Consideration of oral health within guidelines and policy documents focused on nutritional status and dietary intake for older adults in care homes in the UK: a scoping review

Introduction
Older care home residents are particularly vulnerable to both malnutrition and chronic dental diseases, such as caries and periodontal disease. While high-sugar oral nutritional supplements and fortified foods are commonly used to prevent undernutrition, excessive sugar intake increases the risk of dental caries. Despite the well-established interplay between nutrition and oral health, existing guidelines and policy documents tend to address these aspects separately, resulting in fragmented care. This study aims to examine how oral health is considered within guidelines and policy documents focused on nutritional status and dietary intake for care home residents in the United Kingdom.

Methods
A scoping review was conducted using Arksey and O'Malley's framework. A systematic search identified UK and Irish based guidelines and policy documents addressing both nutrition and oral health in care homes. Documents exclusively covering either nutrition or oral health were excluded. Data were extracted, reviewed and analysed thematically.

Results
Twelve documents were included: five nutritional documents incorporating oral health and seven oral health documents referencing dietary intake. Nutritional documents acknowledged sugar-related oral health risks but lacked practical caries prevention strategies. Oral health documents emphasised sugar restriction and hygiene but provided limited guidance on balancing nutritional adequacy with oral health preservation.

Conclusion
Current guidelines and policy documents insufficiently integrate oral health and nutrition, resulting in fragmented care. Future policies should adopt an interdisciplinary approach, incorporating evidence-based dietary and oral health strategies to improve care home residents' well-being.