Digital denture scanning and 3D printing for residents in care homes: A feasibility study for pre-empting denture loss.

OBJECTIVE: The aim of this study was to assess the feasibility of digitally scanning dentures and 3D printing replica dentures for care home residents. The study also investigated whether the process and replacement denture was acceptable to the resident. BACKGROUND: Denture loss is a significant issue for people living in care homes and impacts on nutrition, quality of life and dignity. Denture loss is underreported, and care home residents have barriers to accessing dental care. The conventional process for remaking a denture can often take approximately 2 months with multiple clinical stages, often not feasible in adults with frailty and cognitive impairment. Scanning and 3D (3 dimensional) printing are increasingly used in dentistry, this rapidly evolving technology may provide an innovative solution to denture loss. MATERIALS AND METHODS: A digital workflow was established using a handheld scanner and 3D printing technology. Care home residents wearing functional acrylic dentures were recruited. Dentures were scanned within the care home, and the scan was sent to a dental laboratory for 3D printing. The dentures were fitted at a subsequent visit, and semi-structured interviews were undertaken with the resident. Using thematic analysis, the feasibility of this pathway was assessed, and the use of digital scanning technology was explored. RESULTS: Eight residents successfully had dentures scanned and replicated to a satisfactory standard. It took, on average, 10 minutes to scan a denture and 20 minutes to print the denture. All replica dentures were satisfactory to the resident. Qualitative data from semi-structured interviews showed that study participants were satisfied with denture replacements and the process. The 3 main themes that emerged were: the significance of dentures to the individual, satisfaction with the scanning process and general low self-esteem and fatigue. CONCLUSIONS: This study has established a workflow for digitally storing dentures and replicating them satisfactorily. In the context of a care home setting, a scan of a denture can be used to provide a replacement denture if lost or broken. A large-scale study could follow now that the feasibility of this pathway has been demonstrated.

The impact of a quality improvement initiative to reduce denture loss in an acute hospital.

Background Denture loss is a significant problem for patients admitted to hospital in the UK. Initiatives aimed at staff and patients have been introduced at many hospitals to try and reduce and solve this issue.Aim This investigation aimed to evaluate the impact of a quality improvement programme on denture loss at an acute hospital, including the reasons dentures were reported as lost or broken and who reported them.Method Information on dentures which were lost or broken was collected in an acute hospital between 2016-2021 and included the number of losses, the reason for the loss/breakage and who reported them. The number of complaints and financial reimbursement related to denture loss was also obtained from the trust for the same period.Results In total, 123 dentures were reported as lost or broken between 2016-2021. The most commonly reported reasons for loss were patient transfers between wards, being left on hospital trays, or when patients were sleeping. Patients or carers are more likely to report a lost denture compared to hospital staff. Reimbursement paid by the trust for denture incidents is much lower than the numbers reported.Conclusion Creating a single reporting pathway for denture loss and implementing methods to reduce denture loss led to an increase in the numbers of dentures reported as lost. This is likely to be attributed to an increased awareness of reporting pathways. Denture loss is a significant financial burden to the NHS, in addition to causing patients and families distress and is most likely under-reported in many hospitals.

Dental care pathways for adult inpatients in an acute hospital: a five-year service evaluation.

Introduction The oral health of adult inpatients has been found to deteriorate during hospital admissions, which can impact on eating and drinking, risk of hospital-acquired infections and overall recovery, thus extending the length of admission.Aim The aim of this paper was to evaluate the reasons for inpatient referrals to the dental and maxillofacial department and the treatment outcomes through analysis of referrals over a five-year period collected prospectively.Method Data were collected from inpatient referrals to the dental and maxillofacial department at East Surrey Hospital over five years from January 2014 to December 2018. Information about reason for referral and treatment outcomes was reflected on.Results In total, 851 referrals were received from hospital staff over five years. The most common reason for referral was related to acute dental pain and potential analgesic overdose (16%), followed by suspected dental abscess or facial swelling (12%) and dental assessment for cardiac inpatients (11%). The most common treatment outcomes included consultation and advice only (16%) or dental extraction (16%). A large proportion of outcomes related to management of oral pain due to dry mouth (9%), oral ulceration (6%), broken dentures (8%) or fillings (5%).Conclusion The data collected show there is a clear need and benefit for hospitals to commission dental services for inpatients.