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Oral Care

  • Our MD, Jo Bonser will be speaking live at the Care and Dementia Expo on September 15th, will you be joining us?

    Jo will be sharing her personal story of helping to care for her Mum, which has led her to help care homes improve their mealtime experience for people living with dementia.

    Jo told us:

    In November of 2016, my sister and I were told our Mum wouldn’t survive Christmas.

    These are the words no one ever wants to hear about their loved one, but my Mum’s GP warned us that Mum had given up on life and was ready to die.

    There was no denying that Mum was really poorly, living at home with vascular dementia aged 95, she had suffered 3 falls, several urinary and chest infections and had no appetite or interest in eating or drinking resulting in dramatic weight loss and dehydration. She would not pick up a knife or fork to eat and if you tried to assist her with a meal she would turn away from you.

    However, my Mum was an incredibly strong, and stubborn, lady and we weren’t prepared to just accept what the care professionals said, so we set to work to do whatever we could to help her recover.

    With my, then, 26 years experience from working in the care sector, and having some knowledge of nutrition and hydration for our elders, I decided to take charge of Mum’s mealtimes and began to observe her mealtime behaviours to see what I could do to improve her dining experience and ultimately her nutrition levels.

    I learned that getting people with dementia to eat can be challenging, and that complex interaction with the mealtime environment, plus many eating difficulties can prevent their nutritional intake.

    Following research, I found an online mealtime assessment tool and started to observe Mum’s mealtime behaviours, to identify, find solutions and create a care plan to help overcome her mealtime eating difficulties with the goal of bringing enjoyment for her at mealtimes, giving her back her mealtime independence, preventing malnutrition and improving her quality of life.

    The assessment tool provided me with a list of suggested interventions of which I chose several to trial with Mum including:

    • Decluttering the mealtime environment to reduce confusion levels.
    • Reducing noise levels resulting in a calmer setting which improved her nutrition
    • Introducing adapted crockery and cutlery to help her regain eating independence
    • Eating with her to make mealtimes more social occasions

    Mum’s transformation was miraculous! Within weeks, Mum was back to eating completely independently, enjoying her meals and gaining weight.

    The care professionals couldn’t believe her transformation and her end-of-life care nurse, Sally, stopped her visits saying ‘you don’t need my help anymore!’

    Having seen Mum’s transformation, I wanted to share my learnings with others, who were caring for people with dementia, to enable them to also experience more positive and dignified mealtimes and improved nutrition.

    And so Mum provided me with the inspiration to write my guide, as a free resource, with one aim – to help people with dementia achieve the most dignified, independent and delicious dining experience possible.

    I had walked a mile in the shoes of those who care for people with dementia. I had faced their challenges, and I had been able to overcome them and I wanted to share the strategies which had worked for us.

    I wanted to empower care managers and their teams and family members caring for people living with dementia to understand they CAN make a big difference in the way they support their people to lead to improved engagement, enjoyment at mealtimes

    I wanted them to really think about how their dining experience made their residents feel by putting themselves in their shoes.

    Would their dining experience pass the ‘Mum’ test - would it be good enough for their loved ones? And if not why should it be good enough for anyone else?

    My guide is designed for busy care managers, combining solutions to common mealtime challenges, packed with best practice guidance and tips to improve the dementia mealtime experience and ideas of product solutions that are available to be enabling for people with dementia. All from one trusted source, to save them valuable time.

    My guide launched in 2017 and was requested and distributed to many different care professionals and types of organisations, more than I could have imagined:

    OT’s, care home managers, local authorities, care trainers, CQC inspectors, SALT teams, dietitians, care quality consultants, care catering specialists, end of life nurses, home care companies are just some of the people who have had copies and have fed back what a valuable resource it has been.

    Following feedback from a senior dietitian within the BDA, who highly rated it and helped me with areas to improve, I updated it in 2018 and very much see it as an evolving resource as I learn more and more research is done.

