45 Oral health experiences and needs among young adults after a first episode psychosis some cases this leads to dental phobia” [23] (p.278). In our study, fear was not an issue for patients after FEP. With regard to needs and interventions, the participants stated the importance of support from others. This support could be in the form of a reminder for an appointment to prevent missing appointments. In sending reminders, there is a difference between dentists and dental hygienists. The results of our study showed that participants report a lower level of non-attendance when they receive a message the day before and the day of the appointment. Studies reporting the needs and interventions of patients diagnosed with SMI support the importance of sending reminders for their appointments, for example, studies focusing on medication adherence using text messages [24]. To date, however, studies have not taken oral health into account, and it is not known whether these outcomes are feasible in patients after FEP. The participants reported the importance of others in helping them remember their daily oral health routine and remember to visit the dentist. This finding raises questions about who is responsible for oral health care for patients after FEP, particularly to prevent problems. Oral health prevention is primarily the responsibility of dentists/dental hygienists, but there is a role to be played by mental health nurses. Mental health nurses have contact with patients on a regular basis, and therefore, they have the opportunity to support patients diagnosed with their oral health, just as they also do in regard to physical health and healthy eating habits. Because of the lack of concrete tools, the Oral Assessment Guide for Psychiatric Care (OAGPC) can be appropriate to methodically coordinate, assess, and evaluate patients’ oral health [25]. The WHO recognizes oral health as a part of integrated care [22]. Using an oral health assessment guide, e.g. during somatic screening, should be incorporated to integrate oral health into daily care, but, studies among integrated care have not taken oral health into account, and therefore, it is not known if an Oral Assessment Guide will increase oral health in patients after FEP. This study was carried out with a small sample size of 18 men (60%) and 12 women, and although the ratio is not equal, the results were comparable, and no gender issues were found. Out of thirty participants, 21 participants used drugs, often cannabis, at some time in their life (70%). The prevalence of substance use among people with FEP is in line with previously published data in Canada [26] and Austra2
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