Oral health in care homes: turning research into practical action

Care England launches a policy white paper and toolkit, calling for better dental access and shared responsibility across the health and care system.

For someone living in a care home, oral health affects comfort, eating, communication and everyday life. It is an essential part of dignity and wellbeing, yet mouth care can fall between daily care responsibilities and a dental system that is difficult to access.

On 5 November, Care England is launching Improving Oral Health Outcomes for Care Home Residents, a research-led policy white paper accompanied by a practical oral health toolkit. The work calls for government, the NHS, commissioners, regulators, dental professionals and care providers to share responsibility for improvement. It also offers care teams usable resources to support the part they can deliver every day.

The paper builds on the Care Quality Commission’s Smiling matters work of 2019 and 2023. That raised awareness, but the pandemic and wider pressures disrupted progress. Wales has Gwên am Byth and Scotland has Caring for Smiles; England still lacks an equivalent national care-home implementation programme.

No single intervention will solve everything. Drawing on UK research including TOPIC, SENIOR and CONCEALED, alongside COMMIT and FInCH, the paper examines assessment, personalised plans, staff support, daily routines, prevention and nutrition. It recognises the limits of what care homes can do without access to dental assessment and treatment.

Care England is asking the Department of Health and Social Care and NHS England to lead a national implementation programme. It calls for every Integrated Care Board to set out how care homes can access domiciliary and community dentistry, urgent treatment and clear referral pathways. It also asks for funded workforce training, closer links between oral health and nutrition, proportionate regulatory expectations and better information on access and outcomes.

Alongside these policy recommendations, the new resource collection helps teams move from evidence to action. It includes an eight-page research summary, a twelve-page practical guide, three shorter study-specific summaries, an explainer animation and a mobile-friendly interactive staff guide. It also signposts the original TOPIC tools, including oral health assessment, personal care planning, oral hygiene records and training materials.

For providers, the starting point is practical: raise awareness with staff, residents and families; make time for training and support; embed oral health assessment and daily mouth-care routines; keep proportionate records; and review what is working. These steps do not replace NICE guidance, professional dental advice or local referral arrangements.

The research underpinning the work focuses primarily on older adults in care homes. Many principles, personalised care, daily support, staff confidence and access to dental services, have wider relevance across adult social care, including services supporting working-age adults.

This begins a continuing programme, not simply another publication. Care England thanks the Nightingale Hammerson Research Forum for connecting the sector with Professors Georgios Tsakos, Paul Brocklehurst and Gerry McKenna, and helping research reach people who can use it.

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

Read the white paper and access the oral health toolkit