Effective Dental Care for Care Homes Residents: an Interview Study

Objectives: Oral health in care homes is often poor, with residents experiencing higher level of dental disease when compared to their community-dwelling peers. Care home residents have variable access to dental care services and currently no coherent consensus exists about the best arrangements to meet these needs. The purpose of this study was to determine dentists’ and residents’ views on the key factors influencing effective dental care for older people living and dying in care homes.
Methods: Qualitative semi-structured interviews were undertaken with 17 dentists and 13 care home residents. Purposive sampling was used to ensure the sample included a broad range of key characteristics. Data generation and analysis followed the principles of Constructivist Grounded Theory with data being collected, transcribed verbatim and analysed concurrently.
Results: 30 interviews provided overlapping accounts of dental care in care homes. Three main themes were identified that details factors influencing the provision of effective and coordinated dental care for care home residents; the importance of timely access to clinical expertise in Special Care Dentistry to support holistic and multidisciplinary dental care planning; the benefits of access to clinical expertise in palliative dental care to prevent unnecessary attendance for operative dental surgery; and the failure of the current commissioning and remuneration to support effective models of service delivery into care homes.
Conclusions: A lack of integration across health and social care can undermine dental care for older people living in care homes. Ensuring timely access to clinical expertise in palliative dental care and supporting collaborative working between dental, medical and care home staff to take a whole person approach to dental care planning provides a possible explanation of what would enable effective dental-care services for older people living and dying in care homes.