Care homes and poor oral health

What has been noticeable is that the oral hygiene in our vulnerable adult population with #COVID19, has been appalling.” Tweet by D. Hansjee, Speech and Language Therapist, UK

This observation caught my eye as our community enters the second phase of the pandemic — increasing mortality in care homes and long-term care facilities. It may well be that half of all deaths from COVID 19 occur in these venues.

There are no studies or data as yet, on the relationships, if any, between viral respiratory disease and poor oral health. But the role of “appalling oral hygiene” with mortality as well as with chronic respiratory problems in the elderly is well established. Note the following from recent studies:

  • A 2020 study of elderly Japanese patients admitted to an acute care hospital reports that poor oral health is an independent predictor of hospital mortality, increasing the chances of death by 2.5 (versus peers with good oral health).
  • Among older Swedes in intermediate-level care, poor oral health was independently associated with mortality, increasing the chances of death by almost 2 over the next 12 months.
  • Another recent Japanese longitudinal study found poor oral status strongly predicted the onset of adverse health outcomes, including mortality among the community-dwelling elderly.

In the UK, notably, poor oral health in care homes is no longer ignored. Recently, the Care Quality Commission required UK care homes to provide regular oral healthcare and to report oral health outcomes to maintain operating licenses.

So how do we improve oral healthcare in care homes so as to reduce mortality rates?

It is clear new models of delivering oral healthcare services will need development. The parameters are (a) affordability (b) non-invasiveness (to reduce anxiety, pain and aerosols) (c) independence from the already-overburdened nursing team.

Prevora has a unique role to play in oral healthcare in care homes. It works to minimize chronic oral inflammation and caries at the same time, it is readily and quickly administered in the care home with little equipment, and patients tolerate this antiseptic well. And just as important, Prevora can be delivered for a fraction of the cost of dental services.