March 2007

Objectives: To investigate variations in reported oral health care provision and unmet dental need within a sample of care homes for the elderly in Glasgow. Basic research design: Two-phase study of a 50% random sample of 120 care homes (n=60). Phase 1: telephone interviews with care home managers. Phase 2: oral examinations of residents and face-to-face interviews with care staff, in a sub-sample of 10 homes. Clinical setting: Care homes in Greater Glasgow. Participants: Residents and staff. Results: Phase 1: data were collected from 58 of 60 care home managers approached (response rate: 97%). Oral assessment of residents on admission was reported for 78% of nursing homes and 24% of residential homes, and annual screening by a dentist for 85% and 76% respectively. Only 58% of nursing homes and 8% of residential homes had a formal mouth care policy. Staff training in mouth care was not universal and often carried out “in-house”. All managers believed dental support was available when required. Phase 2: 288 oral examinations and 22 staff interviews took place within 10 homes selected. Examinations revealed high levels of oral disease. When interviewed, staff accepted that mouth care was within their remit but failed to document it within patient care plans. Further training on oral health and disease was requested from all levels of staff. Conclusions: Oral disease is common among elderly care home residents in Glasgow. Increased emphasis on implementation of standard oral care protocols and improved education of staff is essential if the oral health of elderly institutionalised residents is to improve. Key words: care home, elderly, nursing staff, oral care