Domiciliary dentistry- Dentistry beyond the surgery.

Living Longer and keeping Our Teeth.

Who will look after them?

Why growing older shouldn't mean losing access to dental care.

There is something rather wonderful happening in dentistry.

We are living longer, and increasingly, we are keeping our natural teeth for much longer too.

Advances in dentistry, improved oral hygiene and a greater emphasis on prevention have helped more people retain their natural teeth into later life.

Of course, everyone's dental journey is different. Teeth can be lost at any age and for many reasons, including gum disease, illness or circumstances beyond a person's control. For many people, dentures play an invaluable role in restoring comfort, function and confidence.

Whether someone has their own teeth, dentures, or a combination of both, their oral health deserves the same care and attention throughout life.

According to the Adult Oral Health Survey 2023, nine out of ten adults aged 75 and over who were examined in England still had some of their natural teeth.

This is a remarkable achievement.

But it raises an important question.

We have become very good at helping people keep their teeth. But who will look after those teeth when they can no longer get to the dentist?

A lifetime of dental care shouldn't end at the front door

Many people now reach their eighties and nineties with mouths that have been carefully maintained throughout their lives.

They may have crowns, bridges, fillings, root canal treatments or dental implants. Some have invested considerable time, effort and money in looking after their teeth.

And these teeth still need care.

As we grow older, our circumstances can change.

Arthritis may make brushing difficult. Reduced mobility can make travelling to appointments increasingly challenging. Dementia, disability or other health conditions may affect the ability to maintain good oral hygiene independently.

Many people also take several medications to manage health conditions. Some medicines can contribute to a dry mouth, increasing the risk of tooth decay.

At the same time, crowns, bridges and existing dental restorations may become more difficult to clean and maintain, particularly when patients become dependent on others for their daily care.

We are now seeing generations of patients whom throughout life keep more natural teeth, often extensively restored, alongside increasingly complex healthcare needs.

Their need for dental care hasn't diminished with age. In many cases, maintaining their oral health has become more challenging.

When getting to the dentist becomes increasingly challenging.

Imagine someone who has attended their dentist regularly for most of their life.

They have taken pride in their smile, cared for their teeth and invested in maintaining their oral health.

Then, following a stroke, serious illness or gradual decline in mobility, they become housebound.

Suddenly, visiting the dentist is no longer straightforward.

Transport may be difficult to arrange. They may require assistance getting into a vehicle. The journey itself may be exhausting or simply impossible.

Appointments are postponed, sometimes indefinitely.

A broken filling may remain untreated. A sharp tooth may cause discomfort. A denture may become loose, making eating difficult.

Eventually, dental care may become something that feels out of reach.

Yet the need for it has not disappeared.

In our own domiciliary dental work across Essex, we regularly meet people who have spent years caring for their teeth but can no longer attend a dental surgery.

Sometimes their needs are relatively simple. They may require a denture adjustment, a dental examination or treatment for a troublesome tooth.

Yet arranging that care can become an enormous challenge for them and their families.

These experiences have made us increasingly aware that one of the greatest challenges facing dentistry is not always the treatment itself, but ensuring that people can access it.

Oral health is about so much more than teeth

Having a comfortable, healthy mouth affects many aspects of everyday life.

Being able to enjoy a meal, speak comfortably, smile confidently and spend time with family and friends matters at every age.

For someone recovering from illness, painful teeth or poorly fitting dentures can make eating a varied and nutritious diet more difficult at a time when good nutrition is particularly important.

For a person living with dementia or communication difficulties, dental pain may not always be easy to recognise or explain.

And for someone who has become dependent on others, maintaining oral hygiene may require sensitive and practical support from family members or carers.

These are not minor inconveniences.

They affect comfort, dignity, confidence and quality of life.

The vital role of NHS Community Dental Services

In England, NHS Community Dental Services provide essential dental care for children and adults whose needs cannot readily be met in a conventional dental practice. This includes some people with complex disabilities, significant medical needs, or severe dental anxiety. Depending on the local service and individual circumstances, care may be provided in community clinics, specialist settings or through domiciliary visits.

These teams do remarkable work. Their dentists and dental care professionals often bring specialist expertise, patience and compassion to patients who need additional time, tailored approaches and coordination with families, carers and other healthcare professionals.

