A link work intervention to support dental visiting in people with severe mental health difficulties: The mouth matters in mental health effectiveness and cost-effectiveness trial

Severe mental health difficulties, such as depression, psychosis, or bipolar disorder, can affect about 1 in 100 people. We know that people living with these conditions often face bigger challenges when it comes to looking after their teeth and gums. This can mean they have more missing or decayed teeth, which can make everyday activities like eating, speaking, or even smiling much harder and add extra stress to their lives.

Seeing a dentist regularly is key to good oral health, but many people with severe mental health difficulties find this particularly tough. There can be many reasons for this: people might feel very anxious or scared about dental visits, or they might struggle with the practical side of things, like booking appointments, planning how to get there, or understanding how to pay or access free dental care. Unfortunately, current efforts to encourage dental visits often don't address these specific challenges for people with severe mental health conditions. That's why we're exploring a new approach.

We recently tried out a 'link worker' programme on a smaller scale, where a dedicated support person helped individuals with severe mental health difficulties to attend dental appointments. This first trial showed promise: people liked the support and it seemed to help them visit the dentist and feel better about their quality of life. Now, we want to test this 'link work' support on a much larger scale across several NHS sites. Our goal is to see if this type of support genuinely helps more people attend regular dental appointments, improves their dental health and well-being, and also understand how much this support costs. We hope to recruit around 480 people to take part in this important study.