The Mouth Care Matters (MCM) Programme aims to create a healthcare team that is more responsive and personalised for patients and delivers better clinical outcomes. Bringing an increased awareness of the importance of good mouth care, how it impacts on general health and quality of life. The initiative is relevant for all people who provide personal care to patients be that in an acute, care home or community setting.
Oral health is an important part of general health and wellbeing. It allows people to eat, speak, smile and also socialise without discomfort or embarrassment. Poor oral health can lead to a deterioration in general health. This links to quality of life and dignity. Research shows that oral care is often lacking in hospital and community care settings. Especially to those patients who may be unable to carry out their own personal care and rely on others for support.
There are four key drivers for this innovation:
Being in hospital has an impact on good oral health
There is evidence that a stay in hospital is associated with a deterioration in oral health of patients (Terezakis et al. 2011). This in turn has been linked to hospitalised-acquired infections; poor nutritional intake; longer hospital stays and increased care costs.
We are a changing population
We are an ageing population; It is predicated that by 2020 around 20% of the population of the United Kingdom will be aged 65 years or older. As people age, many will develop some deterioration in physical and cognitive abilities. Leading them to increasingly need care, either in their own or in residential or nursing homes. And so, whilst people live longer, it is estimated that up to 20% of people aged over 80 years will be affected by complex medical histories and cognitive conditions.
Our mouths are changing
As people are living longer, they are also retaining their teeth longer. In 1968, 37% of the population had no teeth in their mouths. This dropped to only 6% in 2009 (ADHS, 2009). Older people are likely to have large fillings, crowns, bridges and dental implants, all of which need additional care to maintain and keep healthy. Unfortunately as the population gets older, many people develop medical, cognitive or physical disabilities that mean they are less able to care for their mouth and dependent on others to carry out effective care.
We are taking more medication
Dry mouth is a common side effect of over 40 medicines. Having a dry mouth can have a significant negative impact on oral health. By causing pain, difficulty in eating, speaking and an increase in dental disease. Such as dental decay, gum disease and thrush.
There is a wealth of evidence that shows that patient’s oral health was not being assessed and that hospitals and care homes had no policies in place for routine oral health practices. Many staff carrying out mouth care will have had no previous training. It has also been shown that there is no standardisation in the delivery of oral care. There is also a lack of equipment, such as toothbrushes and toothpaste or standardised mouth care recording tools. Mouth Care Matters seeks to address this.
Following a successful pilot project for the Mouth Care Matters programme, Health Education England is setting out to improve oral health. Starting with the below key areas: