Making equity a reality: oral health promotion in a psychiatric setting

The aim of the study addresses the inequity in oral health status of long stay psychiatric patients, by promoting an inter-disciplinary team approach to oral health promotion. A cross sectional study using a modified version of the oral health assessment guide (OHAG) (Eilers et al 1988, Sjorgen & Nordstrom 2000) was used by a nurse who received training and calibration at the School of Dentistry, Queen's University, Belfast, to assess the oral health status of long stay psychiatric patients. The paper provides an overview of the literature relating to oral health within the context of holistic health. It highlights the non-random distribution of oral health problems amongst psychiatric patients and the potential contribution of health needs assessment to the realization of equity. The study focused on 65 long stay patients in a psychiatric hospital, mean length of time patients had been in the hospital was 25.6 years; nine patients had been living in the hospital between 40 and 65 years. The study achieved a response rate of 82% and identified that oral health of the psychiatric patients was generally very poor, compared to the general population. Only one patient did not have calculus, decayed or fractured teeth and 12 of the patients were endentate and there was a conspicuous absence of health promoting behaviours amongst the patient group. A case study is used to highlight the lived reality of the patients and the need for a holistic and an inter-disciplinary approach to oral health promotion, for patients residing in a psychiatric setting. This preliminary investigation highlights the benefits of systematic assessment of need: in this instance the use of the OHAG as a tool, for promoting equity based care by making visible the non random distribution of oral health problems amongst the patients.