A senior dentist has said the unregulated use of fortified high sugar food supplements is causing untold damage to the oral health of thousands of nursing home patients all round the country.

Dr Anne Twomey said the situation was further compounded by a culture of giving gifts of sweets or soft drinks to nursing home patients while simultaneously failing to meet their dental needs.

“These fortified oral nutritional supplements can be effective in increasing a patient’s calorie intake but one of the consequences of constantly sipping these high sugar content drinks is the very negative effect they have on patients’ oral health. When you add in all the gifts of sweets and soft drinks which patients receive you have a recipe for disaster.”

Dr Twomey pointed out that because of the medication these patients are on many of them suffer from dry mouth and this accelerates dental decay.

“Patients who’ve kept their own teeth into old age can lose them in as little as three months. Very often the situation has reached crisis proportions by the time I’m called in and I have to take out 15 to 20 teeth over a short period of time.  Although these patients are among our most vulnerable citizens with limited control over their daily lives, they have little or no access to oral hygiene and preventive measures. For example I came across a case where a woman hadn’t had her teeth brushed in two years.” (See case studies below)

“In addition dentists are generally not included in the multidisciplinary teams which care for them. Basically the HSE is reneging on its duty of care to some 27,000 nursing home patients by completely failing to meet their dental health needs” she said.

Dr Twomey, who is Vice President of the Irish Dental Association, highlighted this issue in a recent edition of the Journal of the IDA. She said a three pronged approach needed to be implemented as a matter of urgency

A low-sugar message should be sent out to all.

“These patients did not reach old age with their original teeth on a high-sugar diet. As well as carefully monitoring the intake of high-sugar food supplements, family and carers should be encouraged to provide low-sugar treats. Patients’ bedrooms often resemble a sweet shop and this will require a cultural change.”

The HSE and HIQA need to step up to their obligations

“As the case studies highlight, this situation cannot be allowed to continue. Training programmes for healthcare assistants in oral care should be mandatory and meaningful. A written oral care plan should be created with these patients where family and carers are involved”

Healthcare professionals should be obliged to involve a dentist in their patient’s care

“Dentists need to be involved when doctors prescribe a high-sugar food supplements or when a chronic debilitating condition is first diagnosed or when a patient is at high risk of inhalation pneumonia. This will reduce crisis management of these patients and help reduce the amount of dental clearances that are needed.”