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.
It is estimated there are more than 400,000 adults living in UK care homes, 80% of whom have some form of dementia. This includes younger adults with learning disabilities also living in care.
Older adults in care homes are more likely to have fewer natural teeth, and those with teeth are less likely to have enough teeth to eat comfortably and socialise without embarrassment.
Professor Gillian Leng, deputy chief executive of NICE, said: “When oral health is ignored or poorly delivered in care homes it can lead to unhappy, irritable residents and for those with dementia, who often can’t describe problems with their teeth or gums, pain and infection may go untreated and worsen.
“Whilst some care homes provide good daily oral health for their residents, we know oral health is too often neglected.
“Our guideline calls for simple changes that could vastly improve the oral health and quality of life of people who are living in care homes across England.”
Recommendations in the guidance focus on improving and maintaining residents’ day-to-day oral healthcare, ensuring staff are properly trained to confidently look after the oral health needs of residents, and there is adequate access to dental services when needed.
The guidance recommends all residents have an oral health assessment when they enter a care home with the results – including any treatment needs – being entered into their personal care plan.
This will ensure staff can perform routine daily mouth care for those who may not be able to do this for themselves. This would include: brushing natural teeth with fluoride toothpaste twice a day; daily oral care for full or partial dentures; and daily use of mouth care products prescribed by dental clinicians and any over-the-counter products preferred by residents.
“Everyone should be able to speak, smile and eat comfortably, but all too often this is jeopardised by poor oral health which can have a significant negative effect on a person’s wellbeing and quality of life,” said Professor Elizabeth Kay, Foundation Dean of Peninsula Dental School, Plymouth University, and Professor and Consultant in dental public health.
Professor Kay added: “The daily routines recommended in the guidance will help prevent problems and assist adults in care homes to have a comfortable, pain-free mouth.
“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.
“Many of us will end up living in a care home and many of us have loved ones currently living in care, so we need to think about how we would like to be looked after and how we would like our relatives to be looked after.”