England’s Quality Care Commission has revealed significant challenges among those living in group settings in its latest report, “Smiling Matters: Oral Health Care in Care Homes.” Now, the Oral Health Foundation is calling on the English government to take action and ensure that oral care for the nation’s elderly is not neglected.
The commission found that 47% of the 100 care homes it examined did not train their staffs about oral healthcare. Also, 73% of individual care plans did not sufficiently cover oral health. Dr. Nigel Carter, OBE, chief executive of the Oral Health Foundation, says the report highlights the need for better communication between the care sector, the National Health Service (NHS), and dentists.
“This concerning report should act as a big wakeup call for the care sector and the NHS. Clearly, oral health is not being given the attention it deserves in care homes,” Carter said. “It is especially worrying as looking after your oral health is equally as important when you get older and shouldn’t be neglected. Dry mouth as a side effect of certain medications and receding gums are both oral health problems which disproportionately affect the elderly.”
Elizabeth Kay, MBE, president of the Oral Health Foundation, who worked on the National Institute for Care Excellence (NICE) Guidelines for care homes, says that the NICE Guidelines are not being followed as they should be.
“The National Institute for Care Excellence Guidelines are very clear. They recommend that managers of care staff ensure that ‘staff provide residents with daily mouth care… [including]… brushing natural teeth at least twice a day with fluoride toothpaste.’ The guidelines also recommend that staff provide ‘daily oral care for full or partial dentures (such as brushing, removing food debris and removing dentures overnight),’” said Kay.
The commission found that 39% of the care home managers that it had spoken with were unaware of the guidelines, while 28% had heard of them and read them. But of those who had heard of them and read them, only 39% felt they had fully implemented their recommendations.
“Evidently, these guidelines are not being implemented as they should, and the oral health of residents in care homes is suffering. It’s absolutely vital that care home staff get the support they need to be able to give their residents the quality of care, and therefore quality of life, that they deserve,” Kay said.
The commission notes that awareness and implementation of the guidelines are low because they currently don’t form part of the contractual and regulatory frameworks the care home sector works toward. Also, some care homes said that they lacked the time to effectively implement the guidelines due to the high number of people with very complex care needs. Managers of smaller care homes or of those that cared for people with learning disabilities were more likely to have heard of or read the guidelines.
“By 2050, there will be 2 billion people aged 60 and over—more than double today’s figure. This problem needs to be addressed now to prevent it affecting any more elderly patients. Only with better organization and a competent elderly care structure in place can we ensure better oral health provision in care homes,” said Carter.
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