Pharmacists’ Oral Health Recommendations to Patients with Mental Illness

Individuals with mental illness typically have poorer oral health than individuals without mental illness and often lack access to regular dental care. Pharmacists are in a unique position to offer oral health recommendations to at-risk patients who are prescribed psychotropic medications. Objectives: This qualitative study aimed to examine oral health questions received by pharmacists, and pharmacists’ attitudes toward discussing oral health with patients with mental illness. Methods: Eighteen pharmacists in clinical community practice participated in semi-structured interviews by telephone. Topics included the types and frequency of oral health questions they receive, oral health recommendations given to patients with mental illness, and pharmacists’ confidence levels in providing oral health advice. Interviews were recorded, transcribed, and coded using Atlas.ti software. Results: Three primary themes were revealed. (1) Most pharmacists estimated they receive oral health questions daily, but questions about oral health side effects of medications were much less common. Participants noted the most commonly asked oral health questions focused on mouth sores, dry mouth, and acute pain. (2) Many pharmacists reported that they, not patients, were likely to bring up oral health side effects of psychotropic medications even though estimated frequency of patients filling these prescriptions ranged from 10% to 80%. (3) Saliva substitutes, mouthwash, and sugarless gum or candy were recommended to patients taking psychotropic medications. Fluorides and topical antiseptics were not commonly recommended. All pharmacists reported they should discuss oral health with at-risk patients, and indicated interest and willingness to pursue additional training in oral health issues. Conclusion: Pharmacists are an underutilized resource in providing oral health recommendations to individuals with mental illness who lack access to other oral health resources. Further, they are willing to engage in more training in order to provide oral health guidance to individuals at high risk of oral disease. Supported by NIH/NIDCR Grant 1K23DE019202-01A2.