King's nursing student explores the role nurses can play in the oral health of mental health service users
Ashley Morgan, a Postgraduate Diploma student in Mental Health Nursing from the Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, recently published a comment piece in the British Journal of Mental Health Nursing on how to effectively empower mental health nurses to promote and assess the oral health of mental health service users in inpatient settings.
The article points out that effective oral assessment is one the key recommendations of the government’s Five Year Forward View for Mental Health ‘for addressing the stark inequalities in oral health outcomes for people living with serious mental health problems.’ It goes on to note that ‘people who use mental health services are more likely to experience significant tooth loss and decay than the wider population.’ In addition, there are specific patients with ‘long-term mental illness, who are at greater risk of dental problems—for example as a result of medications or lifestyle factors such as smoking.’
However, in spite of this clear need, the piece states that ‘many mental health nurses do not carry out oral assessment’. In addition, many nurses experience obstacles when undertaking effective oral health assessments and oral health promotion for mental health patients in inpatient settings. Some of the difficulties nurses may experience included a lack of knowledge, including on the side effects of certain medications on oral health. In addition, although generic oral health assessment tools are widely available, these are not used as often as they could be, with many nurses relying on subjective assessments.
The author concludes that a flexible assessment tool could be developed to help guide nurses through key screening factors in oral health amongst the inpatient mental health population, including information on the effects of medication and lifestyle factors. This tool could include preventative and risk-reduction measures, as well as identifying and documenting poor oral health for treatment. The article also suggests both pre- and post-registration nursing training could be an effective way to help bridge the gap between theory and practice. Finally, the article recommends that additional research be undertaken to understand why many mental health nurses do not carry out oral assessments for patients.
Ashley Morgan commented, “I developed a strong interest in the oral health of patients in inpatient mental health settings during my time as a student mental health nurse. I feel this is an under-valued area of health, and if mental health nurses could be better supported to carry out assessments and promote good oral health, it would have a big impact on patients.”
Professor Jenny Gallagher MBE, Head of Division, Population and Patient Health, King’s Dental Institute added, “It is important to make every encounter count for health – and that includes oral health, which is important for general health and wellbeing. Health professionals definitely need to work together to support people with mental health problems, who can often have poor oral health and require support to reduce their risks of disease and access appropriate care. This is an important area for workforce capacity building and networking.”
Professor Gallagher also pointed out a recent paper, which concluded that ‘psychiatric in-patient settings may provide important opportunities for oral health promotion and intervention [and] this is a neglected component of in-patient care.’ Many of the patients who took part in this particular study did not even have a toothbrush or toothpaste before attending a dedicated inpatient dental clinic.
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For further information please visit the Florence Nightingale Faculty of Nursing and Midwifery website: http://www.kcl.ac.uk/nursing/Index.aspx, or contact Sylvia Christie, Senior Communications Officer at the Florence Nightingale Faculty of Nursing and Midwifery: sylvia.christie@kcl.ac.uk or 020 7848 3062.
For further information about the King’s College London Dental Institute, please contact Laura Shepherd, Senior Communications Office on 0207 188 1163 or laura.2.shepherd@kcl.ac.uk
Notes for Editors:
Papers mentioned in this release:
Oral health assessments: Obstacles, opportunities and achieving better outcomes. Ashley James Morgan. British Journal of Mental Health Nursing (2016), volume 5, issue 5. DOI: http://dx.doi.org/10.12968/bjmh.2016.5.5.212
Perceived oral health needs in psychiatric in-patients: impact of a dedicated dental clinic, Tom Stevens et al.The Psychiatrist (2010), 34, 518-521. DOI 10.1192/pb.bp.109.029157
Florence Nightingale Faculty of Nursing & Midwifery
The Florence Nightingale Faculty of Nursing & Midwifery at King’s College London has its origins in the first nursing school in the world established by Florence Nightingale in 1860.
The Faculty is ranked as the number one faculty for nursing in the UK (QS World University Rankings 2015/16) and works in partnership with leading London NHS Trusts. With close links to industry, health services and policy makers, the Faculty develops leading-edge nurses and midwives of tomorrow – practitioners, partners, and leaders in their field.
The Faculty has over 1,000 full-time pre-registration nursing and midwifery students plus an extensive portfolio of undergraduate and postgraduate activities to meet the needs of a wide range of healthcare professionals seeking continuing professional development. The Faculty is at the forefront of health services, policy, and evaluation research. For more information visit: www.kcl.ac.uk/nursing
The Dental Institute
King’s College London Dental Institute is one of the foremost Dental Schools in the world. Recently ranked fourth in the world in dentistry by the QS World University Rankings 2016, and first in the UK, the Dental Institute aims to maximise impact on health and wellbeing by integrating excellence across four areas:
- Education / teaching
- World-class science
- Clinical approaches
- Patient care
The Faculty’s international reputation attracts students and staff from across the globe. The largest dental academic centre in the UK, they teach over 700 undergraduate students, 140 graduate taught students, 300 distance learning students and 110 graduate research students.
The Dental Institute has over 85 academic staff and is organised into four research divisions: Craniofacial Development & Stem Cell Biology, Mucosal & Salivary Research, Tissue Engineering & Biophotonics and Population & Patient Health. The research divisions complement the teaching and clinical service initiatives.
As well as excellent research facilities the Dental Institute has internationally recognised education programmes. With highly skilled teachers and supervisors, there are exceptional facilities, including access to over 300,000 patients each year across the two world-famous hospitals, Guy’s and St Thomas’, for hands-on clinical training. They are one of the most comprehensive dental academic health science centres in Europe.
Further details of the Institute may be found on its website: www.kcl.ac.uk/dentistry
About King’s College London
www.kcl.ac.uk
King's College London is one of the top 25 universities in the world (2016/17 QS World University Rankings) and among the oldest in England. King's has more than 27,600 students (of whom nearly 10,500 are graduate students) from some 150 countries worldwide, and some 6,800 staff.
King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King’s was ranked 6th nationally in the ‘power’ ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King’s was deemed ‘world-leading’ or ‘internationally excellent’ (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £684 million. For more information about King’s please visit ‘King’s in Brief’.