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Failure to diagnose oral health conditions can prolong patients’ stay in hospital


  Posted by: The Probe      13th September 2019

The British Dental Association (BDA) has called for better oral health care for patients admitted to hospital, as new research shows a lack of oral health training among junior doctors could be impacting on patient care and jeopardising recovery times.  

The authors of A survey of the knowledge of junior doctors in managing oral conditions in adult in patients(1), published today in the British Dental Journal, identified that routine failures to assess the mouth and misdiagnosis of oral conditions by doctors can contribute to longer hospital admissions. 

The study, based on a survey of 146 junior doctors, found that most (92%) of them did not feel confident in diagnosing common oral conditions and 50% did not routinely assess the mouth as part of their oral health assessment. Only 39% were able to spot signs of oral cancer.

Equally worrying, the researchers point out, is that the provision of onsite or domiciliary dental services to treat urgent oral conditions that develop when people are in hospital is not always available and this could contribute to their overall health and recovery. The BDA has expressed deep concern over the lack of integration and dental provision across all care settings, starkly illustrated in the Care Quality Commission’s (CQC) recent report on care homes

The BDA believes that Ministers should prioritise this when the average age of hospital patients is now 80 years(2) and more older patients are retaining at least some of their teeth for life(3). Oral health is an integral part of general health and these issues need to be addressed. 

Peter Dyer, BDA chair of hospital dentists, said: 

“Dental care for inpatients, particularly the elderly, must be recognised better in our hospitals.

“Failure to engage on oral health can jeopardise the recovery of older patients, as pre-existing problems go untreated, and conditions – including cancers – may not be spotted.   

“The result heaps more pressure on our NHS. Yes, doctors need appropriate training, but health bosses must also ensure appropriate dental services are actually available for inpatients.  

“Oral and dental diagnosis with referral to the appropriate department for treatment can be key if we want to reduce unnecessary care and prolonged stays in hospital.”

1. Mili Doshi, Maydini Weeraman and Jessica Mann. A survey of the knowledge of junior doctors in managing oral conditions in adult inpatients. Br Dent J 2019; 227 No. 5, September 13, 393-98.

2. King’s Fund, cited in the above study.

3. The Faculty of Dental Surgery of the Royal College of Surgeons, England, estimates that at least 1,8 million people over 65 have existing oral disease before admission and untreated tooth decay.

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