99 Oral Health Interventions in Patients with a Mental Health Disorder to all respondents to promote knowledge about their own oral health status. Results show a significant improvement in exact answers between pre-test/post-test questionnaires (p < 0.001), and especially in questions concerning the goals of oral hygiene [51]. One year after the intervention, respondents showed improvement in knowledge and attitude towards oral cancer prevention and toothbrushing had become a daily routine after every meal (in 67.1%). Moreover, 65.9% of respondents had received a dental examination in the previous year. Female gender and more than 10 years of smoking addiction were associated with an improvement of toothbrushing. Respondents with more than 10 years of alcohol addiction were less likely to change [51]. The study of Khokhar et al. [52] focused on outpatients with SMI (not further specified) and professionals. The intervention included the provision of toothbrushes, toothpaste, and mouthwash to respondents without a toothbrush in order to encourage better oral health. Staff was educated on the importance of dental care planning and the inclusion in individual care planning. Access to local dental services was improved. Additionally, respondents received an educational session on dental health. Results of this intervention shows the improvement in access to toothbrushes and the increase of knowledge. The practice of brushing teeth twice a day increased from 29% to 38%. There was no change in number of respondents who had their dentures checked [52]. The study of Silverstein et al. [53] focused on the impact of oral health education in inpatients with eating disorders (anorexia nervosa and bulimia nervosa) to change self-image and oral health practices. Respondents received a pre-test/post-test questionnaire to assess demographics, oral health knowledge, and self-image. The educational programme consisted of three sessions, each with one topic: (i) general oral health education; (ii) aesthetics, effects of eating disorders, pain; and (iii) nutrition for oral health. Every session took 30 min. During the last 10 min of the session, respondents were able to ask questions about their oral health or the sessions’ topic. The results show that patients who reported going to the dentist regularly were significantly more likely to respond that their teeth had a positive effect on their self-image, how they look to others, their general health, and general happiness, compared to respondents who reported going occasionally, or only when they have a problem. Knowledge about general oral health and the impact of an eating disorder on oral health was improved after the oral health sessions. 4
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