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Better oral health for adults in care homes

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  Posted by: The Probe      27th September 2019

For the majority of people, there is no place like home. The familiar surroundings, memories, family and friends along with the ability to stay independent and live happily and healthily to an old age is what most people hope for.[i]However, for frail or elderly people or those that have a chronic or disabling condition a residential or nursing home provides a safe environment with constant access to professional care and support.

Over 400,00 people live in care homes in the UK. Around 30,000 are younger people with learning disabilities, but approximately 70 per cent are older adults with some form of dementia or memory problems.[ii]The demand for residential living is expected to grow[iii]and providers strive hard to offer residents compassionate, dignified care in a homelike environment where residents are able to maintain their identity, a certain level of independence and have meaningful experiences.  Indeed, the Care Quality Commision (CQC) and other regulators check the standards of care providers across the UK to ensure that residents are safe and treated with dignity and respect. Care service inspections also ensure that care, treatment and support is effective and that good outcomes are achieved to maintain quality of life.[iv]

As anyone in the dental profession knows, poor oral health can impact a person’s well-being both physically and psychologically. It can influence how they look, speak, eat, socialise and enjoy life.[v]Plus, there is a growing body of evidence to indicate that periodontitis is a risk factor for certain systemic diseases and that impaired oral health can have a highly negative effect on quality of life.[vi]Nevertheless, it appears that helping older adults living in care homes to maintain good oral health, is still not a priority. Three years ago, the National Institute for Health and Care Excellence (NICE) published “Oral health for adults in care homes” as a guideline. Recommendations were included to ensure that care homes had plans and policies in place to properly assess individual oral health care needs; manage daily mouth care; report any oral health concerns and provide support to access both general and emergency dental services.[vii]

However, according to “Smiles Matter”, the latest CQC review, it appears that many elderly people living in care homes in England are not being supported adequately.

After visiting 100 care homes in England and reviewing 291 care plans, the CQC revealed that:

  • 39 per cent of home care managers were not aware of the NICE guidelines, and only 28 per cent had heard of it and read it.
  • Most homes had no policy to promote and protect people’s oral health (52 per cent).
  • Nearly half were not training staff to support daily oral healthcare (47 per cent).
  • Of the care plans reviewed, 73 per cent only partly covered or did not cover oral health care at all.
  • Although 37 per cent of care homes said residents could always or nearly always access NHS dental care, the review found that 10 per cent had no way of accessing emergency treatment.[viii]

Poor oral health could be leaving these, our most vulnerable members of society, in pain or discomfort, embarrassed, lacking in confidence or even unable to speak or eat properly. Yet dental practices can help by forming links with local care homes to help promote the maintenance and improvement of oral health in their residents. They can support staff with educational material and training, as well as the capacity to offer appointments for routine dental care and emergency appointments when needed.

Dental professionals can also offer advice on the delivery of daily oral health care plans and recommend the most suitable, clinically-proven oral health products for each resident. The Waterpik®Sonic Fusion flossing toothbrush for example, combines the proven effectiveness of the Waterpik® Water Flosser with an advanced sonic toothbrush, which is up to twice as effective as regular brushing and flossing.[ix]This device can be used independently or with the help of a trained carer to both brush and floss the teeth easily but also effectively, to remove oral bacteria and actively help to prevent disease and decay and improve oral health.

The alarming CQC review highlights the deficiencies in the oral care provision afforded to older adults presently living in residential care homes. Certainly, the current situation could have a major impact on the quality of life of these people. Yet considerable improvements are possible if the importance of oral health is elevated within residential care and better connections are made with local dental practices and professionals. Indeed, by taking active steps to improve oral health and mouth care, there is the potential for older adults, including those with advanced care needs, to lead healthier, happier, more enjoyable lives.


For more information on Waterpik® products please visit Waterpik® products are available from Amazon, Asda, Costco UK, Superdrug online and in stores across the UK and Ireland. The Cordless Plus White WP-450, Cordless Plus Black WP-462 and JT450 Classic Jet Tips are also available in store at Boots as well as online at



[i]Office for National Statistics. Statistical bulletin National Bereavement Survey (VOICES) 2011.–voices-/2011/stb-statistical-bulletin.html

{Accessed 24thJune 2019}

[ii]Alzheimer’s Society. Facts for the media.[Accessed 24th June 2019]

[iii]Laing and Buisson 2017. Care Homes for Older People market analysis and projections.[Accesed 24th June 2019]

[iv]Which? Quality and regulation of care providers.[Accessed 24th June 2019]

[v]World Health Organisation (WHO) Aubrey Sheiham. Bulletin of the World Health Organisation. Oral health, general health and quality of life.

[vi]Gil-Montoya J.A. et al. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review. Clin Interv Aging. 2015; 10: 461–467.[Accessed 24thJune 2019]

[vii]National Institute for Health and Care Excellence (NICE). NICE Pathways. Older adults in care homes overview.

[viii]Care Quality Commission. Smiling Matters. Oral health care in care homes. Summary of our review. June 2019.[Accessed 24th June 2019]

[ix]Goyal CR, Qaqish JG, Schuller R, Lyle DM. Comparison of a novel sonic toothbrush to a traditional sonic toothbrush and manual brushing and flossing on plaque, gingival bleeding and inflammation: a randomized controlled clinical trial. Compend Contin Edu Dent, June 2018; 39(2)(Special Iss. 1).[Accessed 24th June 2019]


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