Psychology and Sociology in Oral Health PDF

Psychology and sociology in oral health Lauren Stockham FCSP, Year 1 Intended learning outcomes: Aim: to provide an overview of psychology and sociology in oral health. At the end of this session students will be able to: Outline how psychological and sociological factors can influence and i...

Psychology and sociology in oral health Lauren Stockham FCSP, Year 1 Intended learning outcomes: Aim: to provide an overview of psychology and sociology in oral health. At the end of this session students will be able to: Outline how psychological and sociological factors can influence and impact on oral health. Apply psychological and sociological concepts in delivering patient-centered care and in own reflective practice. Assessment of learning Formative: Reflection and reading Summative: E-assessment OSCE Future: Clinical practice as an effective clinician Overview of related content for Behavioural and Social Sciences throughout the program Graduate: Registered professional Year 3: Continue personal and Consolidation professional Patient-centred care in development Year 2: Application CCPDTH Population health and Leadership and promotion management Year 1: Theoretical Special care dentistry Behaviour Change Patient-centred care in Psychology and ACPDTH sociology Dental anxiety Patient support techniques What is the point of this? HOW ARE PSYCHOLOGICAL AND SOCIOLOGICAL FACTORS RELEVANT TO ORAL HEALTH?  Activity 1 1800’s ‘dental’ visit. Imagine yourself in the patients’ shoes… - Thoughts? - Feelings? - Will you return to them? - Why does all this matter? https://www.theguardian.com/society/gallery/2014/jun/16/a-history-of-dentistry-in-pictures  Explanation – why would you do this? Sociological factors: - Structure of society - Aim to resolve pain Psychological factors: - Pain – do anything to fix, - Traumatic experience never forget, - Tell others, avoid at all costs. Impact – affects relationship, future care https://www.theguardian.com/society/gallery/2014/jun/16/a-history-of-dentistry-in-pictures and oral health. Concepts and influencing factors PSYCHOLOGY AND SOCIOLOGY Definitions Aim to understand why we do what we do (behave), in the context we are in (society). We refers to everyone, our Psychology interactions and experiences. “…the study of the mind, how it dictates and influences our behaviour from communication and memory to thought and emotion.” The British Psychological Society 2024 Sociology “Sociology is the study of how society is organised and how we experience life.” The British Sociology Association 2024 This Photo by Unknown Author is licensed under CC BY-NC Beyond biological sciences The FDI World Dental Federation universal definition: ‘Oral health is multi-faceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex.’ (Gilik et al 2016) Understanding oral health requires more than the science of caries and periodontal disease. Biopsychosocial Model of health and illness These factors reflect the multi- Physiological dimensional influences of Pathology health & illness and how they Biomedical may be experienced by individuals. Psychological Social Thoughts Memory Environmental Step back from the disease and Emotions Cultural see the patient, their Social experience and how you can support them. Adapted from Engel 1997 Biopsychosocial Model applied to oral health Physiological Link back to definition of oral health. Caries Difficult to eat/speak/smile We could restore the caries well, but if we do not take time to understand the experience/concern/influencing factors of the patient and their illness, things will not Social change. Psychological Family attitudes Pain Access to care Affects self-esteem Every patient will experience it differently. Social life Adapted from Engel 1997 Psychological and sociological factors related to oral health and care Psychological Sociological Complex interplay Lived Access to Structure of Cultural Perceptions Experiences Emotions Social norms experiences care dentistry norms Oral hygiene Beliefs Pain Joy Patient Barriers NHS Eating habits habits Professional Drinking Attitudes Positive Anxiety Facilitators Private Social habits (yours) habits... Negative Fear......... Upbringing Family habits This is not an exhaustive list  These factors are in a When do psychological and sociological constant and complex interplay with factors influence oral health: individuals and society in and outside the dental clinic. Unrelated Before a During a After a to a dental dental dental thoughts from dental visit thoughts, eg visit thoughts, eg visit social media experience - are visit fear, anxiety, fear, anxiety - and news they in more or guilt, shame look for signs stories +/- less pain? access, time allowed for social settings planning and appointment ? will they return? eg friends ask booking running late you questions appointment what will they cultural eg experiences, eg trust in share with loved portrayal in pain relationship ones about their films experience?  Impact – both patient and I took time to understand Activity 2: Running late each other – why we behaved the way we did. This improved our patient-professional relationship, their oral health and my own self-awareness. Theres always more to the story, stop and reflect - what else? Patient late >10minutes for 3rd time Me – I feel frustrated, irritated, thinking that this is going to make the rest of my day late. Patient – says ‘you look annoyed’ Me – oh dear I thought, honesty is best policy – explain why and impact, apologise Patient - explains own situation further We agree a change for next time. Activity 3: Reflection Think about a time where you have had to wait because something/one was running late eg doctor/dentist/health appointment. What do you remember about it? What were you thinking? How did it make you feel? What else was happening in your life/that day – before and after – that might influence your reactions? Now flip it so you swap roles – how does this change your thoughts? How you can incorporate this into your practice… WHAT DOES THIS MEAN FOR THERAPISTS AND HYGIENISTS? How to apply it into your practice: Self- Patient- Patient- awareness centred care Patient professional through and history taking relationship reflective enhanced practice oral health Revisit this in Year 2 and Year 3 to help make more sense of it after you have had experiences with patients. Activity 4: What’s your internal weather? Guided meditation explaining here by Dr Mahrukh Khwaja: https://youtu.be/806GMo7XLZI?si=hFwjq92DCYP0yMai Summary Psychology Concepts, definitions and relevance Sociology Biopsychosocial model of health The complex interplay of Influencing factors and their impact on oral health and patient centered care psychological and sociological factors Effective patient history taking, Role of Dental therapists and Build effective patient-professional relationships hygienists Own self-awareness and insight through reflection References: Armfield, J.M., Stewart, J.F. & Spencer, A.J. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health 7, 1 (2007). https://doi.org/10.1186/1472-6831-7-1 - Demonstrates the impact of dental fear on oral health. Downie M, 2017. The dental psychological interface. Scottish Dental Magazine. Available at: [https://www.sdmag.co.uk/2017/04/07/the-dental-psychological-interface/] Accessed: 10 May 2021 - Provides an introduction to history of psychological and case studies in dentistry. Freeman, R. The determinants of dental health attitudes and behaviours. Br Dent J 187, 15–18 (1999). https://doi.org/10.1038/sj.bdj.4800192 https://www.nature.com/articles/4800192 - Discusses the psycho-social factors as determinants of behaviour. Freeman, R. 1999. Reflections on professional and lay perspectives of the dentist–patient interaction. Br Dent J 186, 546–550. https://doi.org/10.1038/sj.bdj.4800166 https://www.nature.com/articles/4800166a1 - discusses the balance of patient and professional perspectives with examples. General Dental Council, 2024. Focus on Standards, Principle one. Available online: https://standards.gdc-uk.org/pages/principle1/principle1.aspx Accessed 6 September 2024 – outlines the 9 principles for the dental team. Oates, J., Weston, W.W. and Jordan, J., 2000. The impact of patient-centered care on outcomes. Fam Pract, 49(9), pp.796- 804. – discusses the impact of patient centred care. Song Y, Luzzi L, Chrisopoulos S, Brennan D. Dentist-patient relationships and oral health impact in Australian adults. Community Dent Oral Epidemiol. 2020; 48: 309–316. https://doi.org/10.1111/cdoe.12534 – discusses the role of dentist-patient relationships.