Survey of hospital doctors' attitudes and knowledge of oral conditions in older patients

The study was designed to assess the views and knowledge of hospital doctor s in general and geriatric medicine on oral health in older people. Eighty two doctors in general and geriatric medicine at two hospitals were shown 1 2 colour slides of oral mucosal conditions and asked to give a diagnosis fo r each slide and complete a questionnaire. Completed questionnaires with th e answers to the coloured slides were returned completed by 70 doctors. The majority of doctors (84%) felt it was important to examine older patien ts' mouths, however only 19% (chi (2) p=0.0001) routinely do so. If asked t o prescribe nystatin by the nursing staff, 30% said they would do so withou t examining the mouth itself. Only 9% of doctors knew that wearing dentures was a specific risk factor for oral candidiasis (chi (2) p=0.001) Altogeth er 56% of doctors did not feel confident in examining the oral cavity and m ost (77%) did not think they had had sufficient training in this examinatio n. Only two doctors correctly diagnosed all of the slides. An early squamou s carcinoma was misdiagnosed by 80% of the doctors (chi (2) p=0.0001). Hospital doctors do not routinely inspect older patients' mouths. Even if s hown slides of typical oral mucosal lesions many hospital doctors are unabl e to diagnose them. Issues on training need to be addressed. From the patie nts' point of view a public health campaign is required to educate older pe ople on the need for a regular dental review and be aware that doctors may not be able to diagnose serious oral conditions.