Unfortunately, the demand for this care can exceed the resources available. Recruitment and staffing challenges, limited clinical capacity and lengthy waiting lists in some areas can make it difficult to arrange timely assessment or treatment. The British Dental Association has highlighted these pressures and called for greater investment and workforce support.

Funding decisions are made through local NHS commissioning arrangements, and waiting times vary from one area to another. England does not have a separate national budget specifically for Community Dental Services, so it is important not to assume that every service faces exactly the same circumstances.

When families struggle to obtain an appointment, this is not a reflection of the dedication of NHS community dental teams. It is a reminder that these invaluable services need the staffing, resources and support to reach the people who depend on them.

Private domiciliary dentistry can sometimes offer an additional option, but it is not affordable for everyone. A strong, well-supported NHS community dental service remains essential if people with additional needs are to have a realistic route to appropriate dental care.

Growing older should not mean that oral health becomes less important.

If anything, it is a time when continued care and support can be especially valuable.

Bringing dentistry to the patient

This is where domiciliary dentistry — dental care provided in a patient's own home, care home or residential setting — can make a real difference.

Many people are unaware that dental professionals can provide a range of assessments and treatments outside a conventional dental surgery.

Depending on the patient's medical circumstances, individual needs and the suitability of the environment, these

may include:

• Dental examinations and oral health assessments

• Preventive advice and appropriate dental cleaning

• Smoothing uncomfortable or sharp tooth edges

• Certain fillings and restorative treatments

• Denture adjustments, repairs and new dentures

• Selected extractions, where these can be safely carried out at home

Of course, not every treatment is suitable for a domiciliary setting.

Patient safety, medical history, appropriate equipment and clinical judgement must always guide what can be provided.

But the question should not simply be whether someone can attend a dental surgery.

We should also be asking what safe and appropriate dental care can be brought to them.

Sometimes, a relatively straightforward intervention can make an enormous difference to someone's comfort and wellbeing.

Looking after our ageing population means looking after their mouths

As a society, we have made tremendous progress in helping people live longer, healthier lives.

Dentistry has played its part by helping people retain their natural teeth well into old age.

But preserving teeth is only part of the achievement.

We also need to ensure that people can continue accessing the professional care required to maintain them, even when their mobility, independence or general health changes.

This requires greater awareness among families, carers, healthcare professionals and dental teams.

It requires us to recognise when people are struggling to access care and to consider what practical alternatives may be available.

And it requires us to remember that oral health remains an important part of general health and wellbeing throughout life.

Because becoming housebound should not mean becoming forgotten by dentistry.

We have helped people keep their teeth for longer. We must now ensure that they can continue to receive dental care for as long as they need it.

Does someone you care for struggle to visit the dentist?

If you have a family member, loved one or care-home resident who is housebound, has limited mobility or finds attending a dental surgery difficult, domiciliary dentistry may offer a solution.

Our Kelvedon-based dental team provides private domiciliary dental care, bringing appropriate dental assessments and treatments to patients in their own homes and residential settings.

We understand that organising dental care for someone with additional needs can feel overwhelming, and we're happy to discuss the options available.

Contact our practice to find out more about our home visit dental service and how we may be able to help.

Kelvedon Dental Centre

1 New Road

CO5 9JN Kelvedon

Colchester

ESSEX

01376-570785

Further reading

Adult Oral Health Survey 2023 — Department of Health and Social Care: https://www.gov.uk/government/statistics/adult-oral-health-survey-2023/clinical-oral-health

NICE: Oral Health for Adults in Care Homes (NG48): https://www.nice.org.uk/guidance/ng48

NHS: Dry Mouth: https://www.nhs.uk/symptoms/dry-mouth/

UK Parliament — Community Dental Services funding (13 July 2026): https://questions-statements.parliament.uk/written-questions/detail/2026-07-06/16109

British Dental Association — Community Dental Services waiting list data: https://www.bda.org/news-and-opinion/news/securing-better-waiting-list-data-for-community-dental-services-in-england/

British Dental Association — Supporting the community dental workforce: https://www.bda.org/media-centre/community-dentists-government-has-a-moral-duty-to-future-proof-service/