Presentations 2020: Ortho&Paeds

367 - Introducing Quality Improvement into Orthodontics

K Thomas S Rogers M Collard
Presented by: Katie Thomas
Cardiff Dental Hospital

Introduction Quality improvement (QI) in healthcare aims to continually improve care delivered to patients. This QI project assess’ the feasibility of topical fluoride varnish (TFV) application during fixed orthodontic treatment at Cardiff Dental Hospital (UDH). Background Enamel demineralisation during orthodontic treatment is a known risk with long term aesthetic and restorative consequences for patients. At UDH and Prince Charles Hospital (PCH), retrospective audits identified an incidence of 45% and 62% of patients with demineralisation following orthodontic treatment. Evidence shows TFV application is effective in reducing demineralisation during treatment. Methods A PDSA (Plan-Do-Study-Act) tool was developed and staff education during audit meetings was undertaken. TFV application by clinicians and fluoride-trained dental nurses was undertaken at the first appointment following placement of the fixed appliance with an aim to repeat every 12 weeks during treatment. Results 48 TFV applications over a 19- week period were undertaken. Qualitative themes were recorded - reasons for no application, ease of application and effect on appointment times. 4/48 TFV applications reported minor difficulties on ease of application. 4/48 applications reported an unfavourable effect on appointment times/clinic flow. Conclusion TFV during fixed orthodontic treatment has been easily implemented within the orthodontic department at UDH with dental nurses playing an instrumental role. Therefore, efforts have been made to increase the number of dental nurses with TFV training. The introduction of TFV application during orthodontic care is now being introduced into other primary and secondary orthodontic settings. The largest challenge in sustainability is ensuring all eligible patients are still being reached, highlighting the need for continued staff engagement. Future quantitative analysis will assess the cost effectiveness of TFV and its effect on demineralisation.
Consent Statement: There are no details on individual patients reported within the abstract.

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