“It's not just about teeth”: supporting AOD recovery and improving client wellbeing through collaboration and partnership access to oral healthcare

Teeth are not just about how we chew or smile. Missing teeth or poor oral health can negatively impact on confidence, resilience and self-worth. For people in AOD recovery, chronic dental issues are common, often caused or exacerbated by AOD use. In early 2022, Palmerston Association led a collaborative partnership to pilot a free oral health program to improve access to dental treatment for clients in our residential AOD treatment program, evaluated by Notre Dame University. In a pre-dental treatment survey, four out of five clients reported feeling self-conscious and avoiding smiling due to the appearance of their teeth. Lack of confidence, pain, and difficulties eating were also experienced by many clients. The program response and evaluation was codesigned with residents receiving AOD treatment. From the outset, Palmerston Farm residents were involved in discussions about a potential oral health project. Residents’ input was sought on the types of dental needs and prior barriers to dental care, and on two occasions, a cohort of residents had the opportunity to meet the dentist. Residents also were asked for their input into the design and development of the project evaluation. This has been a part of the program’s success and is consistent with the observations of good practice in this area. The response to the program has been exceedingly positive, with many clients referring to physical, practical and psychological benefits of having ‘their teeth fixed’. Many have reflected on how it compliments their AOD recovery goals, their broader wellbeing and bolsters their sense of it being a ‘fresh start’. The integration of this trauma informed oral healthcare program within an AOD therapeutic community has already yielded individual and therapeutic benefits beyond expectation. Findings are highly relevant to other populations that face barriers to accessing oral healthcare, and more broadly, to individuals or communities embarking on recovery. As noted by one client, ‘it is not just about teeth’, it’s about mental health, confidence, self-esteem, and hope.... it's a massive part of recovery”. Next steps include continuation of evaluation, with additional strategies to get more data post treatment, presentation at national and international conferences to demonstrate impact, a co-authored paper to be submitted to peer review journal about the oral health pilot, early 2024 and identification of opportunities to leverage from projects its evaluation to advocate for sustainable funding