Barriers and facilitators for oral health screening among tobacco users: a mixed-methods study.

OBJECTIVES: Tobacco consumption adversely affects general and oral health and is considered one of the significant public health burdens globally. The present study aims to assess the barriers and facilitators for attending oral and dental health screening among tobacco users who seek cessation advice. METHODOLOGY: The present mixed-methods study used group concept mapping (GCM) to identify the facilitators/barriers to attending oral health screening among young adults attending face-to-face and virtual Tobacco Cessation Clinic at King Saud University (Riyadh, Saudi Arabia) between September 2022 and April 2023. Study investigators included healthcare social workers, dental interns, and oral and maxillofacial medicinists. Information about demographics, general health, oral/dental health and tobacco use were collected using self-completed questionnaires. The barriers and facilitators were assessed following GCM by brainstorming, sorting, rating, and interpretation activities. Descriptive, multidimensional scaling and hierarchical cluster analysis were used to describe the study participants and produce concept maps of the generated statements. RESULTS: The study included 148 participants who generated 67 statements summarised into 28 statements as facilitators or barriers. Based on a 5-point importance scale, the participants indicated the importance of facilitators under health-related cluster [e.g. when I feel pain] as the highest, followed by personal [e.g. to maintain my mouth hygiene], social [e.g. the quality of treatment] and financial clusters [e.g. the reasonable cost]. Concerning barriers, financial factors [e.g. high cost] acted as the highest-rated barrier, followed by personal [e.g. lack of dental appointments] and health-related [e.g. worry that dental problems will worsen]. The social factors were the least considerable barrier [e.g. lack of time]. Clustering these facilitators/barriers on the concept map indicated their conceptual similarity by an average stress value of 0.23. CONCLUSION: Pain was the most important facilitator to attending oral health screening by young adults seeking tobacco cessation advice. Notable barriers included the high cost of dental treatment and the lack of scheduled appointments. Thus, oral health care providers need to consider scheduling periodic and timely dental check-ups to prevent and reduce the burden of tobacco-associated and pain-causing oral diseases.

Effectiveness of Phone Call Follow-Ups in Improving Patient Compliance to Post-extraction Instructions: A Cross-Sectional Study.

Background Dental extraction is a commonly performed oral surgical procedure. The manner in which post-extraction instructions are given to patients may impact their understanding and adherence to instructions. This study aimed to evaluate the effectiveness of phone call follow-ups over conventional verbal and written post-extraction instructions in terms of patient compliance in Riyadh, Saudi Arabia. Methodology After obtaining informed consent, patients undergoing dental extraction at the Department of Oral and Maxillofacial Surgery were randomly enrolled into one of the three groups based on the mode by which post-extraction instructions were administered. Group A received verbal and written instructions only, and Group B and Group C received additional phone call follow-up on the first postoperative day and the first and third postoperative days, respectively. After seven days, all patients answered a questionnaire to quantify the level of compliance on a score out of 10, which was the outcome variable. The nature of receiving post-extraction instruction was the primary predictor variable. Age, gender, and type of extraction (surgical or non-surgical) were secondary predictors. Descriptive statistical analysis and statistical comparison of mean compliance scores between the groups and the effect of interaction between primary and secondary predictors on the outcome variable were carried out at a 95% significance level (p < 0.05). Results A total of 135 patients (75 males and 60 females; mean age = 36.2 years) were included in the study. While the overall mean compliance score was 8.36 ± 1.08, Group C (9.14 ± 0.78, n = 42) had a significantly higher level of compliance than Group B (8.48 ± 1.01, n = 40) and Group A (7.64 ± 0.83, n = 53) (one-way analysis of variance (ANOVA) F = 34.937; p < 0.001). Similarly, the level of compliance in Group B was significantly higher than that in Group A (p < 0.01). There was no significant statistical relationship between the secondary predictors and the compliance scores. Similarly, two-way ANOVA revealed no statistically significant effect of interaction between the primary and secondary predictor variables on the compliance scores. Individually, the least complied instruction, across all groups, was "rinsing with saline once every six hours for four days," and "biting on a gauze pack for 30 minutes" was the most complied instruction. Conclusions Phone call follow-up after teeth extraction improves patient compliance with post-extraction instructions through reinforcement and education. While a single phone call follow-up one day after extraction along with verbal and written instructions increased patient compliance significantly, a second phone call follow-up on the third postoperative day yielded the best level of compliance.