29 Oral health experiences and needs among young adults after a first episode psychosis Introduction The importance of attention to oral health care in psychiatric patients diagnosed with severe mental illness (SMI) is well described and has been shown to be poor [1]. A decrease in mental health is associated with an increased need for dental care [2]. Kilbourne et al. [3] demonstrate that 61% of patients diagnosed with SMI reported poor oral health and that over 34% of patients stated that oral health problems made it difficult to eat. Poor oral health impacts daily living (e.g., eating, social acceptance, self-esteem, feeling comfortable) and is also associated with chronic disorders, e.g., diabetes, high blood pressure, respiratory disease, and coronary heart disease in patients diagnosed with SMI [4,5]. Kisely [6] states that poor oral health in this group also contributes to avoidable admissions to a general hospital and that dental conditions are a common cause of acute avoidable admissions. This finding shows that oral care is an important part of general health in patients diagnosed with SMI (and a chronic disorder, e.g., diabetes, high blood pressure, respiratory disease, and coronary heart disease). Risk factors for poor oral health are also known, and inferences can be made from syntheses of the literature. These risk factors include the type and stage of mental illness; a lack of motivation and low self-esteem; a lack of perception of oral health problems; lifestyle (e.g., eating, substance use) and the ability to sustain self-care and dental attendance; socio-economic factors (e.g., low income or low education); and the oral side effects of medication [6–8]. Rationale Awareness of and support regarding oral health for patients diagnosed with SMI are of great importance. To prevent poor oral health, with all its consequences, it would be of great interest to intervene in an earlier stage, such as the first episode psychosis (FEP). However, no research on the experiences of young adults’ oral health after FEP has been conducted. The British Society for Disability and Oral Health [8] has published recommendations for oral health care for people with mental health problems, but the suggestions were not practical. In the Netherlands, multidisciplinary guidelines for patients after FEP describe that “during somatic screening it is important to check oral health” (8, p.140) and “during lifestyle screening it is important to check oral health hygiene” [9]. Clinical interventions are lacking, and therefore, there is a sig2
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