Dental Care in Care Homes

3, July 2019

The Care Quality Commission (CQC) has recently published a report on the findings of an in-depth review on the state of oral health care in care homes across England. The review has found that steps are often not being taken to ensure that people get the oral care they need. Good oral health is vital to ensure that a person’s teeth and gums are healthy and to avoid extensive treatment in the future.

By Samantha Swaby

The review

The key findings from the report found that:

The majority (52%) of care homes visited had no policy to promote and protect people’s oral health;
Nearly half (47%) of care homes were not providing any staff training to support people’s daily oral healthcare;
73% of residents’ care plans we reviewed only partly covered or did not cover oral health at all – homes looking after people with dementia being the most likely to have no plan in place;
17% of care homes said they did not assess people’s oral health on admission.

In one case, a 93-year-old woman with advanced dementia, had to attend A&E to have her dentures surgically removed, as they had been left in for weeks and her gums had grown around them. This must have been a frightening experience for this woman and is a situation that could have been avoided, with the appropriate care. For those suffering from dementia, it may not be easy for them to brush their teeth twice a day and therefore, they are reliant on the care home to ensure that their oral health care needs are met.

Kate Terroni, Chief Inspector for Adult Social Care at the Care Quality Commission (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 they are ashamed of their poor oral hygiene but unable to address it themselves. No one should have to live like that.”

Impact of poor oral health

if a person’s oral health is not maintained a person can experience problems such as:

Tooth decay;
Periodontal disease;
Recurrent infections;
Eventual tooth loss.

A person suffering from poor oral health may also find that they suffer from loss of sleep due to dental pain and this can have a big impact on a person. Poor oral health can also affect a person’s social life, confidence and restrict their food choices.

Recommendation

The recommendations include a call for mandatory staff training in oral care, oral health check-ups for all residents upon admission, better signposting to local dental services and the convening of a multi-agency group tasked with raising awareness among people living in care homes, their families and carers of the importance of day-to-day dental hygiene and the need for routine check-ups.

We agree with the recommendations and hope they are implemented as soon as practicable. This will hopefully lead to less of these types of cases and less people suffering with dental problems.