Methods: Questionnaires were mailed to the managers of all residential care homes for the elderly in the two towns and responses were received from 84 homes (a 77% response rate). These self-reporting questionnaires were used to collect information about the following oral care procedures: initial dental assessment for new residents, dental records kept for residents, help given if needed with brushing of natural teeth, dentures marked with residents’ names, dentures cleaned and removed from the mouth at night, an established source of dental care, regular check-ups, training of staff to provide oral care and the provision of resources needed by carers for the oral care of residents. From these items, an oral health (OH) score was derived for each home. Scores ranged from 0-10, with 10 representing best practice.
Results: Only 9% of homes had OH scores of 9 or 10. The majority of homes, 54%, had an OH score between 6 and 8, while 33% of homes had scores of 5 or less. (4% gave incomplete information). The most commonly omitted procedures were the marking of dentures and updating staff training. Leaving dentures out at night was the most commonly observed item of best practice. Homes with a proportion of residents needing nursing care had better total OH scores. They were more likely to do initial oral assessments for new residents, have residents’ names marked on their dentures and have residents who frequently brushed their natural teeth (all p<0.05).
Conclusion: The oral care received by residents was less than optimal at most homes. Dual registration homes, offering both residential and nursing care, were more likely to implement best practice procedures.