Improving the Oral Health of People Seeking Substance Use Treatment
People who experience substance use disorder (SUD) also face barriers to accessing oral health care, including those related to social determinants of health: living with low incomes, reduced access to transportation, and lack of adequate insurance coverage. These challenges, especially when taken together, can make it difficult to prioritize oral health until it becomes urgent. When it does, it may be difficult to find a dentist, get to appointments, and carry through with the recommended care plans and follow up visits.
These challenges and barriers are compounded by the direct effects of substance use, including dry mouth and vascular changes, which worsen oral health. Some medications for opioid use disorder, including suboxone and methadone, can also have side effects that affect oral health including dry mouth and mouth acidity. Meanwhile, periodontitis is associated with heart disease, uncontrolled diabetes, substance use, and other systemic conditions.
In partnership with Dr. Hugh Silk at UMass Chan Medical School, RIZE is developing a scalable oral health intervention for people experiencing SUD that can be offered in SUD provider outreach settings. The model is being offered in three tiers of progressively in-depth interventions based on clinician expertise, training, and local internal and external resources.
During year one of the project, UMass Chan Medical School piloted, evaluated, and strengthened the model with its patients. The team engaged more than 360 patients, far exceeding projections, with initial oral health screenings, oral hygiene supplies, and advice. Over 240 were provided with oral health supplies and over 140 identified as in need of dental care. The team has made 87 referrals. Initial findings from the pilot year will be presented at the National Healthcare for the Homeless Council Annual Meeting in May 2025.
In year two, the project will expand into additional outreach settings, such as seasonal and emergency shelters, and will train additional staff in oral health interventions. New activities will address barriers to care illuminated during the pilot, including preventative care and pain management to reduce need for an immediate referral to a dentist and a weekly appointment with a private dentist for immediate referrals on site.