Care home managers' perspectives on domiciliary dental care: a qualitative study.

Background: Domiciliary dental care (DDC) is an established, safe and cost-effective alternative to standard care which can increase accessibility to professional dental care for care-dependent individuals. Qualitative research with care home managers has explored current practices and specific barriers to accessing dental care services: this has highlighted problems with dentist availability, accessibility and financial concerns. No research has explored reported experiences of DCC implementation in care home settings.

Objective: This study aimed to explore care home manager's perspectives and preferences on DDC following its wider implementation.

Methods: The study used a qualitative approach in a constructivist paradigm. Six semi-structured face-to-face interviews were conducted with ten care home managers from a purposive sample of care homes participating in DDC. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis.

Results: Five major themes were defined. Care home managers preferred DDC to avoid logistical challenges and stress for residents, highlighting the need for on-site dental services. While they wished for reliable partnerships with locally based oral health professionals, this was seen as unrealistic due to their limited willingness to treat care home residents. DDC was valued for its accessibility and support, yet financial concerns were raised due to increasing costs associated with DDC. Managers also emphasized the importance of stable oral care teams within the care home; they noted, however, that this was difficult to achieve due to high staff turnover in long-term care.

Conclusions: Domiciliary dental care was widely accepted and appreciated by the care home managers in this study, but increasing costs presented a significant threat to its sustainability.