Brushing up on oral hygiene with denture campaign

A denture campaign is helping patients and staff brush up on oral hygiene skills to prevent prolonged stays in hospital and reduce the risk of life-threatening complications.

Failing to maintain a healthy mouth can result in a number of wide-ranging problems, varying from very minor discomfort to even putting life at risk.

At its worst, poor oral hygiene can lead to respiratory infections, chest infections, aspiration pneumonia or even bacterial endocarditis.

An educational programme, designed by one of Swansea Bay’s experienced dental nurses during the pandemic, is getting to the root of the problem by spreading the word about good oral hygiene to both patients and staff.

The Denture Daisy was developed by Sarah Francis, who works in Morriston Hospital’s Head and Neck Department.

Its focus was initially around denture awareness for colleagues, but has since led to further training for staff as well as promoting oral hygiene to patients. It has also nurtured ‘mouth care champions’, who ensure high standards are maintained on the wards they work on.

Sarah’s efforts led to a nomination for the health board’s Living Our Values Awards 2022, as well as further internal recognition.

PICTURED: Sarah with Executive Director of Nursing Gareth Howells.

Sarah said: “I came up with the Denture Daisy during the first outbreak of Covid when dental nurses were asked to work on the wards to help out.

“When we were accompanying health care support workers and washing patients, I noticed that personal care tended to start from the neck down while the mouth was overlooked.

“When we asked patients if they wanted us to clean their teeth, they would often say they didn’t have anything with them, or they didn’t do it because their gums would bleed, and they’d be scared by that. We’d reassure them that by cleaning their teeth and gums regularly then that would stop their gums bleeding and they’d be a lot healthier for it.

“There were also occasions when patients’ dentures were not cleaned daily and denture pots were not always provided on the wards as staff were unaware some patients had dentures, so we needed a way of correcting that.”

Sarah then planted the seed of the Denture Daisy,  which began as a symbol placed on a patient’s bed to inform staff that they wear dentures.

Working alongside Belinda Walters and Sian Morgan from the Medical Illustrations team, Sarah designed posters to highlight where dentures get lost - under bed sheets, wrapped in tissues or on meal trays.

As well as improving patient care, the scheme also saves money, as the cost of replacing lost dentures can range between £280-£2,500.

It is the value in health benefits, however, which top the priority list.

Sarah, who has been a dental nurse for 33 years, has trained staff across Morriston Hospital. She said: “I have a massive passion for oral health, and it’s something I have worked really hard to make people aware of.

PICTURED: Sarah with a Denture Daisy poster highlighting the importance of healthy oral hygiene.

“The training educates staff on the importance of promoting healthy oral hygiene to patients and identify whether they need help to clean their teeth or dentures. Nurses are very busy on the wards and have a lot of responsibilities, but this education is so important.

“Good oral hygiene can give some people their independence back, while educating staff on how to recognise common mouth problems, such as dry mouth, can really make a difference to a person’s quality of life.

“So it’s essential that staff help people take care of their mouth. Mouth care champions are being reintroduced on the wards to ensure there is always a supply of mouth care tools and products available, while they also educate colleagues on the importance of good mouth care.”

She added: “Poor oral health has serious health implications. If a patient’s mouth is not clean it could lead to respiratory infections, chest infections or aspiration pneumonia, which is caused by breathing in vomit, a foreign object such as a peanut or a harmful substance, such as smoke or a chemical. All of these can add to a patient’s length of time in hospital.”

Sarah explained that bleeding gums can lead to bacteria entering the blood stream through the veins in a patient’s neck and attack heart muscles which can lead to bacterial endocarditis - a potentially life-threatening condition.

“For example, a patient who needs a new heart valve would see us for a dental assessment. But if they have broken teeth or abscesses, we would need to remove them before they go for surgery as they would be vulnerable for bacterial endocarditis,” she said.

“I tell staff that they can’t control how our patients come in, but you can give them a clean and comfortable mouth when they leave.”

Clinical educator Heather Harries said: “The daisy denture has been included in all of the training Sarah has delivered to myself and wards within medicine. It has provided us with a positive prompt.

“The denture daisy not only benefits staff’s knowledge, but, most importantly, it helps patients maintain healthy oral hygiene.”

PICTURED: Sarah was among the nominees for the health board's LOV Awards 2022.

Sarah was among the nominees for the health board’s annual awards last year, while she has also received an Executive Director of Nursing award certificate of excellence for her work.

Executive Director of Nursing Gareth Howells said: “Sarah is an excellent role model and has been driven and self-motivated to push this passion forward.

“Sarah is such an asset to the head and neck department in Morriston Hospital and to the health board. She is an inspiration to us all in ensuring that our patients receive the best care in an area that is so important to their comfort and well-being.”