105 Oral Health Interventions in Patients with a Mental Health Disorder intervention cannot be advised yet, although the methodological quality of studies seems sufficient. Research in patients with a severe mental illness (SMI) demonstrated that 58% of the patients had low oral health-related quality of life (OHRQoL) [55]. This supports the importance of oral health interventions in patients diagnosed with a mental health disorder. Reflection on Types of Interventions Firstly, it is remarkable that none of the studies in our scoping review focused on preventive care. Secondly, knowledge on oral health in patients and nurses is quite well-studied, however research into behavioural change in patients as outcome, as well as in mental health professionals, is also desirable. Knowledge and awareness are a first step; however, behaviour change in on oral health is a complex process that requires another approach. Reminder strategies combined with oral health education showed to have a significant effect on behaviour of patients with a mental health disorder (schizophrenia, depression, bipolar disorder) [46]. Reminder systems, such as post-it, are easy to implement. Alqahtani et al. [56] show that reminder strategies enable a system to remind the user to perform the target behaviour. Reminders are often implemented to remind users to perform activity in mental health disorders [56]. There are no studies examining the effects of reminder strategies focusing on oral health in mental health apps. Therefore, further research on reminder strategies improving oral health is needed. Overall, educational interventions significantly improve knowledge of mental health professionals on general health and the importance of oral healthcare. The combination of educational interventions and behavioural interventions are only studied in patients with psychotic and bipolar disorder. These studies demonstrate that the combination of these elements is effective on oral hygiene (as measured with the plaque index) and oral health knowledge (Almomani et al., 2006; 2009). Oral health interventions using physical elements were only studied in patients with autism spectrum disorders [50]. These patients benefitted by a decrease of bleeding sites; however, 14 weeks after this intervention, there was no longer a post-treatment effect. This is in line with the study of Kay and Locker [57], who dis4
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