In 2016 Harriet undertook a placeent as part of her clinical rotation training as a student Dental Hygienist at the University of Bristol Dental Hospital, delivering mouth care to vulnerable patients in both the stroke ward and the intensive care unit.  For instance, Harriet was able to contribute to and provide mouth care to soothe a patient’s painful mouth by assisting with brushing using a TePe Special Care Toothbrush and moistening their mouth using BioXtra Dry Mouth Gel. On another occasion, she located an untreated mouth ulcer in a patient who was on an End of Life (EoL) care pathway. In both cases, Harriet’s professional oral health care brought enormous relief to the patient and had a hugely positive impact on their quality of life.  Harriet undertook some further research, which uncovered that hospitalisation is linked to a deterioration in dental health, which can then lead to: -

 

• Poor nutritional intake
• An increase in hospital acquired infections such as pneumonia
• Longer hospital stays
• Increased care costs (Doshi, 2019).

 

In February 2019, Harriet achieved a position as Clinical Mouth Care Training Lead for Health Education England (South West) with key responsibility for Great Western Hospital, Swindon.  She is part of the HEE South West Mouth Care Matters team headed up by past president of the British Society of Dental Hygiene and Therapy (BSDHT) Mike Wheeler. The team developed a number of new initiatives, such as implementing that each patient should have a specific mouth care plan, and introducing a new Oral Health Assessment Tool, with all patients having their mouths assessed within 24 hours of admission.

 

Although Covid-19 was a disruptive force for many healthcare sectors, the team found that it only increased their commitment to make changes. This was reinforced when Public Health England (PHE) produced guidance entitled ‘Mouth care for hospitalised patients with confirmed or suspected COVID-19’.  With mouth care services increasingly in demand, Harriet produced a video demonstrating basic care techniques such as tooth brushing and applying dry mouth products, enabling her to provide information and guidance to many more people than she could in person. Additionally, with her colleague Jo Prior, Harriet started a “Trolley Dash”. Using donations from commercial companies including TePe, they created welfare packs for staff consisting of a TePe Compact Medium Toothbrush, Interdental Brush trial packs, EasyPicks in XS/S, disclosing tablets and leaflets about looking after your own oral health, plus a tube of Oral B toothpaste.  Staff had to answer three questions about mouth care to win the pack, so the whole initiative was educational as well as great fun. The improved knowledge of the nursing staff made them more likely to include an element of mouth care within their approach to patients, so the positive impacts were far reaching. The programme was further reinforced by organising drop-in sessions for staff on a Friday, so expert advice was never far away.

 

Harriet is proof that with passion, commitment and hard work mouth care can form a core element of the holistic health care approach.  This can deliver significant improvements in general health and in particular in the patient’s sense of wellbeing. Most of all, Harriet’s innovative approach with trolley dashes, quizzes and drop in sessions proves that improving awareness of mouth care isn’t just important, it can be great fun too.