Outreach service for mental health service users

Abstract

Background: People with mental illness suffer from various oral manifestations, including more caries experience, higher prevalence of deep periodontal pockets, temporomandibular disorders and dry mouth. Dental health care to this group of people has been neglected in Hong Kong. Objectives: The project aimed to impart basic dental knowledge to the mental health service users and to improve their oral health. Methods: A total of 35 mental health service users, aged from 30-72, participated in the project. Participants underwent clinical oral examinations for assessment of their oral health conditions. Self-completed questionnaires were distributed to assess their oral health related quality of life, self-perceived oral conditions and oral health knowledge. Oral health talks and individualised oral hygiene instructions were provided. Mental health service users were reassessed after two weeks. Visible plaque index (VPI) and gingival bleeding index (GBI) were recorded in both visits for comparison of the oral hygiene status. Another set of questionnaire was distributed to assess improvements, if any, in the mental health service users‟ oral health knowledge. Subsequently, 35 of them received treatments. Results: Majority of mental health service users (85%) had not had a dental visit within one year. The baseline visit showed that mental health service users generally had more caries experience and more deep periodontal pockets. Misconceptions were found in mental health service users‟ oral health knowledge (mean score = 24.5 out of 44). Improvements had been shown after baseline visit (mean score = 26.8, p=0.014). Mental health service users showed significant reduction in VPI (from 42.6% to 23.3%, p<0.001) and GBI (from 39.7% to 29.5%, p=0.001) in the second visit. Treatments including 28 scaling, 27 topical fluoride applications and 10 simple restorations with atraumatic restorative technique were performed. Most mental health service users gave positive feedback on the service provided with a mean score of 9 out of 10 in overall satisfaction. Conclusion: People with mental illness have more severe oral diseases and hence a greater treatment need. Their oral health knowledge and oral hygiene status were improved through this outreach service. More dental service and more comprehensive dental education should be delivered to mental health service users.