Abstract
BackgroundThe present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs).MethodsThe study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study.ResultsThirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p < 0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs. Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment.ConclusionsDental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.
Highlights
The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs)
Forty-one percent of dentists educated in Norway, 38% of dentists educated abroad and 68% of the dental hygienists had had an undergraduate education in dental management of drug users
The Norwegian government has been strengthening the interprofessional collaboration between health care institutions [18] and reducing social inequalities for vulnerable patient groups in the present study, only 33% of the dentists and 21% of the dental hygienists responded that they were satisfied with the collaboration they had with the RIs
Summary
The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). Drug users represent a group with multiple health challenges, including serious oral health problems, high unmet treatment needs, and reduced oral health-related quality of life [1,2,3,4]. Prevention and treatment of oral diseases among drug users might facilitate their rehabilitation and recovery from substance use disorder, both in terms of elimination of pain and discomfort, and in enhancing their appearance and self-esteem [5,6,7]. Since 2005, adults with substance use disorder that are in rehabilitation institutions under specialist treatment, medication-assisted rehabilitation programs, or under municipal care due to their drug dependence have free of charge necessary dental care in the PDS. Necessary dental care usually consists of examinations, preventive and selective restorative treatments to assure satisfactory chewing function, and being able to communicate and socialize without problems caused by the teeth [9]
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