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Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
Oral Health Needs Assessments
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Oral Health Needs Assessments

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  • 1. An Oral Health Needs Assessment of Prisoners in HMP Brixton Ellie Heidari Senior Clinical Teacher Sedation & Special Care Dentistry King’s College London
  • 2. Key areas <ul><li>Health Needs Assessment </li></ul><ul><li>The Oral Health Needs Assessment </li></ul><ul><li>Outcome of the OHNA </li></ul>
  • 3.   What is Health Needs Assessment? <ul><li>A systematic method which identifies unmet health and healthcare needs of a population </li></ul>Source: Wright J, Williams R&amp; Wilkinson J BMJ 1998;316:1310-1313 (25 April)
  • 4. Why is HNA important? <ul><li>‘ The purpose of needs assessment in health care is to gather the information required to bring about change beneficial to the health of the population.’ </li></ul>
  • 5. Why has HNA become important? <ul><li>Inequalities </li></ul><ul><li>Limitation of resources </li></ul><ul><li>Prioritisation with resources </li></ul><ul><li>Expectations </li></ul>
  • 6. The OHNA development <ul><li>Expressed needs </li></ul><ul><li>Normative needs </li></ul>
  • 7. The Oral Health Needs Assessment’s aim   To investigate the oral health status and dental treatment requirements of prisoners in HMP Brixton.
  • 8. Permission &amp; Ethical approval <ul><li>Local Research Ethics Committee </li></ul><ul><li>Northern and Yorkshire Multi-Centre Research Ethics Committee (MREC) </li></ul><ul><li>Committee’s location </li></ul><ul><li>The committee’s members </li></ul>
  • 9. Problems during the pilot study <ul><li>1. Forms </li></ul><ul><ul><li>Not returned </li></ul></ul><ul><ul><li>Were missing because prisoners had been released, bailed or transferred. </li></ul></ul><ul><li>2. No dental treatment - no participation </li></ul><ul><li>Outcome: Convenience sample </li></ul>
  • 10. Results <ul><li>Demography </li></ul><ul><li>Young population </li></ul><ul><li>Social classes IV, V </li></ul><ul><li> High unemployment rate </li></ul>
  • 11. Results <ul><li>Poor General Health </li></ul><ul><li>Depression &amp; mental illnesses </li></ul><ul><li>Smokers, alcohol/drug dependency </li></ul><ul><li> </li></ul><ul><li>Poor Oral Health </li></ul><ul><li> Attitude </li></ul><ul><li> lack of perceived needs especially before imprisonment </li></ul><ul><li>Dental attendance, preference, treatment </li></ul><ul><li>Barriers (apathy, anxiety) </li></ul><ul><li> Emergency rx &amp; pain control </li></ul>
  • 12. Factors affecting oral health <ul><li>Unhealthy behaviours </li></ul><ul><li>Drug use </li></ul><ul><li>Alcohol consumption </li></ul><ul><li>Tobacco smoking </li></ul><ul><li>Sugar consumption </li></ul><ul><li>2) Low use of dental services </li></ul><ul><li>Dental anxiety </li></ul><ul><li>Priorities </li></ul><ul><li>3) Attitudes of dental care professionals </li></ul><ul><li>4) Low use of preventive oral health services </li></ul>
  • 13. Oral Health Promotion (before OHNA) <ul><li>“ Single approach” </li></ul><ul><li>Advice on </li></ul><ul><ul><ul><li>Smoking cessation </li></ul></ul></ul><ul><ul><ul><li>Alcohol consumption </li></ul></ul></ul><ul><ul><ul><li>- Recreational drugs </li></ul></ul></ul><ul><ul><ul><li>- Diet/calorie intake </li></ul></ul></ul><ul><li>Craving </li></ul><ul><li>Mixer </li></ul>
  • 14. Oral Health Promotion (after OHNA) <ul><li>“ Whole team approach” </li></ul><ul><li>Liaised with the medical team </li></ul><ul><li>Prison smoking cessation programme </li></ul><ul><li>Pharmacist </li></ul><ul><li>The canteen shop </li></ul>
  • 15. Oral Health Promotion Constraints <ul><li>Mobile, shortage/lack of staff </li></ul><ul><li>- Dental Care Professional </li></ul><ul><li>Source: Dyer &amp; Robinson 2006 </li></ul><ul><li>- Prison staff </li></ul><ul><li> Lack of training to undertake health intervention </li></ul><ul><li>Mobile prison population </li></ul><ul><li>Insufficient funding </li></ul><ul><li>Time </li></ul><ul><li>Difficulties to evaluate </li></ul><ul><li> </li></ul>
  • 16. To consider <ul><li>A standardised HNA </li></ul><ul><li>Encourage oral health promotion Motivate/maintain/value </li></ul><ul><li>Change health/oral health related behaviour </li></ul><ul><li>Funding/resources </li></ul><ul><li>To increase provision of dental services </li></ul><ul><li>To perform research/audit </li></ul><ul><li>To improve toothbrush/paste </li></ul><ul><li>Interprofessional integration </li></ul><ul><li>Identify the most vulnerable group </li></ul><ul><li>Pain/infection control </li></ul><ul><li>Staff support network </li></ul><ul><li>Clinical governance </li></ul><ul><li>Follow up in community </li></ul>
  • 17. Thank you for your time and attention

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