Smiling Matters: Oral Care in Care Homes Report

Early in 2019 we visited twenty care homes across Brighton and Hove to assess the oral care of residents.
older woman sitting in chair by a garden smiling


We spoke to care staff and residents, including frail older people, younger adults, and people of all ages with long-term ill health, Learning Disabilities and mental health conditions.

We wanted to know how staff assessed residents for oral health, whether they assisted residents with cleaning their mouths, including teeth and dentures and whether residents had regular and easy access to a dentist.

“You can see a doctor, a physiotherapist, a chiropodist in the home, so why isn’t it possible to see a dentist for a check-up?”
— Care home resident

Our findings

  • 55% of homes have no visiting dentist but 91% of residents are not well enough to visit a dentist surgery.
  • 48% of care home staff do not carry out routine oral health checks on admission.
  • 37% of care home staff have had no training in oral health.
  • 41% of care home staff did not know if their care home had a policy covering oral and dental health.
  • Specialist training improves oral health, but the training is not compulsory.

For full details on our finding please read the full report.

Specialist Training

Brighton and Hove provide an ‘oral health promotion team’ giving specialist training for care home staff. 20% of the homes we visited had benefited from that specialist training, provided by the SCFT. Checking against four key quality measures all of these homes scored higher than Care Homes who had not received the training.

Healthwatch has made 18 recommendations to care home staff and management for improvements in routine checks and policy awareness and to commissioners for training to be considered as part of contract requirements.


“We welcome this report from Healthwatch, which identifies recommendations – all in line with the council’s approach to promoting oral health.”
— Rob Persey, Executive Director of Health & Adult Social Care and Alistair Hill, Director of Public Health at Brighton and Hove City Council.


You can download the full report here. If you need this report in a different format,
please contact us at 01273 234 041.

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