Sir, I am writing to request input from my esteemed colleagues. I am in a privileged position to provide domiciliary oral care for the patients that need it. This includes care for patients in residential care homes. I have been doing this for several years now in Newcastle-upon-Tyne.

The patients are in the care homes because they cannot care for themselves and need assistance from carers in every aspect of their lives. However, visiting these care homes I find the oral care for the residents to be very inadequate. Quite often the carers cannot remember when the residents' teeth were last cleaned and look bewildered when their oral care is enquired about. The teeth are caked in plaque of various colour schemes and infused with food. If the resident is a denture wearer, it is a lucky guess if the denture actually belongs to the resident. I have seen many dentures in an unacceptable condition and which certainly have not been cleaned regularly. Carers have a difficult task on their hands and provide excellent care on the whole. Perhaps it is a lack of knowledge about oral care and how to provide it for these patients that leads to this shortcoming.

I have witnessed too many residents in this terrible condition. Surely in our civilised society we can provide our elderly and ability-impaired members with a more complete care?

Perhaps a solution would be regular visits to the care homes by general dental practitioners, community dentists or the oral health promotion team informing carers on oral health care. Another option would be visits by dental students as part of outreach training. This would be mutually beneficial to the care homes and the students.

I would like to ask my esteemed colleagues: is this a universal problem or is this problem isolated to Newcastle-upon-Tyne?