Jessica Mann, Dental Core Trainee and Mili Doshi, Special Care Consultant. Mili Doshi will be speaking at BGS Spring Meeting in Gateshead.
Did you know there are more bacteria living in your mouth than there are people in the world? The mouth is biggest hole in the body – it is highly visible, we eat though it, talk through it and smile with it, but when we need help caring for it, often that help is not there! Yet deteriorating oral health can have severe consequences for the rest of the body…
If you have a problem with your vision a doctor will check your eyes, but if you are not eating is it common practice for a doctor or nurse to check if there are problems with the mouth? Can you imagine how it would feel if you hadn’t brushed your teeth for a week, or if your mouth became so dry through dehydration, that your tongue became stuck to your palate? For these reasons alone, we need to raise awareness amongst staff and patients and put the mouth back in the body.
The oral cavity is the gateway to our body; we need a functioning mouth to eat, speak, and smile. If we don’t remove the bacteria (plaque = bacteria) in our mouths by daily brushing, it can lead to aspiration pneumonia, a condition with high mortality rates extending hospital stay by an average of eight days. There is evidence that poor oral health is linked to systemic conditions such as aspiration pneumonia, diabetes, cardiovascular disease and even dementia.
Remember when the handwashing campaign was introduced into the NHS? This simple, yet effective concept has significantly reduced the rate of hospital acquired infections. The Mouth Care Matters initiative is another simple concept; putting the mouth back into the body and making it part of the patient’s daily care routine. In essence, it asks that staff look into the mouth, treat it like any other part of the body and incorporate it into their daily care routine. If someone was soiled, unclean and suffering with bed sores you wouldn’t allow it to remain neglected as we know the consequences, why should this happen with the mouth?
The poor state of mouth care for hospital patients is not the fault of hospital staff – sometimes it can be as simple as not having a stock of toothbrushes on a ward, and nursing assistants, who attend to most mouth care, often have no training. How can we expect someone to support tooth brushing for a patient with dementia who is saying ”no, no, no”, if they haven’t had training on how to manage this? Training staff so they understand why oral health is so important and arming them with the skills needed to deliver it is therefore vital. Hospitals must also be adequately stocked with appropriate mouth care products.
Most doctors receive no oral health training in their undergraduate or postgraduate training and so it is perhaps unsurprising that in a recent hospital-based survey, 100% of junior doctors said they did not feel very confident in diagnosing oral related conditions. Training in diagnosis and management of common oral conditions such as oral thrush and mucosal ulceration is essential. Incidence rates for oral cancer are projected to rise by 33% in the UK by 2035 (to 20 cases per 100,000 people) – doctors must therefore be aware of the early signs and symptoms if better outcomes are to be achieved.
Want to learn some more about oral health and about how multidisciplinary teams can work collaborative to improve it? If so, there’s a dedicated oral health talk at the upcoming BGS meeting – we hope to see you there.