Dentists issue warning over worsening oral health in care homes

The care sector regulator has found improvements to awareness of oral health among care home providers – but dentists have warned that residents’ access to dental healthcare is worsening.

Care Quality Commission (CQC) published the findings of a follow-up review on the state of oral healthcare in care homes across England, which it said showed improvements in the understanding of how important oral health is to keep people healthy.

CQC first reviewed oral health in care homes in 2019, and found steps were often not being taken to ensure that people got the oral healthcare they needed.

The follow-up review found:

• Care homes are much more aware of the NICE oral health guideline. In 2019, only 61% were aware of the guidance. This has now increased to 91%
• More than double the proportion of care plans fully covered oral health needs compared to 2019 (60% in 2022; 27% in 2019)
• The percentage of care home providers saying that staff always (or mostly always) receive specific training in oral health has doubled from 30% in 2019 to 60% in 2022
• Inspectors 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 also highlighted that not enough dentists were able or willing to visit care homes to treat people who may be less mobile

But the British Dental Association (BDA) highlighted figures from the same review showing that since 2019 the proportion of residents never accessing NHS dental care routinely has grown from 6% to 25%. Those stating residents were always or mostly always able to access care fell from 67% to 35%.

Giten Dabhi, Chair of the BDA’s England Community Dental Services committee, said: ‘For years we’ve needed a revolution in oral health in our care homes. Now real progress risks being undone as access to care falls off a cliff.

‘The government must step up. Ministers have a moral duty to residents that can be left unable to eat, drink and communicate.’

Mary Cridge, Director of Adult Social Care at the 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.’

Image: Caroline LM