Oral health for adults in care homes

Why this is important

No research studies were identified that look at care homes in England to determine what interventions are effective and cost effective at improving and maintaining access to dental services. This includes the impact on residents' oral health. Providing and maintaining access to dental services may have resource implications for care homes and it is not clear how the various approaches compare in terms of costs and benefits.

Why this is important

There is a lack of good quality data on the effectiveness of oral health interventions and the costs of delivering them to residents in care homes in England. There is also no robust data on the differential effects on sub-populations in care homes. This includes: people with dementia, people in poor physical health, those with a short life expectancy and younger adults.

It is important to have good quality data to understand the differential impact of oral health interventions to ensure equitable access to oral health treatments and services.

This data is needed for evaluation purposes, to inform future guidance and commissioning decisions, and is vital for informing efficient and fair use of increasingly limited resources.

Why this is important

Oral health research tends to use clinical dental indices (such as the plaque, gingival and denture plaque indices) to provide a measure of statistical relevance. This approach often fails to recognise the difference between what clinicians value in research and what residents or care staff may value more generally. In addition, clinical dental indices cannot be used as the basis of a cost–utility analysis.

A range of person-centred measures and study designs are needed that can also be used to determine cost effectiveness. These measures would capture the views of all residents living in care homes and could include:

Why this is important

There is a lack of evidence on the delivery of daily mouth care for adults in care homes in England. Research is needed to find out whether this helps to maintain or improve residents' oral health and any other aspect of their physical health and wellbeing, including their self-esteem and dignity or language, reasoning and judgement.

There is little research about the oral health needs of adults with poor physical health, or a short life expectancy, or adults with dementia. It is important to understand the impact of oral health interventions on these groups to ensure equitable access to oral health services.

Why this is important

No research has been conducted in England that demonstrates a reduction in demand on other resources, such as hospital admissions, as a result of oral health care interventions. This is particularly important if limited resources are to be used efficiently.

Why this is important

Understanding more about the facilitators and barriers to these activities (including staff training) is a high research priority because it could inform the development of an evidence-based, practical mouth care and assessment manual for care home workers.