Facilitators and Challenges in Oral Health Care for Iranian Patients Undergoing Opioid Maintenance Treatment: A Qualitative Study.

Introduction: This qualitative study aimed to explore the challenges and enablers of oral health care for patients receiving opioid maintenance treatment. Methods: Forty-nine patients under opioid maintenance treatment were included in the study. All interviews were audio recorded and transcribed verbatim. The interview proceeded until data saturation, after which the collected data were analyzed using content analysis methods. Findings: The most common reasons for problems preventing access to dental services include lack of financial resources, long travel distances (e.g., living in mountainous areas), prioritizing drug seeking, limited availability of dentists, addiction-related indifference, difficulty tolerating waiting times, fear of arrest, lack of time off from work, and prioritizing substance use over dental treatment. Two participants reported that the clinic staff were kind and behaved appropriately. Additionally, seven participants stated that the staff did not discriminate between them and other patients. Regarding dental services, the participants requested that costs be covered, services be insured or free, and that they be informed about suitable service locations. Conclusion: Patients undergoing maintenance treatment with opioids need more oral and dental health care than the general population. For better access of patients undergoing opioid maintenance treatment to these services, it is better to provide special centers for these people with trained personnel to treat them with insurance coverage.