CQC finds improvements to oral health in care homes

Published: 20 March 2023 Page last updated: 20 March 2023

The Care Quality Commission (CQC) has today published the findings of a follow-up review on the state of oral health care in care homes across England. This review shows there have been improvements in the understanding of how important oral health is to keep people healthy.

CQC first reviewed oral health in care homes in 2019, and found steps were often not being taken to ensure that people get the oral health care they need to ensure that they are pain-free and that their dignity is respected.

The health and social care regulator has conducted a follow-up review of how providers have responded to its recommendations from 2019 and was pleased to find that improvements were being made. 

The review found:

  • Care homes are much more aware of the NICE oral health guideline. In 2019, only 61% were aware of the guidance. This has now increased to 91%
  • More than double the proportion of care plans fully covered oral health needs, compared to our review of care plans in 2019 (60% in 2022; 27% in 2019), however more work needs to be done to ensure all care plans cover oral health.
  • The percentage of care home providers saying that staff always (or mostly always) receive specific training in oral health has doubled from 30% in 2019 to 60% in 2022. This however means 40% of staff may not receive training, which needs to improve.
  • Inspectors remain concerned that people living in care homes are missing out on vital care from dental practitioners – both at the right time and in the right place.
  • Care home providers also highlighted that not enough dentists were able or willing to visit care homes to treat people who may be less mobile.

Commenting on the report, Mary Cridge Director of Adult Social Care at CQC said:

"Our review for our first Smiling matters report in 2019 set out to discover how well care home and dental providers were implementing the NICE guideline on oral health. We found that staff awareness of the guideline recommendations was low, and not everyone was supported to keep their teeth or dentures clean.

"Whilst I am pleased to see that many of our recommendations from 2019 have been taken on board, and providers are more aware of how important oral health is to keeping people healthy, we recognise that there is still room for improvement. In particular, it is imperative that more is done to ensure people have access to vital care from dentists and that oral and dental health is included in all care plans.

"We have made further recommendations for both adult social care providers and staff, as well as dental providers so every resident of every care home have their oral health needs met."


CQC has made a number of recommendations, including:

  • Care home providers raise awareness of what people should expect when they enter a care home and their families, such as:
  • getting an oral health assessment on admission to a care home
  • how much treatment should cost, and who is exempt and entitled to free treatment on the NHS.
  • To improve collaboration in planning for the health and wellbeing of people in their area, we suggest that commissioners:
  • promote cross-sector integration between care home and dental professionals
  • use funding to improve oral health in care homes – through local initiatives like peer-to-peer support schemes or increasing dental access and training.

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Notes to editors

The 2019 Smiling Matters report can be found on the CQC website.

The NICE guidline (NG48) covers oral health, including dental health and daily mouth care, for adults in care homes. The aim is to maintain and improve their oral health and ensure timely access to dental treatment.

Between April and June 2022, CQC inspected 50 care homes, where it asked in-depth questions about oral health care to find out what has changed since its original set of special inspections that were completed in January 2019.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.