    In 2018, I delivered ‘The Dementia Mealtime Challenge’, an interactive workshop I created based on my guide, at the National Association of Care Catering annual training and development forum. Several people who were present, have since come back to say thank you we have implemented all the suggestions from your workshop!

    This is now available as a workshop for teams in care homes who are serious about looking at ways to improve their mealtime experience.

    2019 saw me start my first consultancy project after an outstanding care provider approached me to work with them on a project to further improve their already excellent mealtime experience. This led to me developing a range of services to offer care homes including:

    • Mealtime observational audits
    • Enabling independence at mealtimes assessments for individuals
    • Creating enabling dining environment audits for people living with dementia
    • Mealtime equipment audit
    • Partnership working with care teams on improvement plans and implementation.
    • Retained support to measure continuous improvement.

    I am passionate about helping people and sharing my knowledge, and with my own experience and care sector background would love to work with more care homes to help them too.

     

    I am thrilled to be speaking in the Dementia Theatre at the Care and Dementia show, and also to be providing a further sensory learning experience and a fun competition with great prizes we are offering if you come and see us on our stand at the show.

     

     

    Download your own copy of our Dignified Dining Solution Guide below or visit our website at www.hcsuk.co.uk.

    Many people have asked me, ‘how much is your guide?’ and they are delighted when I tell them it’s free and I call it my little gift to the universe.’

     

  • What Is Dry Mouth And How Does It Affect Oral Health

    Oral health care and effects of dry mouth

    Every once in a while we all experience a dry mouth, especially when we are nervous, upset or under stress. However, for some people, dry mouth, or xerostomia, is a common condition that is caused by lack of saliva in the mouth and is thought to affect at least 1 in 4 of the population, with 60% being in the 60+ age group, and over 33% going undiagnosed. If dry mouth is not treated it can be highly uncomfortable and can impact on oral health.

    Saliva plays several important roles when it comes to keeping our mouths healthy. In addition to its role in digestion, saliva helps to cleanse the oral cavity, facilitate oral processing and swallowing of food, maintaining a neutral pH and preventing tooth demineralisation.

    The Main Causes Of Dry Mouth

    • Lack of hydration
    • Snoring/mouth breathing
    • Some long term health conditions
    • Taking multiple medications - more than 500 medications, both prescription and over the counter, have dry mouth as a side effect
    • Head and neck cancer and cancer therapy dry mouth is one of the most common complications during and after radiotherapy and treatment.

    Who Is Susceptible To Dry Mouth?

    oral health with diabetes

    People with diabetes

    Patients with high blood sugar levels are prone to experiencing dry mouth and it can lead to further oral health complications.

    Effects of dry mouth and cancer patients oral healthcare

    People having treatment for cancer

    Patients who are having treatment for cancer, in particular head and neck cancer, are at significant risk of developing dry mouth. Dry mouth is one of the most common complications during and after radiotherapy treatment.

     

    oral health in dementia

    People living with dementia

    One of the main side effects of the medication patients with dementia and Alzheimer take is dry mouth. Common medications with this side effect include; antidepressants, antipsychotics and sedatives.

     

    oral health with polypharmacy patients

    People on multi-medication (polypharmacy)

    More than 500 medications, both over the counter and prescription, have xerostomia as a side effect and the prevalence increases with each medication taken. More than 3 medications taken in combination can lead to a 50% risk of developing dry mouth.

     

    oral health and dry mouth effects for people with depression

    People with depression

    Antidepressants are one of the groups of medication most commonly associated with dry mouth.

     

    people with auto-immune disease and oral health

    People with Auto-immune diseases

    Patients with autoimmune diseases, such as Sjögren’s syndrome, may suffer from dry mouth. This is due to their body’s immune system attacking glands that secrete fluid, especially the saliva glands.

     

    How Does Dry Mouth Impact Oral Health?

