At Health + Care Andrew Coles, Product Manager at Person Centred Software, and Jane Peterson, founder of Knowledge Oral Health Care, spoke about how good Oral Care improves Residents' Health and Wellbeing. They covered the importance of maintaining residents’ oral health for CQC compliance, and how care planning with Mobile Care Monitoring’s evidencing system supports management and evidence of oral health in care homes.

1. Jane Peterson RDH,BSc
DENTAL HYGIENIST
DENTAL HEALTH EDUCATOR
BSc ORAL HEALTH PROMOTION
Andrew Coles
PRODUCT MANAGER, PERSON CENTRED SOFTWARE
Determined to make a difference because oral health matters
How good Oral Care improves
Residents’ Health & Wellbeing

2. Who are we to talk?
DENTAL HYGIENIST
DENTAL HEALTH EDUCATOR
BSc ORAL HEALTH PROMOTION
Andrew Coles
Product Manager
Jane
Peterson
RDH,BSc

3. Why care
about
Oral
Health?
As a gateway to the body, what you
put in your mouth and your oral
health affects the rest of your body

4. Frenkel et al1.
The carers perception of brushing residents’ teeth, to be seen as
infringing on their personal space
Forsell et al2.
discovered the majority of nursing staff found oral hygiene procedures
unpleasant …….difficulty accessing the mouth and lack of cooperation
from residents
1. Frenkel, H., Harvey, I., & Needs, K. (n.d). Oral health care education and its effect on caregivers' knowledge and attitudes: a randomised controlled trial. Community Dentistry And Oral Epidemiology, 30(2), 91-100.
2. Forsell, M., Sjögren, P., Kullberg, E., Johansson, O., Wedel, P., Herbst, B., & Hoogstraate, J. (2011). Attitudes and perceptions towards oral hygiene tasks among geriatric nursing home staff. International Journal Of
Dental Hygiene, 9(3), 199-203. doi:10.1111/j.1601-5037.2010.00477.x
Some perceptions of oral health care health
care from a carers view

5. Studies show that daily oral hygiene often gets missed
Barriers
• Time
• People that resist
Recognition that care homes need to
prioritize oral care
8 July 2016, Jackie Brook,carehome.co.uk; RNHA calls for help in improving the oral health of older people in care homes

6. 1968 1/3
1998 17%
NOW LESS THAN 6%
PEOPLE OVER 65YRS WITH NO TEETH
People are increasingly coming into care homes
with more of their own teeth

7. Advanced Dentistry
• Crowns
• Bridges
• Implants
• Dentures
People are increasingly presenting with advanced dentistry such as:

8. Dental Plaque
Dental plaque is a biofilm
made up from bacteria and
their excretions sitting
mainly at the gum line and
between the teeth which
starts forming just hours
after brushing.

9. Gingivitis (bleeding gums)
If plaque is allowed to remain on the teeth it will irritate the gums causing them to
become inflamed. Inflamed will bleed when brushed.
This is called GINGIVITIS

10. Ulcerated Leg
5cm2 to 20cm2 depending on how much perio disease there is. It’s the size of the
palm of a hand
+ =

11. Impact of
poor oral health
and the body

12. Impact of Poor Oral Health and the Body
Poor oral health has been linked to;
• HEART DISEASE
• DIABETES
• RHEUMATOID ARTHRITIS
• DEMENTIA
• ASPIRATION PNEUMONIA

13. Experts believe that bacteria from
the mouth enter the bloodstream
and cause damage to organs.
Links Between Poor Oral Health And The Effects On The
Body

14. Poor oral health and dementia
It is thought that bacteria from
periodontal disease can cause
inflammation in the brain killing
brain cells
Inflammation and Alzheimer’s disease: Possible role of periodontal diseases Angela R. Kamer,Ronald G. Craig,Ananda P. Dasanayake,Miroslaw Brys,Lidia Glodzik-
Sobanska,Mony J. De Leon Alzheimer’s & Dementia Elsevier July 2008

15. Aspiration Pneumonia
Aspiration pneumonia is a life-
threatening condition where plaque
and food debris from around the
teeth and dentures get inhaled into
the lungs to cause an infection.

