Oral health & nutrition in care home residents

Elderly lady holding apple

Oral and dental health is an important part of our wellbeing, especially in older adults. This blog will take you through why it’s important to support care home residents with their oral health, why good nutrition is important and how caterers can play their part in reducing risk.

Why are we talking about it?

More than half of all care home residents suffer with tooth decay. This is higher than in the general population of over 75s of which 40% suffer. The Care Quality Commission (CQC) conducted a report into the issues faced by care home residents in relation to oral health and found that there was a lack of care plans in place for residents around oral health, as well as staff feeling undertrained in the area. As such, the National Institute for Care Excellence (NICE) updated their guidelines on improving oral health for adults in care homes to address these inequalities, and ensure that oral health is considered right from admission and throughout an older person’s stay in a care home.

What’s the risk of poor oral health?

Not only does poor toothbrushing and oral hygiene cause the obvious: bad breath, dental decay, and infection, but it can also affect people’s ability to eat, speak and socialise normally. Medical complications which can arise from poor oral health include malnutrition due to reduced food and drink intake; pneumonia due to harmful bacteria colonising on dental plaque; and even oral cancer (not directly linked but usually identified if an older person were having regular dental check-ups).

Those living in care homes are at higher risk of poor oral health for many reasons including long term health conditions such as Parkinson’s disease, arthritis, and dementia. These conditions may make it harder for someone to brush their teeth or it can affect their memory, and so they forget. Older people are more likely to take medicines, many of which cause reduced saliva, leading to a dry mouth which increases the risk of oral disease. Additionally, due to improvements in dentistry and access in the UK, people more commonly now keep their own natural teeth. Consequently, more complex dental work is required compared to those who have dentures.

elderly lady brushing teeth

What can we do about it and what role does nutrition play?

Care home staff can work together to support residents with their oral health by:

  • Supporting with tooth brushing
  • Providing reminders for those who may not require support but might forget to brush their teeth
  • Ensuring timely access to a dentist
  • Providing good nutrition.

When we think of the types of foods which may lead to poor dental hygiene, the first thing that springs to mind is sugar. Sugar is well known for increasing the risk of dental caries, but did you know that there are other nutrients which may improve or worsen oral health?

As you can see, there are various nutrients and specific foods to think about. But how does that translate into the daily catering offering? See below for some mouth-friendly tips.

Elderly people holding mug

Tips for caterers in care homes to promote good oral health for residents:

  • Encourage neutral, low sugar drinks between meals such as tea or coffee with milk, water or a glass of milk
  • Puddings can include sugar but try to reduce the amount used and rely on natural sugar in fruit-based puddings*
  • Encourage acid-neutralising, nourishing snacks between meals such as cheese and biscuits or a glass of milk
  • Offer a healthy, balanced menu which includes wholegrains, vegetables, eggs, nuts, seeds, oily fish, and dairy products to ensure good intake of vitamins and minerals which are important for oral health
  • Consider adding a coding system for ‘good dental health’ options on the menu
  • Ensure hydration levels are maintained throughout the day.

*It is important to provide a healthy, balanced diet to all residents whilst taking individual needs into account. As it is common for care home residents to suffer with malnutrition and low weight, a high energy diet is sometimes necessary which may include high sugar foods such as puddings and sweet snacks. Teamwork is required between nursing and catering staff on individual needs of each resident.

If you need any further support, allmanhall’s dietitians can support you with advice or training. Please contact us at hello@allmanhall.co.uk to discuss your needs.

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