Oral Care Post Stroke – Perceptions of Non-dental Professionals in Sydney

Objectives: Stroke is a serious outcome of cerebrovascular disease affecting approximately 15 million people annually and causing around 6.2 million deaths. It is one of the world’s leading causes of disability, accentuating the need for appropriate post-stroke management. Oral care is an important component of post-stroke management and is a key recommendation in the Australian National Clinical Guidelines for stroke. A multidisciplinary approach involving non-dental professionals could be beneficial in improving oral health outcomes post stroke but currently, there is limited evidence on current practices among hospitals in this area. This study aims to understand the oral health knowledge, attitudes and perceptions of nurses, speech pathologists, dieticians and occupational therapists across an acute stroke and stroke rehabilitation setting in Sydney, Australia.
Methods: Data was collected for this qualitative study via two focus groups with 15 nursing staff (acute care hospital) and 7 interdisciplinary staff (stroke rehabilitation hospital).
Results: Thematic analyses of the data showed that although oral health was an important consideration especially for ‘Nil by mouth’ and dysphagia patients, there was no protocol for assessing oral health or providing oral care for patients across both hospitals. Staff acknowledged the importance of good oral health for stroke patients and were receptive to establishing an integrated oral health program. Middle or end of acute hospital stay was considered the most appropriate time for introducing oral health-related behaviour modifications with patients whereas the consensus during rehabilitation was to introduce oral care at the time of admission and then reinforce it throughout the stay. Main barriers to oral care included lack of training, resources, information about oral health including appropriate dental referral pathways post discharge and patient motivation.
Conclusions: The findings suggest that a multidisciplinary integrated oral health program involving nurses and allied health professionals has potential to improve oral health outcomes for patients post-stroke.