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NICE calls for better oral health in care homes


Care home staff should receive training so they can “confidently” look after the oral health needs of their residents and, as a result, help to improve dignity, comfort and infection prevention.

Oral health and access to dental treatments needs to be given the same priority as general health for all adults in care homes, according to the National Health and Care Excellence.

“Simple changes such as these will vastly improve the oral health and quality of life”

Gillian Leng

NICE said that more than half of older adults in care homes have tooth decay, compared to 40% of over 75s and 33% of over 85s who do not live in care homes.

In addition, older adults in care homes are more likely to have fewer natural teeth, and those with teeth were less likely to have enough teeth to eat comfortably and socialise without embarrassment.

However, the institute said that current practice in care homes to monitor oral health varied from home to home and good quality information about the sector as a whole was not available.

NICE noted that homes faced a number of difficulties such as managing existing dental problems, residents who may refuse assistance and staff who have not been trained in oral health care.


Gillian Leng

It also acknowledged that funding and local arrangements for dental services provided to care homes were often poorly understood and confusing.

For example, dentists did not routinely visit care homes because domiciliary care was not always part of the work they were paid to do under the current general dental services contract.

NICE’s new guideline, published today, called for day-to-day oral healthcare to be improved and maintained, with staff properly trained to confidently look after the oral health needs of residents and adequate access to dental services when needed.

Meanwhile, NICE encouraged health and wellbeing boards to ensure dental services were provided for care home residents, and for home managers to contact their local board if concerned about the availability of services.

Professor Gillian Leng, deputy chief executive of NICE, said: “Our guideline calls for an oral health assessment of each resident when they enter a care home with the results – including any treatment needs – being entered into their personal care plan.

“Ensuring staff can perform routine daily mouth care for those who may not be able to do this for themselves means residents’ oral health can be actively monitored,” she added.

“Simple changes such as these will vastly improve the oral health and quality of life of people who are living in care homes across England,” said Professor Leng.

“We want to see more staff given training about what they can do to help”

Elizabeth Kay

Andrea Sutcliffe, chief inspector of adult social care at the Care Quality Commission, added: “I encourage everyone who is in charge of running care homes to be aware of this new NICE guidance.”

Professor Elizabeth Kay, from Peninsula Dental School at Plymouth University and a member of the NICE guideline development group, said: “This guidance is about maintaining basic human dignity in those who may need help in looking after themselves.

“The daily routines recommended in the guidance will help prevent these problems and assist adults in care homes to have a comfortable, pain-free mouth,” she said.

“Awareness of oral health needs to be raised within care homes and we want to see more staff given training about what they can do to help,” she added.


Readers' comments (2)

  • michael stone

    I seem to recall reading about the problem a while ago.

    I'm not sure that this is mentioned in the article above, but I think one of the factors is that people with dementia tend to have worse oral care than those who don't, and perhaps a higher percentage of people who are living in care homes do have dementia.

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  • Many elderly are on fragmin or aspirin or other coagulant drugs I'd never advise floss,. Just gental brushing and mouthwash.

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