Exploring oral health challenges and integration strategies in opioid treatment programs: perspectives from clinicians and clients

Grace Wong; Anna Cheng; Kyle Cheng; Angela Masoe; Sanjana D’Hary; Mark Enea Montebello

doi:10.1071/PY24134

RESEARCH ARTICLE (Open Access)

Next Contents Vol 31(1)

Exploring oral health challenges and integration strategies in opioid treatment programs: perspectives from clinicians and clients

Grace Wong

^A ^B ^C ^* , Anna Cheng ^A , Kyle Cheng ^A ^B , Angela Masoe ^D , Sanjana D’Hary ^A and Mark Enea Montebello ^E ^F ^G

+ Author Affiliations

- Author Affiliations

^A Primary and Community Health, Oral Health Services, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia.

^B Sydney Dental School, Faculty of Medicine and Health, the University of Sydney, Sydney, NSW, Australia.

^C School of Nursing and Midwifery, Western Sydney University, Liverpool, NSW, Australia.

^D Centre for Oral Health Strategy, NSW Health, St Leonards, NSW, Australia.

^E Drug and Alcohol Services, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia.

^F Specialty of Addiction Medicine, Northern Clinical School, The University of Sydney, St Leonards, NSW, Australia.

^G National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.

^* Correspondence to: grace.wong4@health.nsw.gov.au

Australian Journal of Primary Health 31, PY24134 https://doi.org/10.1071/PY24134

Submitted: 23 August 2024 Accepted: 17 December 2024 Published: 7 January 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Despite the paramount importance of oral health, individuals undergoing treatment for opioid use disorder face unique challenges beyond traditional addiction care. This qualitative study explores the challenges Opioid Treatment Program (OTP) clients in Australia encounter when accessing oral health care, aiming to understand the underlying factors and identify effective strategies for integrating oral health into an OTP.

Methods

Semi-structured interviews were conducted with OTP clients, OTP clinicians and oral health clinicians using tested interview guides. Thematic analysis identified patterns and themes across participants’ responses.

Results

Client behaviour and traits such as inadequate health prioritisation, crisis-driven care and lack of motivation, shaped by a complex social environment, contribute significantly to inconsistent care and neglected oral health. Addiction exacerbates oral health issues as clients prioritise drug use over oral care and financial constraints, resulting in poor oral hygiene and a higher prevalence of dental problems. Psychological barriers such as dental anxiety deter clients from seeking care, while access issues including administrative burdens and system barriers, lost phones and unstable living conditions hinder consistent management of oral health. Stakeholders recommend actionable steps to address OTP clients’ challenges, including integrating holistic care, establishing collaborative support systems, improving awareness and education and enhancing accessibility and flexible scheduling.

Conclusion

This study established a framework for improving OTP clients’ oral health through integrated, holistic strategies. By addressing gaps in existing research, it supports the development of public health policies integrating oral health care into OTPs, aiming to foster collaboration, improve access and advance client education for better health outcomes.

Keywords: delivery of health care, facilities and services utilisation, health disparities, health services accessibility, integrated care, opioid use disorders, oral health, social determinants of health.

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