People with long standing serious mental illnesses often have poor dental hygiene. With the erosion of teeth comes erosion of quality of life.
Dental & Physical Health
Study aims
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To undertake a cluster-randomised controlled trial in Nottinghamshire, Derbyshire and Lincolnshire to improve the oral health of Early Intervention in Psychosis service users.
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To examine the impact of poor oral health, using an established Quality of Life instrument.
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To disseminate findings in a way that is likely to support best practice.
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To understand factors that facilitate or inhibit the implementation of research findings.
Why is the project necessary?
People with long standing serious mental illnesses often have poor dental hygiene. With the erosion of teeth comes erosion of quality of life.
Findings so far
We have undertaken three Cochrane reviews to investigate the effects of monitoring and giving of advice. There are no trials of health care monitoring despite NICE recommendations to do this as a public health measure (DOH 2005). Trials of general advice do exist but trials are small and uninformative. We found a single directly relevant randomised control trial, allocating fewer than 60 people to receive oral health motivational interviewing from a psychologist in addition to an education package versus the use of the education package alone (Almomani et al 2009).
Inclusion criteria specified that participants should be people with serious mental illness who did not use electric toothbrushes (the study was sponsored by a firm who made electric toothbrushes.) Findings suggested there was some benefit for motivational interviewing. This procedure involved considerable changes from routine care which would be impossible to implement in everyday practice. Outcomes were measured on scales (e.g. Modified Quigley-Hein Plaque Index) the clinical meaning of which was not clearly explained, even within the trial itself of advice.