Care homes need to make oral health a priority, report says

Care homes in England are neglecting the oral health of their residents, a new report suggests.

A Care Quality Commission (CQC) review found gaps in the support on offer to elderly people, which could be putting their health and dignity at risk.

The regulator is calling for care homes to ensure dental care is treated in the same way as physical and mental health, improved guidance for dentists on how to treat residents, and better provision of services in these settings.

The British Dental Association (BDA) said a “revolution” is needed in how dentistry is approached in residential homes.

Some care home residents are not getting enough help to look after teeth and dentures (Joe Giddens/ PA)
Some care home residents are not getting enough help to look after teeth and dentures (Joe Giddens/ PA)

The CQC review comes three years after the National Institute for Health and Care Excellence (Nice) published advice to boost oral health in care homes.

“Our findings show that too many people living in care homes are not being supported to maintain and improve their oral health,” the report states.

“Three years on from the publication of the Nice guidelines, oral health in care homes is still not a priority.”

Inspectors visited 100 care homes in England between October 2018 and January 2019 as part of the review.

More than half (52%) had no policy to promote oral health, and 47% were not training staff in how they could help residents in looking after their teeth, the review found.

The care plans of 73% of residents did not cover, or only partly covered, their oral health.

While 67% of care homes said residents could always or nearly always access NHS dental care, the review also found that 10% had no way of accessing emergency treatment.

“All too often, treatment would only be sought when people were in pain, but issues with accessing emergency NHS dental care meant care homes would call a GP or NHS 111, or even take the person to A&E – putting an added burden on services that are already under pressure,” the report said.

The CQC is calling for mandatory care home staff training in oral care, check-ups for all residents when they are admitted and better links with local dental services.

It also suggests the importance of routine check-ups and dental health should be highlighted to families and carers.

Kate Terroni, chief inspector for adult social care at the CQC, said: “Oral health cannot be treated as an afterthought.

“It can make the difference between someone who is free from pain, enjoys eating and is able to confidently express themselves through talking and smiling – and someone who is in pain, unable to enjoy their food and who covers their mouth with their hand when they smile because of their poor oral hygiene but unable to address it themselves.

“Care home managers must recognise the significance of oral health – and professionals including GPs, dentists, dental hygienists and community nurses need to work together to elevate the importance of oral health in care homes and to prioritise this as part of their work.

“The changes needed can only happen with the efforts of all parts of the health and care system coming together, supporting people who use services, their families and carers to be aware of the importance of oral care.”

Charlotte Waite, from the BDA’s England community dental services committee, said: “This welcome report shines a light on services that are failing some of the most vulnerable in our society.

“There are residents left unable to eat, drink and communicate, as an overstretched NHS struggles to provide the care they need.

“We require nothing short of a revolution in the approach to dentistry in residential homes.

“Oral health can no longer remain the missing piece when it comes to care planning and budgets.”

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