental health disorder measured using the Mini International Neuropsychiatric Interview) (M.I.N.I) Norwegian Translation Version 6.0.0
7. Oral status measured using dental survey conducted by dentist (DMFT index, Oral hygiene index, Periodontal Index, Sialometri)
Secondary outcome measures
Barriers and facilitators for oral health and access to dental services for people with SMI measured using semi-structured interview at baseline and follow up (after treatment end)
Overall trial start date
01/10/2015
Overall trial end date
31/12/2021
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Receive support from the Community Mental Health Services in a Norwegian municipality
2. 18 years old or more
3. Psychiatric health challenges and are in need of psychosocial support
4. Live in their own homes
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
All service-users receiving support from the Community Me All service users (N=82) receiving individual support from the Community mental health team were informed and asked to participate. This was done in order to secure rich and diverse data from participants in the target group on the research question.
Total final enrolment
52
Participant exclusion criteria
Not understanding Norwegian or English language
Recruitment start date
01/12/2017
Recruitment end date
01/03/2019
Locations
Countries of recruitment
Norway
Trial participating centre
Community dental clinic
Stord
Stord
5401
Norway
Trial participating centre
Community Mental Health Centre
Stord
Stord
5401
Norway
Trial participating centre
Oral Health Centre of Expertise in Western Norway
Pb 2354 Møllendal
Bergen
5867
Norway
Sponsor information
Organisation
Oral Health Centre of Expertise in Western Norway
Sponsor details
Pb 2354
Møllendal
Bergen
5867
Norway
+47 55337600
ellen.berggren@vlfk.no
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Hospital/treatment centre
Funder name
Oral Health Centre of Expertise in Western Norway
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
Directorate of Health in Norway
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Barriers and facilitators for dental treatment for people with severe mental illness (qualitative study, intended to be published in 2020 or 2021.
Oral health and dental treatment in persons with severe mental illness in Norway, as compared to general public norms.
IPD sharing statement:
The current data sharing plans for this study are unknown and will be available at a later date
Intention to publish date
31/12/2022
Participant level data
To be made available at a later date
Basic results (scientific)
Publication list