England urged to close care home oral health gap as new toolkit launches

Care England pairs a call for better NHS dental access with practical resources to help care teams put research into everyday care.

Care England is calling for a national programme to improve oral health in care homes, warning that guidance alone will not protect residents from avoidable pain, infection and difficulty eating without consistent daily support and reliable access to dental care.

Launching today, Improving Oral Health Outcomes for Care Home Residents: A policy white paper and good practice guide for England, and its accompanying toolkit bring together the case for change and practical support for care teams to act now.

Read the white paper and access the toolkit

The paper describes how poor oral health can affect eating, weight and quality of life, and its association with aspiration pneumonia. It argues that mouth care must be part of prevention, nutrition and everyday wellbeing, not treated as a minor personal-care task.

Developed with Professor Georgios Tsakos, Professor Paul Brocklehurst and Professor Gerry McKenna, the work draws on research funded by the National Institute for Health and Care Research (NIHR). It connects the responsibilities of care providers with the action needed from government, NHS commissioners, dental services and regulators.

The paper builds on the Care Quality Commission’s Smiling matters reports of 2019 and 2023. The 2023 progress report found improvements in care homes’ awareness, assessment and training, but worsening access to NHS dentistry: 25% of providers responding in 2022 said residents could never access NHS dental care, compared with 6% in the earlier review.

Drawing on Wales’s Gwên am Byth and Scotland’s Caring for Smiles programmes, Care England says England must now catch up with coordinated implementation, not leave individual care homes to overcome gaps in the wider system.

Professor Martin Green OBE, Chief Executive of Care England, said:

“A care home can help someone brush their teeth; it cannot fix gaps in NHS dentistry. We cannot ask providers to take responsibility for daily oral care while leaving residents without a reliable route to professional treatment.

 

“Oral health is about whether someone can eat comfortably, speak, smile and live without pain. It is not an optional extra.

 

“We are giving providers practical resources to help them improve care now. Government, commissioners and dental services must match that commitment with access, training and clear responsibility. England has the guidance and examples from Wales and Scotland. It is time to turn them into consistent support for residents.”

The report calls for DHSC and NHS England to lead a national implementation programme; every Integrated Care Board to publish a care home dental access plan, including care delivered in residents’ homes and urgent referral routes; and funded staff training with protected time. It also calls for oral health to be integrated with nutrition and hydration, aligned regulatory and commissioning expectations, and better data on access and outcomes.

The toolkit brings together an eight-page research summary, a twelve-page practical guide, an explainer animation and an interactive staff guide. It also signposts the existing TOPIC assessment and care-planning tools, oral hygiene records and training video.

Care teams are offered five steps: raise awareness; provide training and time; establish healthy mouth-care routines; keep useful records; and review progress. The resources support existing NICE guidance and professional advice rather than replace them.

Professor Georgios Tsakos, Professor of Dental Public Health at University College London (UCL), said:

“The research shows why improving oral health requires more than a single intervention. Staff need usable tools, confidence and time, and visiting dental teams need to work alongside everyday care rather than be seen as a replacement for it.

 

“Working with Care England has helped us translate the research into resources that care teams can understand and use. We want these materials to support conversations between residents, families, care staff and dental professionals, and help homes review what they can improve.”

The work is being launched at the Nightingale Hammerson Research Forum on 5 November. Care England thanks the Forum for connecting the organisation with the academic team and helping research reach care providers.

Read the white paper and access the toolkit through Care England’s publication page. A short registration form opens access to the resources.

Read the white paper and access the oral health toolkit