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Smile wide with pride: outcomes of an oral health promotion project among Aboriginal opiate treatment program clients

14 Jul 2014

Examines the effectiveness of oral health promotion programs among Indigenous opiate treatment program clients and analyses dental appointment compliance in this population.


Drug abuse is a significant issue for society with drug-related crimes continuing to be a significant social problem. Oral hygiene goes way down the priority list for these people and while drug users are an at-risk group with regards to oral health, their dependants are at a higher risk because of sub-standard diet and oral hygiene practices due to their parents’ dysfunctional state during their period of addiction. Drug abuse in Aboriginal families would be expected to have a more deleterious effect on the oral health of their families than it would in non-Aboriginal families, because the level of baseline risk for dental diseases is higher among Aboriginal communities. Various studies including the second National oral health survey (2004-2006) have shown that Aboriginal Australians have poorer oral health when compared to other Australians. A recent study has established that the oral health related quality of life in Aboriginal Australians was poor with all risk factors (socio-economic, dental service utilisation, financial and dental self-care factors) amenable to change. Methadone users often have very severe dental pathology (including periodontal disease) at younger ages when compared to the general population. High rates of caries exist among people with opiate dependencies due to a complex, dynamic combination of diet and other factors. They exhibit heightened dental fear. Opiate treatment program (OTP) clients in Port Macquarie and Kempsey, especially Aboriginal clients, demonstrated a lack of knowledge of good oral hygiene practices, lack of awareness of their own dental condition and lack of understanding of the criteria for public dental services, placing them and their dependants at a very high risk for oral disease. OTP clients commonly present as dental emergencies.

Approximately 10% of OTP clients in Port Macquarie and 25% in Kempsey are Aboriginal. OTP clients often contact dental services for emergency dental treatment, mostly when it is too late and there are no other systematic approaches to their problem. In this study a systematic approach to dental health education was tailored to OTP clients in Port Macquarie and Kempsey. The specific aim of this study was to determine whether an oral health promotion program accompanied by assessment and comprehensive dental treatment would improve oral health awareness and behaviours. The study also examined compliance with dental appointments among OTP clients.


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