Feasibility Study of a Behavioral Oral Health Intervention for People With Mental Health Challenges: A...

People with mental health disorders experience disproportionately poor oral health and face persistent barriers to maintaining oral hygiene. This study aimed to assess the feasibility of supporting oral hygiene routines in community-dwelling adults using a self-regulation-based education approach informed by Self-Determination Theory, to identify practical strategies for integrated mental and oral health care.

Thirty-nine participants from two community mental health centers received single-session oral health education at baseline (T1). Oral health status was assessed using the Oral Health Assessment Tool and the Silness and Loe Plaque Index. Oral health knowledge and motivation were measured at T1, 4 weeks (T2) and 8 weeks (T3) using a knowledge questionnaire, the Treatment Self-Regulation Questionnaire, the Perceived Competence Scale and the Relative Autonomy Index (RAI). At T2 and T3, participants received plaque feedback, reinforcement of the key message and motivational support.

Most participants were aged 50 years or older. At baseline, over half of the participants demonstrated poor oral cleanliness, and fewer than one-third had healthy natural teeth. Plaque scores improved significantly from T1 to T2 (mean reduction 21%, p < 0.001), but plateaued by T3. Oral health knowledge improved across all domains, particularly in understanding oral-systemic links and recognizing oral disease risk factors. Autonomous motivation was modest at T1 (RAI = + 0.15), declined at T2 (RAI = -0.93), and partially recovered at T3 (RAI = -0.57), indicating variability in motivational regulation over time.

Single-session oral health education was associated with short-term improvements in knowledge and plaque control; however, sustaining behavior change and motivation likely requires ongoing reinforcement, support and repeated engagement. Visual feedback, structured routines and collaboration between mental health and oral health services may facilitate the integration of oral care into routine community mental health practice.