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Updated: Sep 12, 2025
08:47
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
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Using Role Substitution to Improve Oral Health in Care Homes: A Process Evaluation.
Annie Hendry1, Sarah R Baker2, Gerry McKenna3
1Bangor Institute of Health and Medical Research, Bangor University, Bangor, UK.
Gerodontology
|August 7, 2025
Summary
Role substitution, reallocating dental tasks to therapists and nurses, shows potential for improving older adults' oral health in care homes. However, challenges in partnership and staff attitudes remain barriers to effective service provision.
Area of Science:
- Geriatric Dentistry
- Public Health Dentistry
- Health Services Research
Background:
- Older adults in care homes often experience poor oral health and limited dental services.
- Role substitution, task reallocation from dentists to other dental professionals, is a proposed solution.
Purpose of the Study:
- To evaluate the implementation of role substitution by Dental Therapists and Dental Nurses for dependent older adults in UK care homes.
- To assess the impact on oral health outcomes through a pragmatic cluster-randomised controlled trial and process evaluation.
Main Methods:
- Semistructured interviews with 17 key stakeholders involved in intervention delivery.
- Observations during intervention delivery in 22 care homes.
- Utilisation of the Promoting Action on Research Implementation in Health Services (PARIHS) framework.
Main Results:
- Stakeholders viewed role substitution as a viable alternative to current dental care models.
- Effective partnership working was crucial but not consistently observed; some staff did not prioritize oral health.
- Care home environments presented challenges, with ubiquitous sugary food and drinks impacting daily routines.
Conclusions:
- Role substitution holds promise for addressing the oral health needs of dependent older adults.
- Significant challenges persist in promoting oral health and ensuring effective service delivery within care home settings.
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