Dental Providers' Perceptions of Barriers to Treating the Mentally Ill

Individuals with mental illness have poorer oral health and more unmet dental need than those without mental illness. Objectives: The objective of this study was to examine dental providers' perceptions of both the barriers they face in treating mentally ill patients and the barriers faced by mentally ill patients in seeking dental care. Methods: Dentists and dental staff (N=187; 77.5% female; 38% dentists) completed paper surveys at the 2011 Pacific Northwest Dental Conference regarding their experiences in treating adults with mental illness. Responses were collapsed into “not a barrier” or “possibly or definitely a barrier” to either providing or seeking dental care. Nonparametric bivariate analyses were completed to examine differences in the proportions of responses. Results: Providers were significantly more likely to indicate patients' behavior (83.5%) and fear (76.9%) during treatment as barriers to providing care (p's<.01). Patients' oral home care (46.4%) and level of oral disease (53%), along with the busyness of the dental practice (49.7%; p's<.01) were significantly less likely to be reported as barriers to providing care. Disruption to the practice, provider training in patient management, inadequate reimbursement for treatment, and patients' level of comprehension about care did not reach significance (p's>.05). However, when asked about barriers faced by patients in seeking care (e.g., lack of insurance, fear, distrust of dental or medical providers), over 90% of providers indicated each factor was a possible or definite barrier to patients seeking care (p's<.001). Conclusion: Dental providers indicated mentally ill patients face significantly more barriers to seeking care than dental professionals do in providing care to these patients. Dentists and staff should engage in problem solving with mentally ill patients to help circumvent the many barriers to adequate dental care they face. Supported by University of Washington School of Dentistry Alumni and NIH/NIDCR Grant 5K23DE019202-03.