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How can you 'brush up' on oral care for adults in care homes?

How would you feel if you were unable to brush your teeth or receive any oral care for 2 whole weeks?
Dr Christoffer Van Tulleken, recently carried out this experiment for a new two-part BBC series showing the implications of poor dental hygiene, conducted with Professor Iain Chapple, at the University of Birmingham School of Dentistry.

Dr Tulleken commented: At the end of this time, I brushed my teeth and my gums bled; I had developed mild gum disease. 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.

‘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. And there's mounting evidence that shows an association between poor dental hygiene and a wide variety of illnesses including dementia, pneumonia, diabetes, kidney and heart disease and cancer.

Oral care for adults in care homes
Vulnerable adults are often unable to take proper care of their teeth due to overall weakness or problems like arthritis or impairment of memory, anxiety behaviour, sleep disturbance, depression, and disorientation.

Sometimes they can overlook dental problems because of other more demanding health problems. In such cases it is essential for family members and carers to watch out for symptoms. Weak or loss of teeth also means difficulty in eating leading to lack of nutrition and weight loss.

Adults in residential care are at considerable risk of oral infection, with infection identified in 80% of one study population.

Why good oral care is so important

1. Dental decay and gum disease are entirely preventable.
2. Inadequate oral care can be detrimental to social and emotional well-being and adversely affect interaction with others.
3. To maintain adequate levels of nutrition and hydration for weight maintenance.
4. In palliative and end-of-life care, to keep the resident as comfortable as possible.

Oral care is the responsibility of every member of the care staff in care establishments 24 hours a day.

Oral health risk assessments, care plans and documentation of daily care should be carried out for every resident;

    However research has found the following challenges to achieving and maintaining good oral health in care homes:

    1. This aspect of care is considered by some as distasteful.
    2. With residents who retain some of their teeth, care staff can show reluctance to deliver mouth care, Fear of personal harm from non compliant residents
    3. Staff may not give oral care priority.
    4. Workplace pressures.
    5. Lack of fit for purpose tools with which to work with
    6. Lack of formal guidance and training

    Benefits for care staff:
    A painful mouth can cause challenging behaviour. Good oral care can help reduce this possibility which in turn may:

    1. Encourage resident cooperation
    2. Improve nutrition and hydration
    3. Reduce halitosis
    4. Help meet the resident’s health and welfare needs.

    More emphasis is now being placed on good oral care in Care Homes, The National Institute for Health and Care Excellence (NICE) is currently developing public health guidelines for health and social residential care settings (including nursing homes and residential care homes) on effective approaches to promoting oral health, preventing dental health problems and is due to published in July 2016.

    Added to this, new and long overdue innovations in safe and effective specialist mouthcare; products including the Moutheze oral cleanser, the Bedi shield and the Oralieve Mild Oral Hygiene range for sensitive and dry mouths are already proving to be much needed additions, which fully meet criteria for intended use, for the promotion of better quality oral care.

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