17 General introduction eating and drinking sugary food/drinks) and the ability to sustain self-care and dental attendance; socio-economic factors (e.g., low income, low education); and the oral side effects of medication [35,37,38]. These risk factors significantly impact oral health, as well as quality of life. In particular, given that patients with psychotic disorders possess numerous risk factors, it is imperative that nurses allocate attention to this matter. In practice, nurses find it challenging to initiate action when it comes to oral health, in part because they are unsure about the appropriate interventions [29,39]. This situation may arise not only because mental health services primarily focus on symptoms but also because nurses’ reason from a broad perspective, and risk and health-promoting diagnoses are inadequately applied. This highlights the importance of analyzing existing nursing interventions focused on oral care and developing appropriate interventions in addition. Hence, it is crucial to adopt a co-creative approach in developing interventions. This means choosing a design where MHNs actively participate, provide feedback, and engage in the development of prototypes to ensure that the interventions are relevant and effective. Therefore, we opted for a human-centered and design-oriented approach [40–42]. Oral health in the general population Research among younger people in the Netherlands, conducted by TNO (2017), reveals that the oral health of 5-year-olds has improved in recent years. However, for the other age groups studied (11-, 17-, and 23-year-olds), oral health has either stagnated or deteriorated. Moreover, disparities in oral health exist across all age categories between high- and low-socioeconomic-status (SES) groups, with the low-SES group exhibiting poorer oral health. It is also notable that youths with a migration background have worse oral health and dental behaviours. Furthermore, the significant increase in (erosive) dental wear is concerning: one-fifth of 17 year olds and more than half of 23 year olds show wear down to the dentin [43]. The reasons provided for this include not brushing their teeth twice daily (in 11-yearolds); among the 17-year-olds, there is a prevalence of significant dental plaque and pockets, as well as damage resulting from the consumption of acidic foods and beverages. In 23-year-olds, a high incidence of cavities and periodontal pockets is observed, along with a tendency to delay treatment due to financial considerations. Although this pertains to the general population in the Netherlands, the findings of this study highlight the importance of exploring measures to enhance preventive health behaviours. The points highlight that young adolescents in the general population also suffer from oral health issues. We have contemplated whether this 1
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