100 Chapter 4 The longitudinal study of Yoshii et al. [54] focused on outpatients with SMI (psychotic and mood disorders). A pre-/post-programme questionnaire was conducted with demographic characteristics and self-care related to oral hygiene. Additionally, the post-programme questionnaire included items about understanding the educational booklet. The educational programme consisted of five units: cause of tooth loss, dental caries, dental cleaning, periodontal disease and routine dental check-ups. A slide show of 37 slides was presented by a researcher and the handouts were provided. Yoshii et al. [54] used photographic images as much as possible in their educational materials instead of written explanations to make the booklet as impactful as possible. Results showed that the educational programme showed an improvement in the use of fluoride toothpaste, and the daily use of interdental brushes or floss was increased. There were no changes in the frequency of visits to the dentist in the period over 6 months after the intervention. More than 55% of the respondents still went to the dentist when there is a worrying problem or when there are multiple symptoms [54]. Physical Interventions Mori et al. [50] reported on professional mechanical tooth cleaning (PMTC) in outpatients with an autism spectrum disorder, using an oral examination (consisting of photograph, snap impression, dental radiograph, rough scaling) and the caries activity test, debris index, probing depth, and bleeding on probing to measure the effectivity of interventions. Patients were treated in a dental hospital. The effects of self-care did not significantly change throughout the period of PMTC. The mean probing depth was less than 14 weeks after completion of PMTC, although not statistically significant. The mean number of bleeding sites and debris accumulation was significantly decreased [50]. Interventions Combining Behavioural and Educational Elements Four RCTs combined behavioural and educational elements in an intervention for patients with a psychotic disorder (n = 3) [45–47] in patients with a mood disorder (n = 2) [46,47], and in patients with SMI (n = 1) [48]. In one of these RCTs, educa-
RkJQdWJsaXNoZXIy MTk4NDMw