What factors influence use of dental health services by substance users?

Abstract

Introduction

Several studies show that despite poor oral health substance users fail to access dental care. This was confirmed locally by audit in 2005; 63% (n = 82) were not registered with a dentist and 72% had dental problems, of whom 83% were not receiving treatment.

Objectives

To examine issues affecting substance users use of dental services.

Aims

To identify factors influencing whether substance users visit the dentist, in particular whether having a ‘regular’ dentist is important. Secondly, to compare this with perceptions of dental care staff.

Methods

A cross sectional survey was conducted across Norfolk & Waveney Mental Health Trust's Alcohol and Drugs Service and Norwich dental practices. 87 substance users participated, half of Norwich dentists (n = 67) and 66 reception staff from Norwich dental practices.

Results

Participants reported high levels of dental problems, most commonly toothache (71%). Those having a dentist they normally saw were more likely to have visited the dentist in the previous year (X² = 14.06, p < 0.01). The most common reasons for not receiving treatment were difficulty finding a dentist, difficulty keeping appointments and few available appointments. Dental staff acknowledged similar dental problems, but were more likely to think lack of motivation caused non-attendance. Drug use, substitute prescribing or duration in treatment did not influence frequency of dental visits. Dentists hi-lighted remuneration issues for providing services to substance users.

Conclusions

Having a ‘regular’ dentist could improve use of dental services. Examining capacity and revisiting payments for this group under the new dental contract could improve treatment rates.