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Barriers to Accessing Primary Dental Care in Adults with Alcohol Dependence: A Qualitative Study

Lookup NU author(s): Charlotte Bowes, Dr Matthew Breckons, Dr Richard HolmesORCiD, Professor Justin DurhamORCiD, Dr Beth Bareham



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background:People with alcohol dependence (AD) frequently experience oral health problems, but their dental attendance is poor, with limited evidence to the reasons why from their perspective.Objective:To explore perceived barriers, motivators, and facilitators to accessing primary dental care in people with AD.Methods:Qualitative study consisting of remote one-to-one and group semistructured interviews with a convenience sample of adults with lived experience of AD in northern England. Data were audio-recorded, transcribed, and coded. A reflexive thematic analysis method was used; use of COM-B model informed data interpretation.Results:Twenty adults with lived experience of AD participated in 18 one-to-one interviews and 1 group interview (of 3 participants). Barriers to access were fear and physical, social, and environmental factors (physical effects of AD, financial barriers, nonprioritization of oral health). Motivators to access were pain and prioritization of oral health. Facilitators to access were patterns of alcohol use (i.e., sobriety) and dental service provision within recovery services.Conclusions:Fear of “the dentist” is a major barrier to accessing dental care, and pain is the primary motivator, among people with AD, although neither are unique to this population. Fear and physical, social, and environmental barriers to access contribute to problem-oriented attendance, which negatively affect oral health outcomes. Opportunity to facilitate attendance increases when a person is in remission from AD through their physical capabilities improving. Increasing capability and opportunity can influence attendance beyond the automatic motivation of pain. Provision of dental care within recovery services could facilitate access to care. Understanding the “web of causation” is key to developing any intervention to improve dental access in people with AD. Further research is needed from the perspective of other adult populations with lived experience of AD, as well as of dental professionals, to gain deeper insight into barriers, facilitators, and possible solutions.

Publication metadata

Author(s): Bowes C, Breckons M, Holmes RD, Durham J, Bareham BK

Publication type: Article

Publication status: Published

Journal: JDR Clinical & Translational Research

Year: 2024

Pages: epub ahead of print

Online publication date: 27/01/2024

Acceptance date: 28/03/2023

Date deposited: 02/02/2024

ISSN (print): 2380-0844

ISSN (electronic): 2380-0852

Publisher: Sage Publications, Inc.


DOI: 10.1177/23800844231169642


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