117An Audit of Oral Hygiene in an Acute Stroke Unit; Paving a Path for Improved Dental Care

Abstract

Introduction: The British Society of Gerodontology have published guidelines for the Oral Healthcare of Stroke Survivors. (1) It highlights the risk that poor oral health poses for stroke survivors and emphasises the importance of including oral care measures in post stroke care protocols. The National Stroke guidelines do not reference dentistry specifically which is confounded by a paucity of evidence for staff led interventions in this area. (2) The combination of stroke-related and pre-existing risk factors for poor oral hygiene can negatively impact nutritional status and also increase the risk of aspiration pneumonia which can have repercussions for rehabilitation and functional outcomes.(3, 4) Aim The aim of this audit was to identify risk factors, both stroke-related and pre-existing, for poor oral health in all post-stroke patients admitted to the Acute Stroke and the Rehabilitation Units across UCHG, with a view to developing an Oral Care pathway for this patient cohort. Results: 25 patients in total were identified, 12 (48%) in the acute stroke unit and 13 (52%) in the inpatient rehabilitation facility. 13(52%) had either dysphasia, dysphagia or both, secondary to their stroke. 23(92%) were prescribed medications with oral side-effects. 6(24%) were taking fortified diet supplements. 14(56%) had a significant smoking history. 13(52%) had dentures, with 2(8%) having new problems with their dentures since the stroke. 4(16%) had been to a dentist in the last year. Conclusion: Our audit identified that this cohort of patients is at increased risk of oral health problems due to both prescribed medications and physical complications following their stroke. The majority of patients did not have a recent or upcoming dental assessment. This information emphasises the need for an oral healthcare protocol as part of the stroke management pathway which will be developed following a planned education session to be delivered to our multidisciplinary colleagues.