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A clinical audit into dental hygiene instruction provided in primary dental care.

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Current research suggests that only 60% of denture wearers have adequate denture hygiene. An audit carried out by Milward et al found that there was a lack of knowledge surrounding denture hygiene and that a significant improvement needed to be made to health education surrounding how patients should take care of their dentures (1) . Following extensive research, it was found that to date, there are currently no guidelines in the UK on what denture hygiene instructions should be given to patients. Therefore an audit was decided to be carried out in a primary care setting.



To evaluate the quality of denture hygiene instructions delivered 



1.To determine what denture hygiene instructions are currently delivered to patients
2. To discover if the implementation of an aid improves the delivery of denture hygiene instructions
3.To improve the standard of delivery of instructions in GDP

The study was completed as an audit within a range of dental foundation training practices within London.  Data was collected retrospectively to determine the standard of denture hygiene instruction delivered through verbal methods (n=50). Unfortunately evidence-based guidelines in the UK pertaining to denture hygiene advice do not exist. Criteria selected from evidence-based studies and guidelines published by the American College of Prosthodontists were used, with a standard set to 100%. 


•Sample of 50 in cycle 1 and cycle 2
•The average amount of criteria fulfilled in cycle 1 was 11, with the minimum number found to be 7
•Average criteria in cycle 2 with use of written instructions was 14, with the minimum found to be 12
•Using audit standard as 100%, during cycle 1 standard was only met in 4% (n=2) of cases
•Whereas in cycle 2, the 100% standard was met 24% of the time (n=12) showing a definite improvement

Overall between cycle 1 and cycle 2 there was a significant improvement in the information that was delivered to patients regarding denture hygiene instructions. Particularly advising patients about cleaning their dentures in a bowl of cold water, using cleansers outside the mouth only and being cautious of metal clasps. Initially, there were only a few occasions where this information was explained to patients. The most common information given to patients, that had little increase, was cleaning dentures using soaking and brushing and the use of a denture cleanser to aid cleaning. Providing written and verbal information on denture hygiene advice with the aid of a visual leaflet, using evidenced based information proved to be the most time effective method of increasing education and awareness of denture cleansing methods. 



The majority of patients were found to have knowledge lacking in appropriate and successful denture hygiene. The standard set was not achieved. To improve denture hygiene advice delivered, a graphic written leaflet was produced and offered to patients to aid understanding of information given. On the second audit cycle, this graphic leaflet was shown to improve the delivery of instructions by the GDPs. This has helped to provide an effective and positive solution to improving denture hygiene education in the future.

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