    • Effects of dry mouth in oral health careDifficulty speaking and swallowing - due to a lack of moisture and lubrication in the oral cavity.
    • Gum disease - with a reduced salivary flow bacteria and plaque will not be flushed from the mouth and is more likely to attack the teeth and gums.
    • Tooth decay - saliva helps maintain a neutral pH in the mouth and aids with food clearance. A lack of saliva can cause difficulties in buffering the acids caused by bacteria or ingested foods resulting in tooth decay
    • Viscous or sticky/stringy saliva - due to a lack of moisture and lubrication in the oral cavity.
    • A change in sense of taste - saliva plays a role in our experience of taste so people with dry mouth may find a change in their sense of taste, growing an intolerance towards spicy, salty, or sour foods and drinks.
    • A dry or burning feeling in the mouth, lips and throat
    • Cracked lips - a lack of moisture can cause sores on the lips, split skin at the corners of the lips and cracked dry lips.
    • A rough tongue - moisture of the tongue is maintained by the saliva. However, with a lack of salivary flow, the tongue can become extremely dry, sore and red causing discomfort and even a burning feeling.
    • Severe halitosis - due to the lack of cleansing action provided by normal salivary volume and flow, patients can experience bad breath.
    • Mouth sores

    The Symptoms Can Have A Dramatic Effect On A Person's Wellbeing

    Effects of dry mouth in oral health

    Why Isn't Water The Best Relief Method?

    One of the most frequently used saliva substitutes is water and whilst it can be used as a saliva replacement, it doesn't moisten and lubricate the oral mucosa and teeth adequately - something which is critical to provide relief for dry mouth. In addition, saliva plays a larger role in the mouth than just providing water.

    As dry mouth is rarely associated with systemic dehydration, consuming large quantities of water does not overcome it, but merely provides temporary relief from the symptoms of dry mouth. People who compensate through frequent sipping of water, particularly at night, often report a decrease in sleep quality due to the increased frequency of urination.

    Furthermore, drinking excessive amounts of water could potentially promote the loss of electrolytes and result in electrolyte imbalance.

    Here Are Our Top Tips To Help You To Manage Dry Mouth

    • oral health care for dry mouth with Oralieve productsMaintain good oral hygiene
    • Improve hydration take regular sips of cold water or suck on ice cubes
    • Use water-based mouth gels, sprays and non-foaming toothpaste

    How Can Oralieve Help?

    All our Oralieve products contain bioactive ingredients and enzymes which supplement the natural systems in saliva to provide effective and lasting relief. Oralieve products help promote a healthy, comfortable mouth.

    Having a dry mouth may mean a person’s mouth can be painful when using products containing strong flavours or detergents. Many oral hygiene products contain Sodium Laurel Sulphate SLS, which can irritate oral tissues. Oralieve products do not contain SLS, alcohol or strong flavours and have been tested and developed with dry mouth sufferers.

    Click on an Oralieve product to reveal more information on how it can help the people you support with dry mouth.

    Dry mouth relief with Oralieve mild toothpaste Oralieve Ultra Mild Toothpaste
    Moisturising mouth gel to relieve dry mouth Oralieve Moisturising Mouth Gel
    Oral health products for nourishing lips Oralieve Nourishing Lip Care
    Oral health dry mouth relief with Oralieve moisturising mouth spray Oralieve Moisturising Mouth Spray

    To download our Oral Hygiene Management Guide, click on the link below

    Oral Hygiene Management Guide Long CTA

  • Why Oral Care Needs To Be Given Greater Priority In Care Homes

    We carried out a recent poll to help us understand the challenges care managers are facing to achieving good oral care in care homes, and the results are in!

    • 43% of people who responded stated that ‘staff don’t see it as a priority
    • 30% put it down to a lack of guidance and training
    • 17% said staff fear personal harm
    • 9% stated there was a lack of fit-for-purpose tools

    CQC now heavily promote the importance of oral care in care homes, which includes mandatory training and forming part of the effective and responsive KLOE’s

    Here, Kate Terroni, Chief Inspector for Adult Social Care at the Care Quality Commission (CQC) talks about the importance of oral health:

    “Oral health has a huge impact on our quality of life and we need professionals across a number of sectors to make changes to ensure it is given the priority it needs in care home settings.

