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British Dental Journal volume 213, pages 47–48 (2012)
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Sir, it has been found that methadone patients in Scotland are not being given effective, evidence-based advice concerning their oral hygiene.
Generally, dispensing pharmacists do not feel confident giving effective oral hygiene advice. To address this issue, an oral hygiene leaflet has been created using evidence-based advice where possible, as well as adding other carefully worded and helpful information.
This will be distributed to every dispensing pharmacy in Scotland to ensure methadone patients can be given effective, evidence based oral hygiene advice.
At university, I treated a patient who had never been given any form of oral hygiene instruction. This patient was a long-term methadone patient with several carious lesions but very motivated to improve his oral health and, in particular, the appearance of his teeth. He associated the poor appearance with a ‘misspent youth’ and felt this contributed to his depressed state. To me, this patient was an opportunity not only to restore the teeth but also to impact positively on the psychological wellbeing and perhaps help the patient from methadone dependence altogether.
After talking with a number of pharmacists I found that, generally, most are not confident in delivering effective, evidence-based oral hygiene instruction to methadone patients. To tackle this problem, I created a leaflet (Fig. 1) using simple instructions which could be backed-up with evidence from an evidence-based dentistry textbook. Once this was achieved and set out in an appropriate way, several consultant from different specialities were asked to contribute. The leaflet was then taken to the Assistant Chief Dental Officer for Scotland, Mary McCann, who put me in touch with a dental public health consultant, Colwyn Jones, who has been instrumental in making the project a success through his contacts and previous experiences.
Advice leaflet for methadone patients
Further ideas were contributed by a second multidisciplinary group, this time involving specialist addiction pharmacists, and an NHS design team who ensured that the leaflet met NHS rules and regulations relating to the leaflet design.
It has taken three years, but finally, the number of leaflets chosen to be produced by NHS Scotland was 25,000. The cost of printing these was £627 (or 3p per leaflet). Dentists can now work alongside pharmacists in order to make a small but important contribution in reducing drug-related problems in Scotland.
Edinburgh
G. Isherwood
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Isherwood, G. Methadone and oral care. Br Dent J 213, 47–48 (2012). https://doi.org/10.1038/sj.bdj.2012.620
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DOI: https://doi.org/10.1038/sj.bdj.2012.620
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