Nutrition and Oral Health in Care Homes: A qualitative study of stakeholder perspectives

Abstract

Background: An increasing proportion of older adults currently live in care homes, where many need support with typical conditions of this age group. Oral health is often overlooked due to the historical rationale of edentulism. The current presence of natural teeth in a larger proportion of this population means that poor oral health negatively impacts their quality of life. This study explores how nutrition and dietary intake affect the oral health of older care home residents by gathering insights from stakeholders, aiming to inform strategies to improve oral health through collaborative interventions.

Methods: Semi-structured interviews were conducted with care home residents and family members, staff, and healthcare professionals. Relevant stakeholders such as researchers and policy makers were also included. Reflective thematic analysis of verbatim-transcribed interview recordings led to overarching themes, which were agreed by a subset of participants.

Results: Family members and dentists mostly described general oral health of care home residents as deteriorating. Nutrition provided in this setting was perceived as plentiful and energy-dense, but concerns with weight loss encourages the addition of dairy fat and sugar. Common practices in care homes that raised concerns regarding dental health were the use of oral supplements high in sugar, 'grazing' behaviour, the use of thickeners and visitors gifting with foods and drinks high in sugar.

Conclusions: Meeting energy, medical and cultural requirements while maintaining oral health in older residents of care homes is challenging. Future research should explore strategies co-developed with relevant stakeholders to mitigate nutritional risk factors for oral health.

Clinical significance: Members of the dental team must consider the views and roles of direct and indirect stakeholders when considering the interplay between nutrition and oral health in care homes.

Keywords: Dental care; Nutrition; Older adults; Oral health; Qualitative; Residential care.