Clinical guidelines to support oral health care for older adults

These clinical guidelines support oral health teams to deliver evidence-based care for older adults across the full patient pathway, from prevention and assessment to treatment planning, referral, and end-of-life care.

By using this guidance, you can identify oral health risks earlier, plan ahead and adapt care as people’s health and circumstances change, supporting older people to maintain their oral health, independence, and quality of life.

Summary

Our Faculty of Dental Surgery (FDS) developed these guidelines with input from the Office of the Chief Dental Officer for England and an expert panel of clinicians. It responds to the need for consistent, evidence-based guidance that helps dental teams plan ahead and adapt their approach as people’s oral health, wider health and circumstances change throughout later life.

As more people retain their natural teeth into older age, dental teams need to be prepared for how care may need to change alongside frailty, multimorbidity, cognitive impairment or changing support needs.

These guidelines support clinical decision-making across the whole dental team.

Evidence base

The recommendations draw on:

  • existing clinical guidelines and national standards;
  • current published evidence;
  • expert consensus from specialists in special care dentistry, community dentistry, and dental public health;
  • feedback from stakeholder organisations and practising clinicians.

The development process included evidence reviews, stakeholder consultations and input from multidisciplinary experts working across oral healthcare for older adults.

Practical application

The guidelines provide practical recommendations to help you:

  • create accessible, dementia-friendly care environments with robust safeguarding practices;
  • carry out comprehensive assessments that are consent-led and person-centred;
  • develop personalised prevention plans that support early, anticipatory oral care;
  • plan treatment around frailty, dependency, and individual preferences;
  • adapt care safely and effectively as people’s health, circumstances and support needs change;
  • determine appropriate recall intervals that are individualised;
  • use local pathways to seek specialist advice before making referrals;
  • support comfort, dignity, and oral health during palliative and end-of-life care.

Who are these guidelines for?

These guidelines are for the whole oral health team across primary and community care including dentists, dental nurses, dental hygienists, dental therapists, and dental technicians. They are designed to support teams to prevent, identify, and manage oral health problems in older adults, and to adapt care as people’s needs change over time.

The guidelines sit alongside NHS England’s Framework for maintaining the oral health of our ageing population. Together, the two documents provide complementary support: the NHS England Framework focuses on local planning, commissioning and service delivery, while the FDS guidelines provide practical clinical guidance for oral health teams caring for individual older patients.

Collaborating organisations

This guidance was developed by:

  • FDS, Royal College of Surgeons of England
  • Office of the Chief Dental Officer for England
  • An expert working panel across community dental services, gerodontology, and special care dentistry

These guidelines also benefited from consultation and contributions from a range of stakeholders, including:

Number of pages

37 pages (including appendices and references)

Document

Download PDF: Clinical guidelines to support oral health care for older adults (FDS, September 2026)

Guidelines document chapters

Summary

Provides an overview of the guidelines, key recommendations and the principles underpinning oral healthcare for older adults.

Definitions and glossary

Defines key terminology used throughout the guidelines, including frailty, community dental services, domiciliary care, and special care dentistry.

1. Introduction

Explains the scope of the guidelines, its purpose and how it supports clinical decision-making alongside the NHS England Framework for maintaining the oral health of our ageing population.

2. Oral health in older adults

Examines oral health inequalities, oral health risk factors, and barriers in accessing oral health care.

3. Creating appropriate care environments

Sets out recommendations for improving access, making reasonable adjustments, creating dementia-friendly environments, and safeguarding vulnerable adults.

4. Comprehensive assessment in older adults

Covers clinical assessment, medical and social histories, consent, capacity, pain assessment and urgent dental care considerations.

5. Prevention

Focuses on anticipatory care, dynamic prevention, personalised prevention plans, and supporting carers and care staff to maintain oral health.

6. Treatment planning

Explores pragmatic treatment planning, minimally invasive approaches, shared decision-making, and adapting care according to frailty and dependency levels.

7. Delivery of treatment

Provides guidance on treatment delivery, anxiety management, dentures, implants, and domiciliary care.

8. Recall intervals

Outlines recommendations for risk-based recall intervals, the role of teledentistry, and how recall intervals may change as people grow older. 

9. Onward referral

Explains referral pathways, shared care arrangements, and situations where specialist involvement may be appropriate.

10. End of life care

Provides guidance on maintaining comfort, dignity, and oral health during palliative and end-of-life care.

Appendix 1: Guidelines development process

Describes the methodology, evidence review process, expert panel input, and stakeholder consultation. 

References 

Lists the evidence sources and supporting literature used to inform the guideline.

Date published

September 2026