Dental papers published by the dental and maxillofacial department at Surrey and Sussex Healthcare NHS Trust.
Dr Thayalan Kandiah
Patrick and Kandiah (2019) Patient reported outcome and experience measures for paediatric patients undergoing general anaesthesia
FDJ October 2019
- Presented at Patient experience network national awards – Birmingham March 2019
- Presented at European Association Paediatric Dentistry Congress – Lugano July 2018
Changes were made to the processes involved for children undergoing general anaesthesia for treatment. Overall, it improved both their treatment outcomes resulting in an improved oral health related quality of life, and the patient experience for both children and parents. There is now 100% positive responses for both of these areas.
Patrick and Kandiah (2018) Resistance to change: how much longer will our antibiotics work?
FDJ Volume: 9 Issue: 3, July 2018, pp. 103-111 doi.org/10.1308/rcsfdj.2018.104
- Presented at International Association Paediatric Dentistry Congress – Glasgow 2015
Antimicrobial resistance is a global threat covered heavily within the media. A review of the antibiotic prescribing practices allowed for stringent changes to be made putting steps to minimise antimicrobial resistance for our own patients. This has also led to our team leading the surgical aspect of the antimicrobial guideline development group for the Royal College of Surgeons.
Marshall S, T Kandiah. Specialist led delivery of comprehensive dental care demonstrating low repeat dental paediatric daycase general anaesthetic (PDGA) rates
FDJ Volume 9 Issue: 3, July 2018, pp. 112-115
https://doi.org/10.1308/rcsfdj.2018.112
This project demonstrated the low repeat general anaesthetic (GA) rate for dental extractions at East Surrey Hospital, this was 0.8%. This was similar to the repeat GA rate at Sheffield but much lower than the more commonly reported 10% repeat GA rate nationally. This article was published in a nationally read peer reviewed journal and was used to promote the delivery of specialist-led care. This type of care has shown to lead to lower repeat GA rates for dental treatment in children and this article used the excellent results at East Surrey Hospital as an example.
Marshall S, T Kandiah. Developmental Defects of Enamel in Primary Molars: A Review
Dental Update 2018; 45:961-972
This was one of the first articles on this subject. Both authors (a specialist and consultant in paediatric dentistry working at East Surrey Hospital) felt there was a lack of published information on the subject. Cases from East Surrey Hospital were used as examples in this review of the literature and guidance document. This was aimed at general dental practitioners nationally to guide them in the management of enamel defects in children. This was published in order to improve the knowledge of the readers and improve the care of children in primary care.
Patrick A and Kandiah T (2017) Effectiveness of Safeguarding Children Training
IJPD Oral Sessions Vol 27 p11-35
- Currently awaiting publication
- Presented at International Association Paediatric Dentistry Congress – Santiago Sept 2017
Safeguarding is a vital part of any child’s care and it is essential that anybody involved knows when to raise concerns, and follow current practices. We have changed the format of training and found the most efficient and effective method in order to secure robust measures for our colleagues.
Patrick A and Kandiah T (2017) Knowledge of Emergency Department Staff regarding Dental Trauma
- Presented at European Association Paediatric Dentistry Congress – Turin April 2017
- Presented at South East Coast Emergency Medicine Conference – Surrey 2017
Dental trauma is often managed poorly resulting in a significant burden of care. We have been a welcome addition to emergency department teams by creating a ‘roadshow’ for dental trauma. This initiative is being rolled out internationally.
Marshall S, Kandiah T. An audit evaluating analgesic prescription for paediatric dental extractions under general anaesthetic
International Journal of Paediatric Dentistry 2017 27 (Suppl. 1): 2–11 DOI: 10.1111/ipd.2_1231
This was a three cycle audit which demonstrated a multidisciplinary collaborative approach to overcome barriers for prescription of painkillers for children provided with extractions under general anaesthetic. This audit led to full compliance with national standards at East Surrey Hospital.
Kandiah T, Marshall S. Evaluation of repeat general anaesthetic rate in a consultant-led paediatric dentistry service
International Journal of Paediatric Dentistry 2017 27 (Suppl. 1): 12–41 DOI: 10.1111/ipd.12320
This project was presented at the national conference for the British Society of Paediatric Dentistry. It was later published in the Faculty Dental Journal for the Royal College of Surgeons of England (see reference below)
Marshall S, Kandiah T. Sequelae due to an unusual splint in the management of an avulsion
International Journal of Paediatric Dentistry 2016. 26, S1; 12-36 DOI: 10.1111/ipd.12247
This demonstrated the management of a complicated trauma in a young child and the gold standard care provided at East Surrey Hospital, with discussion over the need for lateral thinking when patients’ have been seen and treated abroad and return for follow up care to their local NHS Hospital.
Mili Doshi
T Stokes, M Doshi and J Preston (2015) Management of a hospitalised patient with dementia – a lesson learned. Journal of disability and Oral health
This report describes the multidisciplinary management of an 80-year-old patient with dementia who developed severe ulceration to her lower lip as a result of habitual lip biting whilst in hospital. The ulceration was of such an extent it prevented the patient from being able to eat and drink, caused a rapid deterioration in oral health, contributed to a four-month ward stay and may have been a cause of hospital acquired pneumonia. The aim of this report is to raise awareness of the importance of oral health as part of general health of vulnerable hospitalised patients.
