Person Centred Software founder and co-director Jonathan Papworth calls for a greater focus on oral health in care homes
According to NHS England, the oral health of the population has been steadily improving over the past 40 years, and the upshot of this is more people are keeping their own teeth for longer. Using assessments of over 7,000 people in residential care, 67.2% have at least some of their own natural teeth. Studies have shown that oral care is not being prioritised in care homes, and this has led to CQC incorporating Oral Care onto the CQC inspection list. Of the people assessed to have their own teeth and who needed help with being washed and dressed each day, only 60.7% had any evidence of oral care each day. Poor oral care leads to gum disease, tooth loss and is linked to other health issues.
Studies show that there is a link between poor oral health and heart disease. 91% of patients with heart disease have gum disease compared to 66% of people with no heart disease. Although it is not clear as to exactly how bacteria from the mouth affects and damages the body, there are other systemic diseases linked to poor oral health such as respiratory infections and diabetic complications. There is even a link between poor oral health and dementia as bacteria from inflamed gums may enter the brain through either nerve channels in the head or through the bloodstream and eventually lead to the development of Alzheimer’s disease.
According to Jane Peterson, a registered dental hygienist who specialises in helping to deliver daily oral care to challenging residents in care homes, delivering daily oral care to some residents can prove challenging, especially as people advance with dementia and can become resistant and uncooperative to oral care. Studies have shown that carers perception of brushing residents’ teeth is seen as infringing on their personal space; they find oral hygiene procedures unpleasant; and have difficulty accessing the mouth, particularly from un-cooperative residents.
Professor Leng, deputy chief executive of NICE (National Institute for Health and Care Excellence) declared “oral health is too often neglected” and “oral health should be a priority in care homes”. NICE has issued two major papers related to oral care: the NICE Guidelines ‘Oral Care for Adults in Care Homes’ was published in July 2016 and in June 2017 Quality Standards were issued which sets out three quality statements:
- Adults who move into a care home have their mouth care needs assessed on admission (oral health assessment)
- Adults living in care homes have their mouth care needs recorded in their personal care plan
- Adults living in care homes are supported to clean their teeth twice a day and to carry out daily care for their dentures
These guidelines are likely to be adopted by CQC inspectors from April this year.
To help improve oral care in your care setting, go to www.personcentredsoftware.com/oralcare where there is more information, resources and links to give the knowledge and tools to ensure oral care is not putting your residents at risk.