Mind the gap: an administrative data analysis of dental treatment outcomes and severe mental illness

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Oral health of people with severe mental illness (SMI) remains an important public health issue, despite evidence pointing suboptimal dental health outcomes in this population.

We test the hypotheses that individuals with SMI have lower contact with dental services and higher levels of fillings and extractions. We also examine effect modification by age-group.

We used linked administrative data from general practitioner (GP), hospital and dental records to examine dental service use and treatments (extractions, fillings, crowns and x-Rays) among the Northern Ireland hospital population between January 2015 and November 2019 (N=798,564).

After adjusting for available socio-demographic characteristics, analysis indicated lower levels of dental service use (OR=0.80, 95% CI=0.77, 0.84), including lower likelihood of fillings (OR=0.81, 0.77, 0.84) and X-rays (OR=0.77, 0.74, 0.81), but higher levels of extractions (OR=1.23, 1.18, 1.29) among patients with SMI. We also found effect modification by age-group, with older individuals with SMI less likely to have each of the four dental treatments.

We suggest that in the general area of physical healthcare for people with SMI, oral healthcare is neglected. There is a need for improved understanding of the barriers to routine care and treatment, and development of psychoeducational interventions.
Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalJournal of Mental Health
Early online date10 May 2022
Publication statusPublished online - 10 May 2022

Bibliographical note

Funding Information:
The authors acknowledge the help provided by the staff of the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO). The HBS is funded by the BSO and the Department of Health, Social Services and Public Safety for Northern Ireland (DHSSPSNI). The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the author and do not necessarily represent those of the BSO. The authors also acknowledge the expert guidance provided by steering committee members from the NI Department of Finance, the Belfast Trust, Cause NI and Inspire, as well as the support and expertise provided by Elizabeth Nelson-Gorman, ADRC-NI Public Engagement, Communications and Impact Manager.

Funding Information:
This study is part of a relatively recent Administrative Data Research (ADR) initiative, funded by the United Kingdom (UK) Economic and Social Research Council (ESRC) to develop the use of routinely collected administrative data for research purposes. The population of interest is drawn from the Northern Ireland (NI) General Practitioner (GP) registered population (as of January 2013) which forms the spine of the study. This spine, which also contains some basic demographic information, is (separately) linked to routinely collected data on (a) hospital-based Patient Administration System (PAS) records on admissions and (b) dental health treatments, derived from Dental Payment System (DPS) data, both provided through the Health and Social Care Northern Ireland (HSCNI) Business Services Organisation (BSO). The data are classed as confidential: it is accessed from within a secure setting; by accredited researchers working under stringent protocols obviating disclosure problems; with data de-identified prior to researcher access.

Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.


  • Psychiatry and Mental health
  • General Medicine
  • Severe mental illness
  • Severe mental disorder
  • Dental health
  • Oral health
  • Dental treatment
  • Administrative data
  • dental treatment
  • oral health
  • dental health
  • severe mental disorder
  • administrative data


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