WORCESTER MEDICINE
Oral Health Supporting the Oral Health Needs of Individuals with Mental Illness?” Continued needs. The most effective referrals for patients with mental and dental health needs are “warm” referrals, with the nurse assisting in communication and regular follow-up with other providers and the patient throughout the process.11 We can follow up with a phone call, message, or other reminder to help encourage patients to take the steps needed to make and keep dental and mental health appointments. Often, it will take several discussions over time to increase patients’ readiness to engage in care. Nurses are well placed to address these gaps in dental care through their ability to partner with patients to assess and meet individual needs. + references:
1. Clark DB. Mental health issues and special care patients. Dental Clinics of North America. 2016;60(3):551-566. 2. Stahl S. Stahl’s essential psychopharmacology: Prescriber’s guide. Sixth edition. Cambridge University Press; 2017. 3. Key substance use and mental health indicators in the United States: Results from the 2019 national survey on drug use and health. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/product/ key-substance-use-and-mental-health-indicators-in-theunited-states-results-from-the-2019-national-survey-on-DrugUse-and-Health/PEP20-07-01-001. Accessed November 6, 2020. 4. Young WG. Tooth wear: diet analysis and advice. International Dental Journal, 2005;55(2):68–72. 5. Tomar SL, Hecht SS, Jaspers I, Gregory, RL, Stepanov, I. Oral health effects of combusted and smokeless tobacco products. Advances in Dental Research, 2019;30(1):4-10. 6. Oral cancer. National Institute of Dental and Craniofacial Research. Accessed November 6, 2020. https://www.nidcr.nih. gov/health-info/oral-cancer/more-info 7. 7. Halonen. H, Nissinen. J, Lehtiniemi H, Salo T, Riipinen. P, Miettunen. J. The association between dental anxiety and psychiatric disorders and symptoms: A systematic review. Clinical Practice and Epidemiology in Mental Health, 2018;14:207-222. 8. Vujicic M, Buchmueller T, Klein R. Dental care presents the highest level of financial barriers, compared to other types of health care services. Health Affairs, 2016;35(12):2176-2182. 9. Brody A. Cost remains barrier to dental care access. Dimensions of Dental Hygiene, 2020;18(2):9. 10. American Dental Association. Managing dry mouth. The Journal of the American Dental Association, 2016;146(2):40. 11. Tips for making trauma-informed warm referrals. Commonwealth of Massachusetts. https://www.mass.gov/ info-details/tips-for-making-trauma-informed-warm-referrals. Accessed November 6, 2020. Shari Harding, DNP, is an assistant professor at the UMass Medical School’s Graduate School of Nursing. Email: shari.harding@umassmed.edu
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Pharmacists as Members of the Oral Healthcare Team Anna Morin, PharmD
T
he role of the pharmacist continues to
evolve from compounding and dispensing to encompass a broader range of functions relating to patient-centered care. Pharmacists serve as key members of the healthcare team, often consulted by other health professionals and the public regarding medication- and health-related questions. The American Pharmacists Association (APhA) Foundation is a not-for-profit organization committed to advancing pharmacists’ patient care services through philanthropy, research, and innovation.1 The Foundation has created an inter-disciplinary framework for pharmacists to play an active role in oral disease prevention, identification, assessment, and referral. Community pharmacists are among the most accessible health professionals and are in a unique position to disseminate information on oral health, especially to those who lack or have limited access to dentists and other oral health professionals. Levels of pharmacist involvement in the promotion of oral health initiatives include providing advice and education regarding: • Over-the-counter (OTC) and prescription oral products • Smoking cessation • Signs and symptoms of oral conditions • Referrals to and endorsement of advice from oral health professionals • The link between oral health and chronic systemic diseases • Medication adverse effects including: mouth ulcers, xerostomia, or osteonecrosis • Healthy eating with a reduction in and frequency of sugar consumption Older patients, in particular, can benefit from oral health services provided by pharmacists. These patients are often taking several prescription and OTC medications for numerous chronic diseases. Pharmacists should monitor patients’ pharmacotherapy for adverse oral health events and talk with both patients and caregivers about the relationship of oral hygiene and overall health. The Beers
JANUARY / FEBRUARY 2021
