Improving dental health is essential to improving overall health

British Geriatrics Society
Date Published:
15 August 2017
Last updated: 
15 August 2017

The Faculty of Dental Surgery at the Royal College of Surgeons of England is concerned about the significant impact that poor oral health is having on older people’s general health and quality of life. The Faculty of Dental Surgery at the Royal College of Surgeons of England is concerned about the significant impact that poor oral health is having on older people’s general health and quality of life. As well as causing pain and making it difficult to speak, eat and take medication, poor oral health is linked to conditions such as malnutrition and aspiration pneumonia. Across England, Wales and Northern Ireland at least 1.8 million people aged 65 and over could have an urgent dental condition such as dental pain, oral sepsis or extensive decay in untreated teeth. By 2040, this number could increase by more than 50%.

There is an urgent need to improve oral healthcare for older people, and this report makes the following recommendations for doing so. Although primarily applicable to England, a number of proposals are also relevant for Scotland, Wales and Northern Ireland:

  • Key health professionals in acute and community care settings should receive training in oral health. This includes nursing staff, junior doctors, pharmacists, geriatricians and all other healthcare staff who have regular contact with older people.
  • Social care providers should give their staff appropriate training about oral health and care, as well as ensuring that all services have an oral care policy and cover oral health as part of initial health assessments. Oral health should always be included in the personalised care plans of those receiving social care.
  • Preventative advice on maintaining good oral health should be easily available for older people themselves, their families and their carers.
  • Government, health services, local authorities, care providers, regulators and the oral health profession should work together to develop a strategy for improving access to dental services for older people.
  • Health and social care regulators should ensure that standards of oral care are assessed during their inspections of care homes and hospitals, and the Healthwatch network should consider how it can promote the importance of oral health. A ‘kite-mark’ scheme should be developed for care homes and providers that can demonstrate good practice in oral healthcare.
  • All hospitals and care homes should have policies in place to minimise denture loss. These should include checking whether a patient has dentures on admission, and ensuring that staff always check for dentures when disposing of food trays and changing bed linen. Hospitals and care homes should also have protocols for when dentures are lost. Patients’ names should be added to all dentures during or after manufacture, and oral care should be part of end-of-life care pathways.
  • More data around older people’s oral health is needed. NHS Digital’s quarterly dental statistics, which only give figures on access to dental services for the overall adult population, should provide a breakdown for people aged 65–74, 75–84, and 85 and over. The Adult Dental Health Survey must also continue monitoring developments in older people’s oral health.
  • Demand for dental services will increase as the population grows and ages. Government must regularly review whether dentistry is sufficiently resourced to meet this, and the oral health profession should ensure its educational curricula reflect older people’s changing needs. The importance of oral health must be recognised in any wider reforms to health and social care.

Good oral health is an essential part of older people’s health care. For older people living with frailty it is critical to ensuring they are hydrated and their nutritional needs are well supported. Poor oral health care can lead to difficulties in eating, and absorbing medications properly. There are also known links between poor oral health care and pneumonia and heart disease. Getting oral health care right is a key part of supporting older people’s health, wellbeing and dignity.

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