Oral health interventions and strategies delivered by care workers to older people living in care homes: an overview of systematic reviews

Background

Poor oral health is common among older people living in long-term residential care environments, or care homes. For decades, various strategies have been proposed to enhance and sustain oral health within this setting. However, implementation of these strategies and interventions has been variable, with limited positive impacts on long term oral health outcomes.

Aim

The aim of this overview of reviews was to identify, appraise and synthesise systematic reviews of interventions or strategies provided by care home staff to support residents with their oral health.

Method

Protocol registration: PROSPERO (International Prospective Register of Systematic Reviews) registration ID: CRD42021293159. The search for systematic reviews was conducted in March 2025 in the following databases: Medline, Embase, CINAHL, PsycINFO and Epistemonikos. An analysis of overlapping primary studies within SRs was undertaken. Quality of reviews was assessed using AMSTAR2. Results were tabulated and a narrative synthesis was conducted.

Results

A total of 14 SRs were included. Most studies focused on training care staff to improve oral health knowledge and skills and just under half of included studies involved oral health care interventions testing protocols, such as regular mouth cleaning and structured regimens tailored to residents’ needs, some studies focused on resident care with dementia or cognitive impairments. Barriers to delivering oral health care were reported including time constraints, insufficient training, staff turnover, and resistance from residents. Suggestions to overcome such barriers were hands-on training to enhance staff confidence, tailored care plans for residents with impairments, managerial support for resource allocation, and fostering collaboration between care staff, family, and dental professionals.

Conclusion

Evidence suggests that interventions are available to improve the oral health and care for this population, particularly around training of staff. However, the detail of the intervention was poorly documented. High-quality research is needed to determine which interventions benefit oral care for older people living in care homes.