Specialist Dental Project

Healthwatch Lincolnshire carried out research in 2017 to understand the experiences of care home residents and staff in accessing NHS dental services. Evidence was gathered from 52 residents across nine care homes, 66 people with learning disabilities and their families, and staff from 47 care homes across Lincolnshire. The findings were intended to inform local oral health planning and strategies for older people. 

The report found significant difficulties in accessing dental care for care home residents. Sixty-three per cent of care homes reported problems obtaining routine dental treatment, while 58% experienced difficulties accessing emergency dental care. Barriers included a lack of available NHS dentists, challenges associated with residents’ complex needs such as dementia and learning disabilities, transport difficulties, and the costs associated with private dental services. 

Although 95% of care homes included oral health in residents’ care plans, 16% did not assess oral health needs when residents moved into the home, and many homes lacked arrangements for regular dental check-ups. Forty-two per cent of homes reported that residents only received dental assessments when symptoms arose. 

Care home staff highlighted the need for routine dental visits within care homes, improved access to NHS dentistry, denture identification systems, regular denture fit assessments, and better collaboration between dental and care services. Staff also called for increased training and awareness, particularly around caring for people with dementia and learning disabilities. 

The report found that only 40% of care homes had a local dentist providing routine care for residents, and only 5% of those dentists were willing to visit care homes directly. Many homes reported that residents could only access dental visits through private providers, which often created financial barriers. Awareness of the Community Dental Services, which provide specialist dental care for people with additional needs, was also very low, with only one of the nine care homes spoken to being aware of the service. 

Residents reported that dental care was difficult to obtain, especially after moving into a care home or a new area. Many relied on family members to arrange appointments, some had to travel considerable distances for treatment, and several reported problems with lost, poorly fitting, or uncomfortable dentures. While some residents said their homes supported oral hygiene, this support was not consistently reported.

The report also identified gaps in staff knowledge and training. Nearly one-third of care homes did not provide oral health training for staff, only 66% knew where to seek help with residents’ oral health needs, and just 55% knew how to access appropriate services for residents with additional needs. 

Healthwatch Lincolnshire concluded that access to NHS dental services for care home residents was inadequate and inequitable. The organisation urged commissioners and providers to improve access to routine and domiciliary dental care, increase awareness of specialist community dental services, strengthen collaboration between health and care sectors, and develop sustainable local solutions to meet the oral health needs of some of the county’s most vulnerable residents.