Instead of using dentists to provide dental care, other members of the dental team could offer an alternative to improve the provision of care and access to services. Dental Therapists and Dental Nurses have been used in a number of research studies that have shown their potential.

We are running a cluster randomised controlled trial over twelve months comparing a model based on Dental Therapists and Dental Nurses and comparing this to usual care. One group of care-homes will receive dental care from Dental Therapists and Dental Nurses for six-months, whilst the other group of care-homes will receive their usual care. The intervention will run for six-months and we will measure plaque levels at this point and at twelve months to determine any ‘carry-over’ effect.

The eligibility criteria for participating care-homes (what they need to take part in the study) is a minimum of five residents (maximum fifteen) that are 65 years and over. Care-homes won't be able to take part if they are currently participating in an existing oral health programme. For practical reasons, care-homes specialising ONLY in end-of-life or palliative care will not be able to participate. Participating residents should have at least six natural teeth and be a full-time resident in the care facility.

Levels of dental plaque will be measured before the study starts, at six-months and then again at twelve-months. We will also be recording the following clinical measures: bleeding on probing (a measure of gum disease), Pain, new dental caries lesions (tooth decay), episodes of unscheduled care and the resident’s quality of life.

Care-homes that receive the active intervention will have: appropriate dental care, prescription of high-fluoride toothpaste, application of high-fluoride varnish every three-months, oral hygiene advice, information about healthy eating and advice and guidance for care-home staff. The other group of care-homes will receive their usual dental care.