    “Oral health cannot be treated as an afterthought. It can make the difference between someone who is free from pain, enjoys eating and is able to confidently express themselves through talking and smiling – and someone who is in pain, unable to enjoy their food and who covers their mouth with their hand when they smile because they are ashamed of their poor oral hygiene but unable to address it themselves. No one should have to live like that.”

    And yet there still seems to be a huge gap between where we are and where we need to be on understanding the huge impact oral health has on overall health.

    Did you know that the state of your teeth affects your overall health, with gum disease linked to lots of serious health problems in other parts of the body?

    Therefore, brushing your teeth regularly to remove plaque can prevent gum disease and improve your overall health.

    Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, explains: "The link between oral health and overall body health is well documented and backed by robust scientific evidence. Despite this, only 1 in 6 people realises that people with gum disease may have an increased risk of stroke or diabetes. And only 1 in 3 is aware of the heart disease link."

    Gum disease may increase your risk of all kinds of other health complications, including stroke, diabetes and heart disease. Gum disease has even been linked with problems in pregnancy and dementia.

    So why is good oral care so important?

    In a two-part BBC series, Dr Christoffer Van Tulleken, carried out an experiment where he didn’t brush his teeth for 2 weeks, to demonstrate the implications of poor dental hygiene.

    Dr Tulleken commented: ‘At the end of this time, I brushed my teeth and my gums bled; I had developed mild gum disease - an infection of the tissues that support the teeth. It's mainly caused by bacteria from plaque build-up on all hard surfaces of the mouth due to lack of oral hygiene. Carry on like this and not treat the problem and I could lose some teeth.’

    Further tests showed that he had also damaged his immune system - In some people who are susceptible to gum disease, the body over-reacts to the bacteria around the gums and causes too much inflammation. In others, the inflammation doesn't clear up. The result of the intense gum inflammation is that it also affects the bloodstream, and is believed to slowly damage blood vessels in the heart and brain over a long period of time. And there is mounting evidence that shows an association between poor oral hygiene and a wide variety of illnesses including:

    • Dementia
    • Pneumonia,
    • Diabetes, and its control
    • Kidney disease
    • Heart disease and heart attacks
    • Stroke
    • Rheumatoid arthritis

    ‘Gum disease isn't just bad for your teeth; it shortens your life - simple as that. So, looking after your teeth is one of the most important health interventions you can make’ he concluded.

    How do you think you would feel if you were unable to brush your teeth for 2 weeks?

    What do you think the implications to your health and wellbeing would be?

    • Inadequate oral care can be detrimental to social and emotional well-being – people become very conscious of not having a fresh mouth and can withdraw socially.
    • Any untreated oral pain can make chewing difficult and uncomfortable and therefore impact adequate levels of nutrition and hydration for weight maintenance

    However, a good oral care regime can help to:-

    • Keep residents as comfortable as possible in palliative and end-of-life care
    • Prevent dental decay and gum disease

    We need to work together to help build knowledge and understanding of the implications of poor oral hygiene and why it needs to be made a priority.

    Why not download a copy of our free Oral Care Guide? And you can check out our comprehensive range of fit-for-purpose oral care product solutions here too.Oral Hygiene Management Guide Long CTA

    We have additional great articles relating to oral care that you may find a worthwhile read! Find them here.

     

    How can I improve oral care for my residents living with dementia?

    What are the safe alternatives to banned pink mouth foam swabs?

    CQC calls for improvements in oral health in care homes

  • How Can I Improve Mouth Care For My Residents Living With Dementia?

    Having helped to care for my own Mum for over 6 years, living with Vascular Dementia I experienced, first-hand, some of the challenges of delivering effective oral care to someone living with dementia. It is proven that they are more likely to resist tooth brushing and that this is often a response to fear or a previous bad experience.

