Care Dependency and Oral Hygiene Need Amongst Care Home Residents

Method: Structured interview and clinical examination using 2010 UK Adult Dental Health Survey criteria plus examining dentist opinion on treatment plan, complexity of treatment anticipated and resources required. 228 homes were randomly selected from the Care and Social Services Inspectorate Wales website. 5 randomly selected residents from each home were invited to participate. NHS research ethical approval was achieved. Data were collected from October 2010-June 2011.  213 care homes took part, 23 homes declined.  342 individuals were lost because of death, absence, refusal/no person able to consent.  708 residents took part.  Analyses were undertaken on the 593 residents who had complete dental examination and treatment planning data and consented themselves.

Results: 42.3% (251) were dentate. 18.7% (100/536) had limited or no brushing ability: dentate 13.6% (32/236); edentate 22.7% (68/300).  Self-reports of needing brushing assistance were associated with inadequate reported frequency of oral care (p=0.001).  81.3% (26/32) dentate patients who required help did not receive oral hygiene care twice a day. 19.4% (115) of residents surveyed did not brush their teeth or gums: dentate 4.8% (12/251); edentate 30.1% (103/342). Self-reported independent brushing was associated with better self-reported dental health (p=0.01).  26.5% (148/593) reported brushing at least twice a day in line with oral hygiene guidance. 24.1% (105/536) of those who reported they could brush well for themselves had “poor”/“very poor” oral hygiene status according to the examining dentist.

Conclusion: Many residents are unable to undertake oral self-care and do not receive regular care from care-givers.  Many of those caring for themselves are not doing this successfully.  Study findings have implications for dental health and social services planning.

Acknowledgement: Welsh Government.