Dentistry and Oral Health in Care Homes Report

What we found:

• different levels of access to dentistry amongst care home residents. There was a distinct difference between those who could afford private dental care and those residents who needed to access NHS dental services.
• residents reduced the regularity of their visits to dental care once they moved into a care home.
• some residents reported having issues with oral health care.
• issues with care homes getting residents to dental appointments.
• that there was general approval from both residents and staff for the concept of dental therapists carrying out visits to care homes and making oral health assessments.
• all managers and senior staff thought that some form of training would be required for dental therapists to ensure they were suitably prepared and equipped to engage with the range of people living in care settings
• all care homes stated that they carry out assessments of oral care for all residents.
• there was no substantial difference in access to dentistry geographically

Our recommendations include:

1. NHS Sussex should work with Healthwatch to enable the learning from this enter and view report to be incorporated into the pilot programme for dental therapists in domiciliary settings.
2. NHS Sussex should share the learning and outcomes from the West Sussex pilot testing the use of dental therapists in domiciliary settings with care homes, the East Sussex Care Association, Adult Social Care and Health services and other stakeholders.
3. Following evaluation of the pilot, NHS Sussex should explore how existing and/or additional resources or dental capacity can be used flexibly to introduce a pilot scheme to explore the use of dental therapists in domiciliary settings in East Sussex.
4. East Sussex NHS Healthcare Trust should review their procedures and processes for supporting people living with dementia to access dental services so this can meet each person’s individual needs, including where appointments are missed due to the patient’s cognitive impairment.
5. Care homes in East Sussex should continue to embed Nice NG48 guidance on oral health policies, oral health assessments, and oral health plans, including a strong emphasis on prevention.
6. The British Association of Dental Therapists and The British Society of Dental Hygiene and Therapy should advocate for dental professionals to be provided with appropriate training to support the delivery of services in domiciliary settings, including care homes, with a particular emphasis on dementia, learning disabilities and complex needs.
7. Healthwatch will share insight and reports on oral health and dentistry provision in care homes with Healthwatch England to support national intelligence on this theme.

Miranda Steeples President of the BSDHT said:

“The BSDHT are pleased to read the results of this forward-thinking project and see the positive feedback from this piece of work. It is heartening to see that two thirds of the residents were open to receiving care from a dental therapist to supplement care they may receive from other oral healthcare professionals. Dental therapists are well-placed to provide oral health reviews and deliver a preventive care plan for those living in residential settings. We look forward to working with Healthwatch to help facilitate the next stages of this exciting venture.”

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