A qualitative study of patients’ knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility Alison Li Sun Cheah BDSc(Hons) 1,a , Ram Pandey BDSc(Hons) 1,a , Mark Daglish BSc MBChB MRCPsych MD 2 , Pauline J. Ford BDSc(Hons) GCHEd MPH PhD 1 and Sue Patterson BSocSci(Hons) Grad Cert Health DIC PhD 3 1 School of Dentistry, The University of Queensland, Herston, Queensland, Australia, 2 FRANZCP Royal Brisbane & Women’s Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia and 3 Metro North Mental Health, Metro North Hospital and Health Service and Griffith University, Herston, Queensland, Australia Accepted for publication 14 December 2016 Correspondence Sue Patterson J Floor Mental Health Centre Royal Brisbane and Women’s Hospital Herston, Queensland 4029, Australia E-mail: susan.patterson@health.qld. gov.au What is known about this topic • Comorbid oral disease compounds the personal, health and social costs associated with substance dependence. • Promoting oral health with this vulnerable population is an ethical and economic imperative. • Creative approaches are required to overcome interlinked social and personal barriers to services including discrimination, cost, lack of knowledge of services, lifestyle and shame. What this paper adds • Substance dependence does not preclude diligent attention to oral hygiene and concern about oral health is common among people admitted for alcohol and drug treatment. • Oral health literacy is generally low; sensitive assessment, facilitation of oral hygiene, Abstract Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients’ views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted ‘good teeth’ but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants’ knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research. Keywords: health promotion, oral health, patients, qualitative, substance dependence, withdrawal provision of information and referrals would be welcomed by most patients. • Matching interventions to needs/circumstances of patients and use of various media and formats will promote acceptability and utility. Introduction The limited evidence available supports clinicians’ practice-based knowl- edge: people seeking treatment for substance use commonly have poor oral health (D’Amore et al. 2011). Rates of oral disease including dental caries and periodontal disease, and tooth loss among people who are dependent on alcohol and/or other drugs are more than twice those of general popula- tions internationally (Scheutz 1984, Du et al. 2001, D’Amore et al. 2011, a Joint first authors. © 2017 John Wiley & Sons Ltd 1209 Health and Social Care in the Community (2017) 25(3), 1209–1217 doi: 10.1111/hsc.12423