Oral health; the gateway to hydration, nutrition, and medication

Yasmin Allen @missdiplom and Nikki Patel @NikkiPatel_

Yasmin is currently working as a clinical fellow in leadership and management in the HEE, her work includes promoting collaboration between health care professionals and the dental team, unscheduled dental care and improving oral health for older people in community and hospital settings. Yasmin also works clinically in the out of hours emergency dental care service on weekends.

Nikki is a community dental officer who looks after the oral health of dependant elderly or medically compromised individuals. She is currently pursuing her Fellowship in Clinical Leadership at Health Education England in London, where she is involved with projects and strategies to overall improve the oral health of the population and develop new and improved ways of working.


Toothbrush_20050716_004Cast your mind back to when you opened your eyes this morning. Then think of how your mouth felt at that time; I bet it was dry, uncomfortable, had a horrible taste and you most likely felt some plaque roughening the surfaces of your teeth. Now think about how your mouth would feel if you hadn’t brushed your teeth after waking up. Or you didn’t brush them for a week after, or even a few weeks after. Your mouth and teeth will now almost certainly feel dirty, odorous, uncomfortable and in turn it may affect your confidence and well being. This is what happens to dependant elderly people far too regularly than we would like to admit. These are the people whose personal care, including their hair care, foot care, nails care and continence care is being delivered as part of their overall support. Yet there is often one part of personal care which is frequently overlooked- the mouth.

The mouth is the gateway to hydration, nutrition, and medication. The maintenance of which is critical to ensure the good health and well being of any individual. If you have an ulcer on the inside of your cheek how do you think this will this affect how likely and how much you are to want to eat? If you have loose teeth how do you think this will this affect your chewing? How is your health going to improve if your Adcal tablet foams instead of dissolves due to the dry nature of your mouth? What if your tablets get stuck underneath your denture and nobody realises, as it hasn’t been taken out to clean? These are all real life examples of what is happening in hospitals and care facilities in the UK today.

Our health and social care professionals deliver a fantastic service across all aspects of healthcare whilst contending with time constraints and workforce capacity issues. However, all too often mouth care is one of those responsibilities that falls off the long and never ending task list.

The consequences of not delivering this simple duty are drastic. Not only does poor mouth care lead to dental problems such as dental decay and gum disease, but studies have shown it is associated with aspiration pneumonia and heart disease. Not being adequately hydrated or not receiving a balanced nutritional intake can result in medications not being absorbed properly, which can in turn affect your recovery and consequently the length of your hospital stay.

When we are older, it may be the case that we or somebody close to us, may spend some time in a health and social care facility and there may be a time when we need to rely on others for our personal care. Would it not be preferable that our stay did not result in the deteriorating condition of our mouths and teeth? That oral cancer was not spotted as health care professionals did not look in your mouth? That you refused to see family and friends because your dentures had been lost during your stay?

Health Education England is working with teams in hospital and community settings to improve knowledge and awareness amongst health and social care staff of good mouth care. Equipping them with the advice and tools to enable them to deliver mouth care and providing resources and support can help avoid some of the issues that can occur if mouth care is not delivered. We have been working to raise awareness in all sectors about how and why mouth care is essential, in addition to how mouth care affects patient safety, length of hospital stay, deterioration in care settings, well being, hydration and nutrition, medicines management and overall health.

Many healthcare professionals are aware of the importance but are not aware of the potential impact that poor mouth care can have. I urge you all to ensure that those people who are relying on others for their personal care get adequate maintenance of their mouths by ensuring good hydration, nutrition and mouth care. If you would like to find out more about the importance of good mouth care and what you can do to help please follow this link http://www.iohopi.co.uk/

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