43 Oral health experiences and needs among young adults after a first episode psychosis All patients reported a lack of knowledge of oral health and oral health care. In particular, there was a lack of knowledge on the influence of risk factors on oral health. There was no difference between patients regarding whether they used drugs or not. There was also a lack of knowledge of the consequences of not taking care of their teeth. It seemed hard to motivate the patients, especially when they used drugs. Nevertheless, in all patients, there was no reported need for health promotion. The patients stated that interfering is not desirable and will only generate resistance. The patients felt stigmatised as though they were children and could no longer think for themselves. Moreover, they believed that they know how to take care of their oral health. This belief is in contrast to the statement from one patient earlier: “awareness is critical. Discussion This phenomenological study in the Netherlands context is unique, and it gives insights into the lived experiences and needs regarding oral health among patients between 18 and 35 years after FEP. The WHO recommends that more investment in under-funded areas of health research were needed and also recommends to translate knowledge into actions to improve oral health [16,17]. Therefore, it was important to explore the experiences and needs of patients after FEP. This study is the first to explore patients’ experiences in four themes. Overall, participants were satisfied with their oral health before the occurrence of psychotic symptoms, and they stated that a decrease in oral health started after that period. In total, four themes were reported based on the lived experiences and needs of the patients: dental care in general, risk factors, experiences, needs and interventions. These four themes were linked to each other. All participants had difficulties in managing their oral health; they were unaware of the consequences of the risk factors and reported the importance of others in helping them. With regard to dental care in general, the participants were not aware of the importance of oral health. A study among patients after FEP and patients after multiple episodes shows that there is less awareness among patients after FEP than among patients after multiple episodes [18]. These findings indicate the importance of using psychoeducational approaches to improve awareness in patients after FEP. 2
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