Rochdale borough has launched a pioneering project to improve the oral health of the elderly population in Heywood, Middleton and Rochdale. On this page you can find information about the project and tips and advice on mouth care for carers and family members who look after older people.


What is the Oral Health Improvement for the Elderly Programme in Rochdale borough?

The Oral Health Improvement for the Elderly Programme is a new project jointly led by NHS Heywood, Middleton and Rochdale Clinical Commissioning Group (HMR CCG) and Rochdale Borough Council to improve the oral health of elderly people in Heywood, Middleton and Rochdale.

Rochdale borough is the only area in Greater Manchester to have invested funds to train care home, home care, community service and hospital staff to clean and check the mouths of vulnerable and older people to reduce the likelihood of them contracting aspiration pneumonia and hospital acquired pneumonia. The programme links into the Greater Manchester Nutrition and Hydration Project, which aims to identify and address malnutrition and dehydration in the 65+ population.


Why does oral health matter so much for the elderly?

Oral health means more than having ‘good teeth’. Studies show a link between poor oral hygiene and particularly aspiration pneumonia which is caused when bacteria in the mouth is inhaled into the lungs. If left untreated, this can lead to further infection in the lining of the lungs and serious breathing difficulties.

Poor oral health is also linked to conditions where the brain function is impaired including Alzheimer’s. Both conditions are a major contributor to serious ill health in older people and the cause of multiple emergency hospital admissions that could be avoided.

Poor oral health, including gum disease and tooth decay, can lead to problems which cause patients to refuse to eat, drink or speak. Patients can become dehydrated and malnourished, and it may take them longer to recover from illness, and it may result in a longer hospital stay.

Finally, a good oral hygiene routine can help patients to maintain their dignity and enjoy good quality of life, and it has a positive effect on a patient’s overall health and wellbeing.


Advice for caring for the oral health of older people

Cleaning the mouth, teeth and dentures is an important part of personal care. Below is advice for carers and family members who look after older people with their own teeth, dentures or no natural teeth, reproduced with kind permission from Caring for Smiles: A Guide for Carers © NHS Health Scotland 2013.


Everybody should clean their teeth or dentures at least twice a day.
Cleaning the mouth, teeth or dentures helps make sure older people:

  • are comfortable
  • are able to eat, drink or talk
  • are free from pain
  • feel better about themselves

Encourage and assist older people to clean their own teeth or dentures. If they are not able to do this, help them following the steps below.

Image 1 Caring For Smiles


 Image 2 Caring for smiles


Image 3 Caring for Smiles


Image 4 Caring for Smile


Caring for the oral health of elderly people with dementia

People with dementia can face oral health problems as their disease progresses. Those in the early stages of dementia will be able to take care of their own dental health or may just need reminding about it; others who are mid to late stage may be dependent on care staff for their oral care and carers may need specialist skills.

When people with dementia lose interest in caring for their mouth or they become incapable of doing so, their risk of developing gum disease and tooth decay increases. Below is advice for carers and family members who look after older people with dementia:

  • Elderly people with mid to late stage dementia may make toothbrushing difficult by clamping their mouth shut or shaking their head. Try to develop a routine, providing mouth care at the same time every day, take your time and be patient and kind.
  • Providing a distraction with singing or giving the person something to hold in their hands can help, as can using a three headed toothbrush if access to their mouth is limited.
  • If the person is very resistant to having their mouth cleaned, it’s important to stop and try again later.
  • Some medication prescribed for patients with dementia can impact on their oral health by causing a dry mouth. Saliva acts as a lubricant and cleans and protects the mouth and teeth. A lack of saliva can lead to a build up of plaque which increases the risk of tooth decay and gum disease, and can also cause discomfort for patients with dentures. Frequent sips of water throughout the day, particularly at mealtimes, can help lubricate the mouth and make patients more comfortable. Prescribed oral lubricants can also improve the symptoms.
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