Poor oral health should not be an inevitable consequence of experiencing severe mental ill health

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by Dr Emily Peckham

The Right To Smile is a new consensus statement which sets out what people with severe mental ill health should expect in terms of their oral healthcare. The consensus was launched at an event in Manchester on the 30th September 2022 which brought together researchers, people with lived experience of severe mental ill health, carers, clinicians and policy makers.  

Oral health is an often-neglected health inequality and whilst in recent years there has been a focus on the physical health of people with severe mental ill health (SMI), the oral health of this population has been largely ignored. Yet the consequences of poor oral health can be serious and people who live with SMI are more likely to have poorer oral health compared to people without mental ill health. 

For example, they are more likely to:

  • have decayed, missing and filled teeth
  • lose all their teeth
  • experience gum and supporting bone problems
  • develop oral cancer

And dental conditions are the third most common reason for preventable hospital admissions in people with SMI.

In addition to physical health problems poor oral health can also lead to a loss of self-esteem with people suffering from poor oral health feeling embarrassed to reveal unsightly teeth leading to a lack of confidence in speaking, laughing or smiling. All of which can in turn contribute to a decline in mental health.

However good oral self-care behaviours can prevent poor oral health, regular toothbrushing with a fluoride toothpaste, reducing frequency of sugar intake, cessation of smoking, and limiting alcohol intake can all reduce the risk of dental problems. To address this a group of people with lived experience of SMI, carers, researchers, clinicians and policy makers came together over a number of months during 2021 to develop a consensus statement on what people with SMI should expect in terms of their oral health, that is The Right to Smile which asserts a ‘whole-person’ approach where there can be no health without oral health. 

The Right to Smile has three key 5-year targets to achieve more effective whole person care:

  1. Any assessment of physical health in people experiencing severe mental ill health must include consideration of oral health.
  2. Access to dental services for people with severe mental ill health needs to improve.
  3. The importance of oral health for people experiencing severe mental ill health should be recognised in healthcare training, systems, and structures.

The consensus statement can be viewed in full here: Oral_Health_Consensus_Statement.pdf (lancaster.ac.uk).

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