Norfolk & Suffolk Care Support Ltd
Smiling matters: oral health care in care homes
< June 2019

Smiling matters: oral health care in care homes

The Care Quality Commission (CQC) has published the findings of an in-depth review on the state of oral health care in care homes across England. The report reveals an extensive lack of awareness of NICE guidelines and concludes that residents are not supported to maintain and their improve oral health.

The review draws on one hundred inspections of care homes on which CQC inspectors were accompanied by inspectors from dental regulation. It reveals that three years on from the publication of NICE guidance on oral health in care homes, steps are often not being taken to ensure that people get the oral health care they need to ensure that they are pain-free and that their dignity is respected.

Key findings include:

  • The majority (52%) of care homes visited had no policy to promote and protect people’s oral health
  • Nearly half (47%) of care homes were not providing any staff training to support people’s daily oral healthcare.
  • 73% of residents’ care plans we reviewed only partly covered or did not cover oral health at all – homes looking after people with dementia being the most likely to have no plan in place.
  • 17% of care homes said they did not assess people’s oral health on admission

Whilst two-thirds (67%) of the care homes that CQC visited said people who used their services could always, or nearly always, access NHS dental care, the report did reveal a lack of dentists who were able or willing to visit care homes. Other challenges people faced involved local dentists not accepting new patients and the length of time it took to get an appointment with an NHS dentist – even for a procedure such as getting dentures fitted.

Of the homes visited, 10% reported they had no way of accessing emergency dental treatment for people. 34% of homes told CQC they had no or limited access to out-of-hours services. Some care home managers stated that they had to call GPs, NHS 111, or even take the person requiring emergency care to A&E.

CQC is calling for a cross-sector approach to tackle the concerns raised by this report, and highlights examples where this has been achieved. The review includes case studies of productive, joined-up relationships between care homes and local dental practices, including dentists providing routine check-ups, ongoing treatment and emergency care, both in and outside the care home.

The recommendations include a call for mandatory staff training in oral care, oral health check-ups for all residents upon admission, better signposting to local dental services and the convening of a multi-agency group tasked with raising awareness among people living in care homes, their families and carers of the importance of day-to-day dental hygiene and the need for routine check-ups.

Download the full report or a summary version here:


Don't forget: Two useful guides to oral health can be found on the N&SCS website: 

Also, some N&SCS endorsed learning providers offer Oral Health training

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