Key words: Special Care Dentistry, lip biting, dry mouth, pneumonia, mouthcare
Date Manuscript Received: 01/07/2015 Date Manuscript Accepted: 18/11/2015 Doi: 10.443/JDOH_Stokes05
Binks C, Doshi M, Mann J (2017) Standardising the delivery of oral health care practice in hospitals , Nurisng Times Nursing Times [online] November 2017 / Vol 113 Issue 11
Abstract Good mouth care is important, not only for oral health but also for general health and wellbeing, yet it is an aspect of care that is often neglected. Mouth Care Matters was launched by Health Education England to improve the oral health of adults in care homes and hospitals. Between 2015 and 2016, the initiative was implemented in 12 acute hospital trusts in Kent, Surrey and Sussex. This article explains why mouth care is important and discusses the results of a questionnaire used to collect baseline data on the 12 trusts’ oral care policies, resources and training.
Citation Binks C et al (2017) Standardising the delivery of oral health care practice in hospitals. Nursing Times [online]; 113: 11, 18-21.
Mann J, Doshi M (2017) An investigation into denture loss in hospitals in Kent, Surrey and Sussex British Dental Journal BDJ volume 223, pages 435–438 (22 September 2017)
Background The loss of dentures for inpatients can have a detrimental effect on their well-being. Self-respect and dignity become compromised along with their ability to eat meals and communicate clearly, and long-term recovery.
Aim This investigation aimed to identify the reported number of dentures lost in hospitals and the financial reimbursements given by trusts to replace them.
Method Information on reported denture loss and reimbursement was collected in 12 trusts throughout Kent, Surrey and Sussex.
Results Eleven out of 12 trusts returned data about how many dentures were lost in their hospitals, between them 695 dentures were reported lost over five years (2011–16). Seven trusts reported financial reimbursements for dentures losses; results showed £357,672 was reimbursed over six years (2010–16), the highest amount reimbursed for a single denture was £2,200.
Conclusion The results indicate that denture loss is a problem in hospitals that contributes to the financial burden for the NHS. Consideration needs to be given by hospitals to find ways to reduce the number of dentures lost every year.
Putting the mouth back into the body, Mrs Mili Doshi and Dr Jalpa Patel
British Journal of Hospital Medicine 2017 78:5, 244-245
Otukoya R, Doshi M (2018) Selecting the right tools for mouth care delivery in hospitals
Nursing Times November 2018 / Vol 114 Issue 11
Abstract Helping people in hospital with mouth care is an important part of personal care. The Mouth Care Matters initiative is helping to raise awareness of the importance of mouth care as an integral part of general care for the rehabilitation of patients who are hospitalised. To provide good and effective oral care, staff need access to training as well as to appropriate mouth care products. This article discusses the types of mouth care products that should be available on a hospital ward and the indications for their use.
Otukoya R, Shepherd E (2018) Principles of effective oral and denture care in adults. Nursing Times; 114: 11, 22-24.
Oral care is a fundamental part of nursing care and failure to provide it can have a negative effect on health and wellbeing. This article explains the procedure for oral and denture care.
Carly Welch,(lead author) Mili Doshi A nationwide survey of confidence and knowledge of assessment and management oral conditions amongst a sample of physicians, United Kingdom . Geriatric Medicine Research Collaborative BMC Res Notes (2019) 12:348 https://doi.org/10.1186/s13104-019-4359-0
This study aimed to assess current confidence and knowledge of oral conditions amongst a sample of UK physicians and doctors in training programmes using a web-based survey.
Results: 131 survey responses were analysed for doctors from FY1 to consultant grade working within medical specialties. 36.6% and 35.9% of those surveyed expressed that they felt confident diagnosing and managing oral condi- tions respectively. The median knowledge score was 60%; 65.6% correctly identified the image that demonstrated a squamous cell carcinoma. 91.6% reported that they felt they needed additional training in the diagnosis and manage- ment of oral conditions. Neither confidence nor knowledge were affected by grade, specialty, or region of practice.
Doshi M, Weerman M, Mann J (2019 accepted and awaiting publication) British Dental journal An educational survey of the knowledge of junior doctors in managing oral conditions in adult inpatients.
Background: Adult inpatients are at risk of developing oral condtitiosn that require input from their medical team. Doctors often have minimla training at both an undergraduate or postgraduate level in oral health and this can impact on their management of patients with oral issues
Aim: The aim of this survey was to investigate the knowledge of junior doctors in Kent, Surrey and Sussex on the knowledge of managing common oral conditons in inpatients
Method: A survey was carried out with 106 junior doctors in Kent Surrey and Sussex who attended oral health training session on their history
Results: 91% of partakers did not feel confident in diagnosing common oral conditions and 98% felt they lacked confidence in the management of common oral conditions. Of all those who took part in the study, 92.5% requested additional training
Conclusion: There is a need for improved training amongst junior doctors in oral health. Additional training (either at undergraduate or graduate level) would greatly improve confidence in the diagnosis and management of common oral conditions. This would greatly improve the quality of care provided to hospitalised patients.