    Continue reading

  • What Are The Safe Oral Care Product Alternatives To Banned Pink Foam Mouth Swabs?

    Video thumbnailWatch our first ever video introduction to the latest blog from Jo Bonser

    covered mouth

    Innovation in safe oral care products for the elderly, vulnerable and for end-of-life care has been painfully slow until very recently, causing a challenge to care homes and hospitals who are trying to deliver safe oral care but without access to fit for purpose products available.

    Continue reading

  • How improving oral hygiene can help to reduce the spread of COVID-19

    As part of National Smile Month which aims to help us achieve good physical and mental well-being by promoting and improving oral health, we wanted to highlight just how important good oral care is right now and how it can help to reduce the risk of the spread of COVID-19.

    We know that in most cases, COVID-19 infection is spread via respiratory droplets such as coughing and sneezing and as these droplets are derived from saliva, the effect of lowering levels of bacteria and viruses in the mouth through toothbrushing and regular cleaning of dentures can only help to reduce the number of viral particles present in the atmosphere.

    In addition to these measures, regular rinsing with mouthwashes that contain 1% Hydrogen Peroxide have been demonstrated to be effective against COVID-19.

    Therefore supporting mouthcare for residents who are unwell with COVID-19, or symptoms, is not only an important part of their overall patient care, but can also reduce the spread of the infection to others.

    Here at Hcsuk, we have set out the latest best practice guidance on oral care for residents with COVID-19 or suspected COVID-19, from Public Health England and guide you through our fit for purpose oral care product range helping you to give your residents the best possible mouthcare to improve their health and wellbeing.

    If oral hygiene is neglected, residents’ mouths will rapidly become dry and sore. The aim of good mouthcare is to maintain oral cleanliness, prevent additional infection and reduce the likelihood of developing bacterial pneumonia.

    On admission, it is important to include an oral assessment for each resident in their care plan.

    When providing mouthcare for residents with COVID-19 staff must wear personal protective equipment (PPE) to prevent contact and droplet transmission. This means wearing disposable gloves, plastic apron, eye protection and a fluid resistant face mask. Delivering mouthcare is not an aerosol generating procedure. However, the environment you are working in may require the use of enhanced PPE (e.g. if working where patients are ventilated.)

    Two additional really useful tools to have handy when delivering oral care are a pen torch to enable you to see properly what is happening inside your resident’s mouth (which can be a dark place) and also a Bedi Shield designed to help facilitate oral care with dignity and in a safe, efficient and unobtrusive manner.

    Oral Hygiene Management Guide Long CTA

    Mouthcare for non-ventilated residents

    • if residents are having oxygen via a face mask, check with the nurse in charge before removing this for the time needed to carry out mouthcare

    • assess your resident and consider if they can brush their own teeth, or if you need to help them to keep their mouth moist and clean

    • these residents are more likely to cough when performing mouth care, be gentle, stand to the side or behind them, take breaks to allow the patient to rest and swallow

    • if possible, sit your resident upright

    • if your resident has a dry mouth, encourage sips of fluid (unless nil by mouth), hydrate with a toothbrush or an oral swab dipped in water or apply available dry mouth gel to their tongue, inside of their cheeks and roof of their mouth using an oral cleanser

    • make sure your resident’s lips are kept moist with a nourishing lip balm particularly before cleaning

    • if your resident can brush their own teeth give them a soft, small headed toothbrush with a smear of non-foaming toothpaste

    • do not use an electric toothbrush as this may cause droplets and splash

    • if your resident can spit, give them a disposable bowl to spit into

    • if your resident is unable to spit and bedside suction is available, and you are trained to use it, then use gentle oral suctioning to remove excess saliva and toothpaste

    • after brushing rinse their brush, and store with their toothpaste in a sealed named container

    • if a resident has false teeth (dentures) encourage them to remove these after meals to clean off debris with a toothbrush. Remove dentures at night and store dry, in a named denture pot.

