Oral health in care homes improves but still more to be done

AN updated review of oral health in care homes in England has shown a significant improvement in understanding the importance of ensuring adequate mouth care.

The Care Quality Commission (CQC) has published the findings of a follow-up to a 2019 review, which shows that awareness of NICE guidance on oral health for adults in care homes has risen from 61 per cent in 2019 to 91 per cent.

The review, based on inspections of 50 care homes, also found that more than double the proportion of care plans now fully cover oral health needs compared to 2019 (60 per cent in 2022; 27 per cent in 2019) – but the CQC points out that more work needs to be done to ensure all care plans cover oral health.

More staff now receive specific training in oral health, with the percentage of care home providers saying that staff always (or mostly always) receive training increased from 30 per cent in 2019 to 60 per cent – although this also leaves much room for improvement.

The CQC says its inspectors do remain concerned that people living in care homes are missing out on vital care from dental practitioners – both at the right time and in the right place. Care home providers have also highlighted that not enough dentists were able or willing to visit care homes to treat people who may be less mobile.

Mary Cridge, director of adult social care at CQC said: "Our review for our first Smiling matters report in 2019 set out to discover how well care home and dental providers were implementing the NICE guideline on oral health. We found that staff awareness of the guideline recommendations was low, and not everyone was supported to keep their teeth or dentures clean.

"Whilst I am pleased to see that many of our recommendations from 2019 have been taken on board, and providers are more aware of how important oral health is to keeping people healthy, we recognise that there is still room for improvement. In particular, it is imperative that more is done to ensure people have access to vital care from dentists and that oral and dental health is included in all care plans.

"We have made further recommendations for both adult social care providers and staff, as well as dental providers so every resident of every care home have their oral health needs met."

Mr Matthew Garrett, Dean of the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons of England, commented on the findings: “It is encouraging that despite the pandemic, care homes have shown improvements in almost all areas and have become more aware of NICE oral health guidelines.

“However, it is concerning that the number of people in care homes who could ‘never’ access dental care rose from 6 per cent in 2019 to 25 per cent in 2022. Also that some dentists were unable to visit care homes.

“We hope that as Integrated Care Systems develop their local plans for oral health, care homes receive the commissioning required to better integrate with dental professionals.”