- Published: Monday, 11 September 2023 07:40
- Written by Guy Tuggle
- Hits: 1095
Patients in hospitals and care homes who lose their dentures are costing the NHS £1.9m, in a conservative estimate. But aside from the financial cost, the inconvenience and distress caused to patients has a much higher price.
Dentures are typically lost in bedding, are wrapped in tissue and left on meal trays only to be discarded, are ’lost in transit’ between wards and establishments or may be ’vomited out’. In addition to loss of dignity, a patient’s ability to eat is severely compromised, thereby placing an additional burden - and cost - on care providers at meal times.
The problem was highlighted and reported as far back as 2017. 89% of dentures lost in hospitals are not found, igniting an often lengthy and distressing patient journey. To compound the problem, many ’victims’ are frail, elderly, and lacking in mental capacity.
In his latest NHS and Oral Health Update (4th September) Interim Chief Dental Officer for England Jason Wong has turned a spotlight on the issue, signposting readers to the recently published Guidelines for Preventing and Managing Denture Loss in Hospitals and Community Residential Settings.
An average of 3,375 dentures are potentially being lost or broken in hospitals every year and this figure is likely to be higher when community rehabilitation facilities are included.
Many denture loss events ultimately end up at the door of the patient’s dentist to resolve.
In his communication, Wong states ’Denture loss is often underreported in hospital and community residential settings due to a lack of standardised prevention or management policies regarding denture loss.
Hospital patients and community service users often move between rooms, wards and departments, making the loss of dentures more likely to occur during these transfers, or during mealtimes or sleep, when dentures may be removed and inadvertently disposed of.
The Guidelines make various recommendations which, when followed, should reduce the incidence, cost and human inconvenience of denture loss in care. All clinical and social staff providing care to patients in a hospital and community residential setting fall within scope.
Amongst the proposals are an oral health assessment for all patients being admitted for more than 24 hours. In hospital scenarios, it should be documented if a patient has brought dentures and if the admission is via A&E the patient should be asked if they wear dentures and provided with a labelled container.
Upstream, it is recommended that patients known to be at risk are provided with ’labelled’ dentures by their dentist. During fabrication, laminated paper, which includes the patient’s first initial and surname in size eight font should be included in the denture. This simple procedure (see 4.4 of Guidelines) will require consent from the patient of those with POA over them.
The appointment of a ’Lead’ to police compliance, training of staff and record keeping are inevitable bricks in the wall of the new Guidelines.
Urging the profession to read and embrace the Guidelines, Jason Wong said ", I hope that this work will increase the number of dentures being labelled by the dental team. Increased awareness and practical application of denture labelling will result in reduced numbers of dentures being lost, and in turn will help to maintain the dignity and quality of life of many patients".
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