    • residents may not wish to wear dentures when unwell and it is important that they are stored in a named denture pot to avoid them getting lost

    • if eating, encourage residents to have a few sips of water after meals to clear any left-over food from their mouth

    • if a resident is confused, refuses, or resists care, stop and try again later, remembering to record any non-compliance in their care plan.

    To try and help make life easier for you during what must be both an incredibly busy and stressful time for care managers we have put together a COVID-19 Complete Oral Care Solution Pack which contains everything you need, as described above to deliver effective oral care for your residents with COVID-19, or suspected COVID-19 in one hygienic and reusable plastic box.

    This guidance outlines mouthcare for adults and children with COVID-19 or suspected COVID-19 who are non-ventilated and those having step down or end of life care.

    If you would like any further information, assistance or samples of any of our oral care products included in this article, then please don’t hesitate to contact our Business Development Manager Jan Kelly on her mobile 07968 994660 or email her at [email protected]

    Oral Hygiene Management Guide Long CTA

  • Hcsuk helping you to achieve latest best practice guidance on mouthcare for residents with COVID-19 or suspected COVID-19

    The importance of good oral care in care settings has been in the spotlight since NICE (The National Institute for Health and Care Excellence) published guidance over 3 years ago, and this has now become a priority with the Care Quality Commission. There is mounting evidence that shows an association between poor oral hygiene and a wide variety of illnesses including Pneumonia.

    Therefore supporting mouthcare for residents who are unwell with COVID-19, or symptoms, is an important part of their overall patient care.

    Here at Hcsuk, we set out the latest best practice guidance from Public Health England and guide you through our fit for purpose oral care product range helping you to give your residents the best possible mouthcare to improve their health and wellbeing.

    If oral hygiene is neglected, residents’ mouths will rapidly become dry and sore. The aim of good mouthcare is to maintain oral cleanliness, prevent additional infection and reduce the likelihood of developing bacterial pneumonia.

    On admission, it is important to include an oral assessment for each resident in their care plan.

    When providing mouthcare for residents with COVID19 staff must wear personal protective equipment (PPE) to prevent contact and droplet transmission. This means wearing disposable gloves, plastic apron, eye protection and a fluid resistant face mask. Delivering mouthcare is not an aerosol generating procedure. However, the environment you are working in may require the use of enhanced PPE (e.g. if working where patients are ventilated.)

    Two additional really useful tools to have handy when delivering oral care are a pen torch to enable you to see properly what is happening inside your resident’s mouth (which can be a dark place) and also a Bedi Shield designed to help facilitate oral care with dignity and in a safe, efficient and unobtrusive manner.

    Oral Hygiene Management Guide Long CTA

    Mouthcare for non-ventilated residents

    • if residents are having oxygen via a face mask, check with the nurse in charge before removing this for the time needed to carry out mouthcare

    • assess your resident and consider if they can brush their own teeth, or if you need to help them to keep their mouth moist and clean

    • these residents are more likely to cough when performing mouth care, be gentle, stand to the side or behind them, take breaks to allow the patient to rest and swallow

    • if possible, sit your resident upright

    • if your resident has a dry mouth, encourage sips of fluid (unless nil by mouth), hydrate with a toothbrush or an oral swab dipped in water or apply available dry mouth gel to their tongue, inside of their cheeks and roof of their mouth using an oral cleanser

    • make sure your resident’s lips are kept moist with a nourishing lip balm particularly before cleaning

    • if your resident can brush their own teeth give them a soft, small headed toothbrush with a smear of non-foaming toothpaste

    • do not use an electric toothbrush as this may cause droplets and splash

    • if your resident can spit, give them a disposable bowl to spit into

    • if your resident is unable to spit and bedside suction is available, and you are trained to use it, then use gentle oral suctioning to remove excess saliva and toothpaste

    • after brushing rinse their brush, and store with their toothpaste in a sealed named container

    • if a resident has false teeth (dentures) encourage them to remove these after meals to clean off debris with a toothbrush. Remove dentures at night and store dry, in a named denture pot.

