Restart Smiling: Co-Produced Oral Health Training for Mental Health Staff

Objectives: To co-produce an oral health training resource for staff delivering physical health checks and follow-up care for people with severe mental illness in primary and secondary mental health services.
Methods: This study followed three-stage framework, after obtaining ethics approval. Stage 1 - pre-scoping included defining the problem, mapping stakeholders and systems, and understanding policy drivers and priorities. Stage 2 - evidence and resources review included searching existing oral health resources, non-dental professionals’ training packages, and National Health Services' programmes to promote health behaviours in people with severe mental illness. Stage 3 - coproduction with stakeholders included undertaking 19 one-to-one semi-structured interviews and 14 consultations with people with severe mental illness, their carers, mental health and dental professionals (of all levels), clinical and public health leads, policymakers and commissioners. Interview data was analysed thematically.
Results: A training resource for mental health staff, titled Restart Smiling, was coproduced with stakeholders. It covered: (i) the importance and responsibility for promoting good oral health in people with severe mental illness, (ii) oral health questions to incorporate into the physical health checks, (iii) brief interventions for oral hygiene, dry mouth, mouth cancer, diet and accessing dental care, (iv) description of oral hygiene equipment, and (v) the delivery of oral hygiene advice through a step-by-step behavioural change approach. Restart Smiling included scenarios, quizzes, videos, leaflets and other resources. It takes 30 minutes to complete and could be delivered online or in person.
Conclusions: A flagship oral health training resource for mental health and primary care staff was co-produced through a highly participatory approach. The next step is to iteratively prototype Restart Smiling using process data on fidelity and acceptability to key stakeholders.