New research suggests that oral health deteriorates during hospitalisation and is associated with an increased risk of malnutrition in older patients.
Research published in the Journal of Clinical Periodontology1 provides the latest evidence that oral health is being overlooked in hospitals, with potential serious consequences. The research examined the oral health of 162 patients on arrival and two weeks later and discovered an increase in gum disease and levels of plaque.
The research also found that ‘the hospitals had no policies in place for routine oral health practices, and that no members of the hospital teams assessed the patients’ oral health conditions during the hospitalisation period’.
A French study into the oral health of hospitalised elderly patients also identified a number of problems. The research found that poor oral health could be linked to a negative effect on nutritional status2, highlighting the need for better food choices for patients.
In previous studies, poor oral health and dysfunction has been linked to a negative effect on nutritional status. There are also consequences for quality of life, well-being and personal dignity during hospital stays.
The research points to several potential reasons for the decline in oral health during hospitalisation including the low priority given to oral care provision and the implementation of improper oral care regimes, both as a direct consequence of hospitalisation.
Dr Nigel Carter OBE, Chief Executive of the British Dental Health Foundation, thinks both studies point to a clear need for oral health to be a greater priority during hospital stays.
Dr Carter said: “In a challenging hospital environment it may be inevitable that oral care is seen as a low priority, but it is clear that more needs to be done. Low priority is given to oral care provision, which includes the implementation of proper oral care regimes.
“There are guidelines for the provision of oral care in hospital settings, but as the research points out, there is limited detail for carers. The help of close family and friends during hospital stays can make a difference to this aspect of their care and well-being and more should be done to encourage their involvement.
“It is also clear from the Campaign for Better Hospital Food initiative that standards need to be improved. There is a link between nutrition and oral health, and we call on the Government to implement compulsory hospital food standards.”
Alex Jackson, Co-ordinator, Campaign for Better Hospital Food, added: “Many patients complain about losing weight in hospital because of the lack of appetising, nutritious food on offer to them, and it comes as no surprise that this problem might be made worse by inadequate oral care available to them during their stay. Hospital meals in England are often poor quality and unhealthy and inappropriate to the needs of the patient. This is particularly unacceptable for patients suffering from dental health issues who may not wish, or be able, to eat what’s on offer if it is difficult to chew and contains lots of sugar, salt and saturated fat. The government must help to improve oral care in our hospitals by ensuring that patient meals are healthy, freshly prepared and presented in a manner which helps patients to eat.”
Anyone who wants advice about the oral care of a loved one in hospital can contact our Dental Helpline on 0845 063 1188. The line is staffed by qualified dental nurses, who will be able to advise how best to provide oral care during hospitalisation and what to do when the patient is discharged and returns home.
1.Sousa LLA, Silva Filho WLSe, Mendes RF, Moita Neto JM, Prado Junior RR. Oral health of patients under short hospitalization period: observational study. J Clin Periodontol 2014; doi:10.1111/jcpe.12250.
2.Gerodontology 2014; doi: 10.1111/ger.12123 Relationships between oral health, dysphagia and undernutrition in hospitalised elderly patients