Dental Team Accreditation Scheme

Communication

Traditionally, health care professionals including dental professionals have been considered poor at giving full information to patients.

This is especially so during routine examinations. The clinician knows what he or she is doing but often doesn’t think it necessary to pass that information on, particularly if no suspect conditions are found.

Examples of this come from surveys when dentists have been asked if they routinely check for early signs of mouth cancer and patients asked if they have received such an examination. Results indicate that while almost 100% of dentists confirm they carry out these exams less than 20% of patients actually remember having had one!

Patients cannot be expected to understand medical procedures. Hearing words like ‘buccal sulci’ or ‘parotid papillae’ means nothing to most people. It’s up to us to make it clear that an early detection exam is being done and stress its importance. It’s easy and doesn’t take up any time. We simply need to say words like: ‘Now I’m examining the skin of your face, mouth and throat for any signs of disease, including early signs of mouth cancer. It’s not just your teeth we’re interested in!’

We can follow with a brief description of how mouth cancer is still increasing in the UK, the importance of early detection to improve outcomes and the importance of monthly self-examinations using the protocols available on the Mouth Cancer Foundation website – www.mouthcancerfoundation.org. We can mention the website also contains a great deal of further information that patients can explore.

This leaves patients in no doubt of our commitment to their general well-being and increases their awareness of a poorly understood condition, and that might just save their lives!

Education

One of the greatest obstacles to early detection is patients not reporting symptoms in a timely way.

This is largely because of the public’s limited understanding of the signs and symptoms of mouth cancer or the lifestyle factors that might put them at greater risk.

Dental team members can have a huge impact in improving this situation. With proper instruction all team members, clinical and non-clinical can give advice and guidance. In addition, further information can be put on practice websites. Follow the self-check process on the relevant self-check leaflet and Mouth Cancer Foundation website – www.mouthcancerfoundation.org/wp-content/uploads/2020/10/mouth-cancer-foundation-information-leaflet-final-croped.pdf

Information that does not advertise commercial practice products or services can be sent to patients in the form of emails or email newsletters.

The charity has some great leaflets suitable for patients to take away after their check-up.

Our social media channels can also be used as can ‘live’ events on Facebook and other platforms when questions and answers can also be featured.

Press releases picked up by the local media can be very powerful especially with an accompanying story from a patient or local resident.

Many clubs and societies are keeping online contact with their members and looking for useful material to include. Healthcare information is always popular. Short videos shared with these groups can give more of a personal touch.

The important thing is to raise awareness in as many ways as possible. Information empowers people and as dental professionals we have an important role to play in the health of the wider community.

Team Meetings

The team meeting is the time to pull everything together. It’s important all team members attend. If that is not possible absent team members should be kept fully appraised by the Scheme Representative of the business of the meeting.

At the first Scheme meeting planning the implementation of the scheme should be undertaken. Different team members should be nominated to carry out various duties. Nomination is important because if this is not done there will be a high risk that each team member is under the impression that someone else is responsible for a certain task, with the result that nobody does it!

It’s important that everybody understands the purpose and the working of the scheme. It’s equally important that every member can confidently answer questions from patients so appropriate education must be arranged or provided for team members.

Local referral pathways should be investigated and recorded. Criteria for referrals should be discussed and a follow-up protocol put in place.

Many care homes have expressed a desire for help from dental professionals. The dental health of residents is often poor and residents tend not to receive regular check-up or treatment appointments. Care home staff are often inadequately trained in dental management and lacking in awareness of the signs and symptoms of mouth cancer.

Practices should contact local care homes and find out if they would like support. They can then tailor a package of support services appropriate to local needs. During the pandemic this will need to be done electronically by email and if possible, by online meetings.

Simple audit protocols should be put in place to ensure the commitments of the scheme are being met. At subsequent meetings these can be checked and improvements or enhancements discussed.

Finally, at team meetings give yourself a pat on the back to thank yourself for the great service you are providing!

Dental Team Accreditation Scheme Representative

Every practice should appoint a Scheme Representative who will act as the Mouth Cancer Foundation Dental Team Accreditation Scheme team leader.

The Scheme Representative can be a clinical or non-clinical team member and act as the go-to person for others in the practice.

The Scheme Representative should chair the Scheme part of practice meetings and be responsible for accurately recording the business of the meeting and distributing minutes to all members, including those unable to attend a particular meeting. He or she should be able to answer questions from other team members and co-ordinate the provision of resources as appropriate.

The Scheme Representative will liaise directly with the Mouth Cancer Foundation, report the progress of the practice and arrange any further help the practice might need from the Foundation.

He or she will also suggest and implement other initiatives, for example promotional events sponsored by the practice, following Mouth Cancer Foundation social media feeds and encouraging team members to involve themselves in Mouth Cancer Foundation activities like the Annual Awareness Walk.

Mouth Cancer Foundation Self-Examination Video

The Mouth Cancer Foundation self-examination video is among the most valuable resources we offer as it enables members of the public to carry out potentially life-saving self-examinations at home.

It is useful when patients are unable to access routine dental services including periodic check-ups. Early detection of mouth cancer is vital to obtaining the best outcomes. Any delay in diagnosis can have serious consequences. Although a periodic professional examination is recommended regular self-examination may be even more effective at identifying early lesions.

The Mouth Cancer Foundation self-examination video should be promoted to patients in every way possible, for example on practice websites, email links and practice information screens where these are still being used.

It’ important we make everyone aware of the signs and symptoms of mouth cancer, the risk factors and crucially the way to conduct a self-examination.

It may also be worth telling patients that while they can easily self-examine it’s even easier if someone else does it for you! Partners and others in the family group or support bubble can examine each other to the benefit of both.

Distributing the Mouth Cancer Foundation self-examination video is one way that even in these challenging times practices can pro-actively promote the well-being of the public.

Promote the Foundation’s resources wherever possible. Where the surgery has a dental TV screens, show the Mouth Cancer Foundation screening videos.

Care Homes

It is estimated that about 410,000 UK residents live in care homes and that there are about 11,300 establishments offering care.

Residents are often elderly and in poor health. Manual dexterity may be limited and conditions like dementia may compromise cognitive ability.

Many residents have mobility problems and are not able to visit dental practices even when local services are available. As a result these residents are deprived of routine examinations including examinations for early signs of mouth cancer even though many of them are in higher-risk groups.

Care home staff generally do a fantastic job of looking after their residents but are short of training in some fields, including dental health and diseases of the mouth.

Dental practices can have a really positive impact in offering advice and training to care home staff on a variety of subjects; tooth and denture cleaning and diet for example. Of the greatest importance of course is helping care home staff recognise signs and symptoms of mouth cancer and when suspected be able to report these quickly to appropriate clinicians for further investigation.

The Mouth Cancer Foundation is committed to helping residents of care homes in any way we can but to do this effectively we need local support. Many care homes have requested information and advice and while we can go some way to providing that centrally it is much better done at a local level.

We would like practices in the Mouth Cancer Foundation Dental Team Accreditation scheme to aspire to putting together local initiatives to help care homes. During the current pandemic these initiatives will have to be carried out by email or video conferencing but it is hoped that in the future Scheme members will be able to visit local homes and provide face to face training.