Improving the Oral Health of Older People in Care Homes: Results From a Randomised Feasibility Study

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TSAKOS, Georgios, BROCKLEHURST, Paul R., SYED, Saif, HARVEY, Michelle, DANIYAL, Sana, WATSON, Sinead, GOULDEN, Nia, VEREY, Anna, CAIRNS, Peter, HEILMANN, Anja, HOARE, Zoe, KEE, Frank, LANGLEY, Joe, LIEVESLEY, Nat, O'NEILL, Ciaran, SHERRIFF, Andrea, SMITH, Craig J., WASSALL, Rebecca R., WATT, Richard G. and MCKENNA, Gerald (2025). Improving the Oral Health of Older People in Care Homes: Results From a Randomised Feasibility Study. Community Dentistry and Oral Epidemiology. [Article]

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Abstract

Objectives:

Poor oral health is a considerable burden for older adults in care homes. The National Institute for Health and Care Excellence (NICE) issued guideline NG48 on “Improving oral health in care homes”. However, empirical evidence for oral health interventions among care home residents is weak, and the feasibility of the NG48 recommended interventions is not established. This study aimed to determine the feasibility of delivering a co‐designed oral health intervention, based on NG48 recommendations, in care homes in two sites in the UK.

Methods:

This was a pragmatic cluster randomised controlled feasibility study with a 12‐month follow‐up, undertaken in 22 care homes across two sites (11 each in London and Northern Ireland). Care homes were randomised to an intervention arm (n = 11), and a control arm (n = 11) that continued with usual routine practice. The complex intervention contained materials were co‐designed with care home staff and consisted of: care home staff training package; Oral Health Assessment Tool (OHAT) administered by trained care home staff; and a support worker assisted twice daily tooth‐brushing regimen with 1500 ppm fluoride toothpaste. Rates of recruitment and retention, data completion, and intervention fidelity were recorded to determine feasibility.

Results:

One‐hundred‐and‐nineteen residents from 22 care homes were recruited and 82 residents from 19 care homes completed the study (retention: 86% for care homes and 69% for residents). Twenty residents were lost to follow‐up and another 17 withdrew throughout the study. Data completion rates ranged between 88% and 97% at baseline and between 91% and 96% at the 12‐month follow‐up. Intervention fidelity records showed high completion rates for oral care plans (90%), and lower rates for weekly oral hygiene records (73%) and the OHAT (61%).

Conclusions:

This study documented the feasibility of an oral health intervention in care homes, while also highlighting issues to consider for a definitive trial to assess the effectiveness of the co‐designed intervention. Trial Registration: Clinical Trial Registration: ISRCTN10276613
More Information
Official URL:
https://onlinelibrary.wiley.com/doi/10.1111/cdoe.1...
Open Access URL:
https://onlinelibrary.wiley.com/doi/epdf/10.1111/c...
Open Access Version:
Published version
Additional Information:
** Article version: VoR ** From Wiley via Jisc Publications Router ** History: received 25-07-2024; rev-recd 29-03-2025; accepted 08-05-2025; epub 10-06-2025. ** Licence for VoR version of this article: http://creativecommons.org/licenses/by/4.0/
Uncontrolled Keywords:
older adults, care homes, cluster randomised controlled trial, oral health, complex intervention, feasibility study

Identifiers

Identification Number:
10.1111/cdoe.13043
ORCID for Georgios Tsakos: ORCID iD orcid.org/0000-0002-5086-235X
ORCID for Paul R. Brocklehurst: ORCID iD orcid.org/0000-0003-1878-9030
ORCID for Saif Syed: ORCID iD orcid.org/0000-0003-1971-3003
ORCID for Sana Daniyal: ORCID iD orcid.org/0000-0001-8886-613X
ORCID for Nia Goulden: ORCID iD orcid.org/0000-0001-6511-3987
ORCID for Anna Verey: ORCID iD orcid.org/0000-0003-1988-5710
ORCID for Anja Heilmann: ORCID iD orcid.org/0000-0002-8188-5087
ORCID for Zoe Hoare: ORCID iD orcid.org/0000-0003-1803-5482
ORCID for Frank Kee: ORCID iD orcid.org/0000-0002-0606-8167
ORCID for Joe Langley: ORCID iD orcid.org/0000-0002-9770-8720
ORCID for Ciaran O'Neill: ORCID iD orcid.org/0000-0001-7668-3934
ORCID for Andrea Sherriff: ORCID iD orcid.org/0000-0002-1016-037X
ORCID for Craig J. Smith: ORCID iD orcid.org/0000-0002-9078-9919
ORCID for Rebecca R. Wassall: ORCID iD orcid.org/0000-0001-6851-5666
ORCID for Richard G. Watt: ORCID iD orcid.org/0000-0001-6229-8584
ORCID for Gerald McKenna: ORCID iD orcid.org/0000-0001-8478-1673

Library

Item Type:
Article
SWORD Depositor:
Colin Knott
Depositing User:
Colin Knott
Date record made live:
13 Jun 2025 08:37
Last Modified:
13 Jun 2025 08:45
Date of first compliant deposit:
13 June 2025
Date of first compliant Open Access:
13 June 2025
Version of first compliant deposit:
Version of Record
URI:
https://shura.shu.ac.uk/id/eprint/35807
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