Oral Health Improvement for People Who Use Drugs

Funding and Collaborations

This project was funded by the Scottish Government and the Corra Foundation and delivered in partnership with Public Health Scotland (PHS), NHS Education for Scotland (NES), and the Scottish Drugs Forum (SDF).

This project explored barriers and facilitators to good oral health for people who use drugs in Scotland and developed practical, co-designed resources to support improved access to care.

The work combined service evaluation and qualitative research involving 90 participants across Scotland, including:

• Health and social care professionals
• People with lived and living experience of substance use

The outputs are now live and in use nationally.

Why This Work Matters

Substance use is a significant public health challenge in Scotland. With an estimated 191 associated deaths per million people in 2024, its drug-related mortality is, per capita, substantially higher than any other constituent country of the UK, and almost ten times the European Union average.

People who use drugs often experience disproportionately poor oral health. This is influenced by:

• Tooth decay, teeth grinding and dry mouth 
• High sugar diets
• Reduced access to dental care

Poor oral health contributes to social stigmatisation, alienation, and low self-esteem, and may undermine recovery efforts. Improving oral healthcare for this group is therefore a public health priority in Scotland.

What We Did

The project used a mixed-methods qualitative approach informed by behaviour change theory. We conducted:

• Online surveys
• Semi-structured interviews
• Focus groups
• A stakeholder co-design workshop

Findings were mapped using the Theoretical Domains Framework and Behaviour Change Wheel to inform intervention development.

Key Findings

Participants strongly agreed that oral health is important but reported significant structural and motivational barriers to engagement. The study identified several consistent barriers:

• Oral health is often deprioritised during active substance use
• Limited awareness of available targeted services
• Health and social care staff’s limited awareness of appropriate engagement strategies related to people who use drugs.
• Health and social care staff’s limited awareness of the oral health implications of substance use.
• Stigmatising experiences within healthcare and social work settings
• Limited collaboration between services

Project Outputs

This project produced:

1. E-learning for Dental Teams titled “Drug Use and Oral Health: An Update for the Dental Team”

This bite-sized ‘Open Badge’ module provides training on the typical lifestyle/characteristics of people with experience of drugs, education on how to address addiction without judgement and language to use to reduce stigma and encourage re-attendance. Completion of the module will provide 1 hour of eCPD for General Dental Council (GDC) registrants. 

The module can be accessed on Turas at: Drug use and oral health : An update for the dental team | Turas | Learn. 

2. E-learning for Social Care & Third Sector Staff titled “Helping People Who Use Drugs with Their Oral Health”

This bite-sized ‘Open Badge’ module provides people who work with those who use drugs,  for example social care or charity workers, with training on how to identify poor oral health, advice on managing this and where to direct patients for support. 

For those working in social care, the module provides a Scottish Social Care Council (SSCC) credit and can be accessed at: https://www.mylearning.scot/badges/helping-people-who-use-drugs-with-their-oral-health/. 

For anyone outwith the social care sector, the module can be accessed on the Turas website at: https://learn.nes.nhs.scot/86300/nes-dental-e-learning/helping-people-who-use-drugs-with-their-oral-health. Please note you must have a Turas account to access the training modules, however anyone can sign up for free on the Turas website. 

3. Targeted Oral Health Information Resource

A fold-out patient information leaflet designed for people actively using drugs and those recovering from drug use. The leaflet contains basic information on common oral health issues associated with substance use, what to do in an emergency, and signposting to both OHI contacts (adapted to board) and addictions support resources. 

The leaflet can be viewed/downloaded through Better Oral Health for Adults in Scotland: Drugs and Oral Health - Publications - Public Health Scotland

4. Revised Comic Resources

Existing comic-style oral health materials that were co-designed with the Scottish Drugs Forum (funded by the Corra Foundation) were refined and reissued following participant feedback. 

• Better oral health for adults in Scotland: dental health access when using drugs - Publications - Public Health Scotland
• Better oral health for adults in Scotland: looking after my dental health - Publications - Public Health Scotland

National Dissemination 

To support with the national dissemination of these resources, in February 2026, a webinar was delivered to showcase:

• Project findings
• Educational resources
• Information materials
• Implementation pathway

The recording of the webinar is available below.