Dentist skill and setting to address dental treatment needs of care home residents in Wales

Abstract

Most treatment need in care homes is basic restorative, periodontal and preventive care. Half of this could be managed by general dentists, some on a domiciliary basis and the rest in primary care dental clinics. The commonest complexity was additional time. More complex treatments were associated with care in clinics, skills in special care dentistry and multidisciplinary care.

A 15‐Year Comparative Prospective Study of Surgical and Prosthetic Care and Aftercare of Overdenture Treatment in the Atrophied Mandible: Augmentation Versus Nonaugmentation

“…Our long‐term results regarding the need for surgical and prosthetic aftercare reflect the need for such care in patients that regularly visited our outpatient department for routine inspection and treatment, when needed. It is advised that aftercare in these (relatively old) patients, when they become care dependent, should be organized in the near vicinity of, and in close cooperation with, their (elderly or nursing) homes . When routine inspections are not taken over by dental care providers in these institutions, the care for these patients with their implants is usually insufficient and may result in major, potentially life‐threatening, complications …”

“…It is advised that aftercare in these (relatively old) patients, when they become care dependent, should be organized in the near vicinity of, and in close cooperation with, their (elderly or nursing) homes. 27,28 When routine inspections are not taken over by dental care providers in these institutions, the care for these patients with their implants is usually insufficient and may result in major, potentially life-threatening, complications. [28][29][30][31] It is concluded that when treating atrophied mandibles, placement of endosseous implants in native bone is preferred above placement of implants in the reconstructed mandible as augmentation surgery is in need of extra time and higher morbidity, in need of general anesthesia, and accompanied with a lower implant survival.…”

What proportion of dental care in care homes could be met by direct access to dental therapists or dental hygienists?

“…13 Much of the care only requires a professional with either some special care experience or generalist level experience. 13 In addition, a considerable proportion of the disease present does not require aggressive interventional treatment.…”

“…13 Much of the care only requires a professional with either some special care experience or generalist level experience. 13 In addition, a considerable proportion of the disease present does not require aggressive interventional treatment. 12 A Cochrane review of the evidence on the effectiveness, costs and cost-effectiveness of dental auxiliaries in providing care traditionally provided by dentists identified just five studies.…”

“…12 Many care home residents require simple dental treatment, complicated by the need for extra time to deliver dental care. 13 Although there is a large volume of need for improved oral hygiene, scaling of teeth, application of Background Many care home residents require simple dental treatment which is complicated by the need for extra time to deliver dental care. The proportion of their care which could be delivered wholly by hygienists or therapists is unknown.…”