    • residents may not wish to wear dentures when unwell and it is important that they are stored in a named denture pot to avoid them getting lost

    • if eating, encourage residents to have a few sips of water after meals to clear any left-over food from their mouth

    • if a resident is confused, refuses, or resists care, stop and try again later, remembering to record any non-compliance in their care plan.

    To try and help make life easier for you during what must be both an incredibly busy and stressful time for care managers we have put together a COVID-19 Complete Oral Care Solution Pack which contains everything you need, as described above to deliver effective oral care for your residents with COVID-19, or suspected COVID-19 in one hygienic and reusable plastic box.

    Explore the COVID-19 Complete Oral Care Solution Pack

    This guidance outlines mouthcare for adults and children with COVID-19 or suspected COVID-19 who are non-ventilated and those having step down or end of life care.

    If you would like any further information, assistance or samples of any of our oral care products included in this article, then please don’t hesitate to contact our Business Development Manager Jan Kelly on her mobile 07968 994660 or email her at [email protected]

    Oral Hygiene Management Guide Long CTA

  • CQC calls for improvements to oral health in care homes

    The Care Quality Commission (CQC) has recently published the findings of an in-depth review on the state of oral health care in care homes across England.

    The review draws on one hundred inspections of care homes on which CQC inspectors were accompanied by inspectors from dental regulation. It reveals that three years on from the publication of NICE guidance on oral health in care homes, steps are often not being taken to ensure that people get the oral health care they need to ensure that they are pain-free and that their dignity is respected.

    Key findings include:

    • The majority (52%) of care homes visited had no policy to promote and protect people’s oral health
    • Nearly half (47%) of care homes were not providing any staff training to support people’s daily oral healthcare
    • 73% of residents’ care plans reviewed only partly covered or did not cover oral health at all – homes looking after people with dementia being the most likely to have no plan in place.
    • 17% of care homes said they did not assess people’s oral health on admission
    • Kate Terroni, Chief Inspector for Adult Social Care at the Care Quality Commission (CQC) said:
    • “Oral health has a huge impact on our quality of life and we need professionals across a number of sectors to make changes to ensure it is given the priority it needs in care home settings
    • “Oral health cannot be treated as an afterthought. It can make the difference between someone who is free from pain, enjoys eating and is able to confidently express themselves through talking and smiling – and someone who is in pain, unable to enjoy their food and who covers their mouth with their hand when they smile because they are ashamed of their poor oral hygiene but unable to address it themselves. No one should have to live like that.

    Why is good oral care so important?

    1. Inadequate oral care can be detrimental to social and emotional well-being
    2. To maintain adequate levels of nutrition and hydration for weight maintenance
    3. To keep residents as comfortable as possible in palliative and end-of-life care
    4. Because dental decay and gum disease are entirely preventable
    5. There is mounting evidence that shows an association between poor oral hygiene and a wide variety of illnesses including:
    • Dementia
    • Pneumonia,
    • Diabetes,
    • Kidney and heart disease
    • Cancer.

    So what is the difference between oral hygiene and oral care?

    Oral Hygiene

    • Cleaning teeth and the oral cavity using toothpaste and toothbrush delivered twice daily

    Oral Care

    • Ensuring that the mouth is clear of trapped food and debris with Moutheze oral cleanser
    • Ensuring that the mouth is pink, clean and moist
    • Checking regularly with a pen torch to ensure the oral environment hasn’t changed - delivered 2 hourly – perhaps when re-positioning
    • Interaction with the person to ask about how their mouth feels – especially for pain and dryness
    • Vulnerable adults are often unable to take proper care of their teeth due to overall weakness or problems like:
    • Arthritis
    • Memory loss
    • Anxiety
    • Sleep disturbance
    • Depression
    • Disorientation

    Research has found the following challenges to achieving and maintaining good oral health for residents in care homes.

