Standards Address the Oral Health of Assisted Living Residents

Dentistry Today


Oral healthcare remains a challenge for the residents and staffs alike of assisted living facilities. That’s why the National Institute for Health and Care Excellence (NICE) in the United Kingdom has published its Quality Standard QS151, “Oral Health in Care Homes.” Designed to improve oral and systemic health as well as nutrition, communication, and social interaction, it comprises 3 quality statements that can be used in assessing care at these facilities: 

  • Adults who move into a care home have their mouth care needs assessed on admission.
  • Adults living in a care home have their mouth care needs recorded in their personal care plan.
  • Adults living in a care home are supported to clean their teeth twice a day and to carry out daily care for their dentures.

“The degree of oral health provision in care homes is highly variable, but these basic measures—assessing, recording, and daily cleaning—could significantly improve the health and quality of life of residents and should be applied universally,” said Paul Batchelor, BDS, PhD, a member of the Quality Standards Advisory Committee that developed the new standard.

Self-care can deteriorate before people are admitted into a care home, according to NICE, so many residents are admitted with poor oral health. Immediate assessment, NICE reports, can lead to tailored care right away. Assessments should address how residents manage their oral hygiene, whether dentures are marked or unmarked, if there is any dental pain, and where and when they last received dental treatment.  

Once assessed, personal care plans should be drafted to ensure that action is taken to meet each resident’s needs and that these needs are regularly reviewed and updated. Finally, daily support should include fluoride toothpaste or appropriate denture-cleaning products, as well as any prescribed or over-the-counter products. Residents who can independently perform oral hygiene should be monitored, while those who can’t should be assisted. 

“With a lack of guidance and support for the oral health of many home residents, the likelihood of developing serious oral health problems is dangerously high. Without basic care, oral health can quickly decline. This often leads to problems being able to eat and drink properly, and therefore a person’s nutrition can suffer,” said Helen Minnery, president of the British Society of Dental Hygiene and Therapy.

“Some oral health problems have also been linked to serious systemic diseases and complications with existing conditions too, such as heart disease and diabetes. For elderly people in a care environment, poor oral health provisions can have disastrous, long-term effects,” said Minnery. “We will be advising our members to form strong links with local care homes around the UK to ensure we can effectively deliver this much needed care.”

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