Oral Health

Objective

To raise awareness of the importance of oral health in care home residents and provide guidance for staff on maintaining oral hygiene to prevent infection, maintain nutrition, and promote overall well-being.

Further information: Public Health Wales Community Dental Services: Gwên am byth - Public Health Wales

Why oral health is important

• Poor oral hygiene can lead to tooth decay, gum disease (periodontitis), oral infections, and systemic health issues such as aspiration pneumonia in older adults.
• Residents who are frail, have cognitive impairment, or use dentures may be at higher risk of oral health problems.
• Maintaining oral health contributes to nutrition, comfort, dignity, and quality of life.

Key messages for Care Home Staff

• Oral health is critical for overall health and well-being.
• Daily oral hygiene routines should be integrated into care plans.
• Staff should observe, document, and escalate any oral health issues promptly.
• Collaboration with dentists and healthcare professionals ensures residents receive timely care.

Key practices for maintaining Oral Health

•  Daily Toothbrushing:
• Brush teeth twice daily using a fluoride toothpaste.
• For residents with cognitive or physical impairment, staff should assist or supervise brushing.
• Denture Care:
• Remove and clean dentures daily using a soft brush and mild detergent or denture cleaner.
• Ensure dentures are soaked overnight in water or a suitable soaking solution.

• Mouth Care for Dependent Residents:
• Use a soft toothbrush or foam swab for those unable to tolerate regular brushing.
• Clean the gums, tongue, and lips to maintain oral hygiene and stimulate circulation.
• Dietary Considerations:
• Limit sugary foods and drinks to reduce risk of tooth decay.
• Encourage water intake to maintain hydration and reduce dry mouth.

Monitoring and Assessment

• Conduct regular oral health assessments using care home oral health tools.
• Document any signs of pain, bleeding, swelling, loose teeth, or difficulty swallowing.
• Report oral health concerns to GP, dentist, or community dental team promptly.

Professional Support and Training

• All care staff should receive training on oral care for older adults, including residents with dementia or swallowing difficulties.
• Dental referral pathways should be clearly established within the care home.
• Community Dental Services in Powys can provide assessment and advice: Email: Gab.Powys@wales.nhs.uk.

Resources 
PHW Poster - phw.nhs.wales/services-and-teams/dental-public-health/files/good-mouthcare-really-does-matter/ 
PHW Poster -phw.nhs.wales/services-and-teams/dental-public-health/files/looking-after-mouths/

References and Further Guidance Links: 
Public Health Wales - Oral Health Resources for Care Homes: https://phw.nhs.wales/services-and-teams/oral-health/ 
GOV. UK - Oral health toolkit for adults in care homes - GOV.UK 
British Society for Disability and Oral Health - Guidance for Staff: https://www.bsdh.org.uk/resources/ 
NICE Guidance - Overview | Oral health for adults in care homes | Guidance | NICE