16. NICE & CQC
Best Practice &
Quality Standards

17. Evidence suggests that nurses have little knowledge
of the link between poor oral health, dysphagia and
pneumonia, so further mouth care training is
recommended.
Mouth care training will improve confidence in
providing oral care.
How to look in the mouth and record what you see
• To demonstrate some coping strategies of how to
overcome people that resist daily oral care in the
dementia person.
Training

18. “ensure that care staff are trained to understand mouth care needs and carry out
the assessment, and that they are aware of signs of dental ill health, for example
tooth decay, abscesses, dry mouth and gum disease. The need for appropriate
training is highlighted”
What NICE say….

20. Getting assistance from the dental profession

21. The Care Quality Commission
expects Registered managers to
take account of nationally
recognised guidance, including
guidance from NICE
Oral Care for Adults in Care Homes (NG48)
NICE Guidelines published in July 2016

22. Being effective and responsive
Showing evidence of how you
support residents to maintain good
oral health

23. The most effective way of
carrying out a physical
examination of the mouth is with
a torch pen.
Oral Health Assessments in care homes

24. What to look for in the mouth
The most effective way of carrying out a physical examination of the mouth is
with a torch pen.
It should be noted if a person has:
o BROKEN TEETH
o WEARS DENTURES (LOOSE/BROKEN)
o HAS ANY SORES IN THE MOUTH (WHERE)?
o IF COMPLAINING OF ANY DISCOMFORT IN THE MOUTH
o IF REGISTERED WITH A DENTIST (WHEN LAST ATTENDED)

26. CQC
An oral care plan needs to be tailored to a persons requirements and
oral care preference to products
Recording mouth care needs in care plans

27. CQC
1 Remind and/or prompt residents to brush
2 Assist with oral care when necessary
3 Return if a person refuses brushing
Supporting daily mouth care in care homes

28. 2
Ensure staff are skilled
to provide
good mouth care
3
Ensure residents
have access
to effective mouth
care products
4
Care staff should have
support from staff with
enhanced oral health
skills (oral champion)
1
Provide staff with
knowledge of why
mouth care is so
important

30. MCM - Oral
Health
• Capture the support required to
manage resident’s oral health
• Mouth care assessment developed
with industry professionals
• Informed care plans with consistent
quality
• Planned actions that can be
monitored
• Evidence the support provided and
how meeting the NICE Quality
Standards
• Holistic resident record that
provides insight into health and
wellbeing

31. Managing Oral Health
• Mouth Assessment
• Support Required
and Risks Assessed
• Care plan guidance
• Personalised actions
Assessment
• Care needs &
reviews
• Planned actions
with preferences
Planned Care
• Easy to capture
support provided
• Intelligent data
capture
• Oral Care Charts
Evidence
recording

32. Assess Needs
and Risks
• Can be made mandatory
to prompt completion
following a new admission
• Regular Reviews
• Responsive questions to
ensure comprehensive
assessment is made

33. Mouth
Assessment
• Simple to follow and
thorough record of mouth
assessments
• Informed care plan
• Guidance based on industry
recommended practices

34. Informed Care Plan
• Oral Health Care Plan; tailored to resident’s needs
• Provide clear instructions to care staff on what actions need to be taken
• Track reviews and progress towards outcomes

35. Planned care
• Oral care actions as
part of resident’s
daily routine
• “must do” actions
reduce risk of
important care
being provided

36. Evidence of care
• Record meaningful records of
support quickly
• Evidence of Mouth care and
Denture Care
• Produce charts and care
intelligence

37. Questions?
www.personcentredsoftware.com See us on Stand B06
Thank you for your time