    • This aspect of care is sometimes considered as distasteful
    • With residents who retain some of their teeth, care staff can show reluctance to deliver mouth care for fear of personal harm from non compliance
    • Staff may not give oral care priority
    • Lack of fit for purpose tools and products with which to work
    • Lack of formal guidance and training
    • Other workplace pressures

    So what do care homes need to do to comply with CQC latest guidelines for oral care?

    What the Care Quality Commission expects

    The Care Quality Commission expects registered managers to take account of nationally recognised guidance, including guidance from NICE.

    Evidence about how you support residents to maintain good oral health will help you demonstrate that your service is both effective and responsive.

    NICE’s guideline on oral health for adults in care homes, including the baseline assessment tool, can be used as part of your preparation for inspection and to support requests for help to other services.

    Oral health assessment

    All residents should have an oral health assessment when they move into the care home, with the result recorded in their care plan. Care staff should start by asking the following questions:

    How do you usually manage your daily mouth care and what help would you like?

    What dental aids do you currently use? For example, manual or electric toothbrush, mouthwash, floss.

    Do you have dentures, and if so are they marked with your name? If not, would you like them to be marked?

    When did you last see a dentist, and who did you see?

    If you don't have a dentist would you like help to find one?

    Using an oral health assessment tool - like the one here - will highlight any areas where residents need specific care and support. Using it for reassessments will indicate any changes that may need action.

    Care staff knowledge and skills

    Care staff need to know when to reassess the oral health of a resident and how to support residents with their daily mouth care to:

    Brush their natural teeth at least twice a day with fluoride
    toothpaste.

    Use their choice of cleaning products for dentures.

    Clean their dentures (brushing, removing food debris, and removing dentures overnight).

    Use their choice of toothbrush, either manual or electric/battery powered, and mouth care products.

    They also need to understand how dental pain or a mouth infection can affect residents’ general health, wellbeing and behaviour.

    Make sure staff know who to ask for advice, how and when to report any concerns about a resident’s oral health, and how changes in a person’s condition might affect their ability to manage their mouth care.

    For more information on Being CQC Ready in Oral Care we have attached a link to a Youtube training video by Knowledge Oral Health, which we hope you will also find useful.

    If you have any questions or would like to discuss any of our fit for purpose oral health product solutions then please don’t hesitate to contact us on 01773 713713 or email us at [email protected]

  • How to deliver excellent oral care for your residents in care homes and achieve CQC compliancy.

     

    It is just under 2 years since, the NICE Quality Standard 'Oral Care in Care Homes ‘was published.

    In it are recommendations that residents in care homes have their oral health needs assessed on admission and recorded in their personal care plans, and are supported to clean their teeth twice a day and/or their dentures daily.

    Why do I want to talk about this and bring it to your attention now?

    Recently, we have heard from both care home customers and CQC inspectors that this is an area of focus for CQC during inspections.

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  • How improving oral care has meant more kisses for care home resident, Mr A, living with Advanced Parkinson’s - A case study

    As part of Parkinson’s Awareness week we wanted to share with you how, by using our empathy for a gentleman living with advanced Parkinson’s, and our knowledge of the condition, we were able to gain a good understanding of his needs and advise on and recommend specialist oral care product solutions for him.

    This has proved to be life changing for Mr A and has led to a more loving and fulfilling relationship with his wife. J

    ‘All I want is to be able to feel that my mouth is fresh and clean every day’

    This is what Mr A told me when I first met him and asked him how I could help improve his oral care.

    I was genuinely moved by his simple wish, and it made me realise that this was something that I completely took for granted – I would never dream of leaving the house without feeling that my teeth are squeaky clean and my breath sweet.

    And it also made me absolutely determined to do everything within my power to help make Mr A’s wishes happen.

    Continue reading

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