Now, staff in care homes are working their socks off—I don’t think there’s many here who would deny this—but, inevitably, things move down the priority list. Indeed, dental care, for many of us over the last 18 months, has taken a back seat due to the need for social distancing, and I’m sure care homes, who have been especially vulnerable to infection during the pandemic, have been mindful of this.

By its nature, dental care is one of the most difficult health services to restore during a pandemic. The written statement issued by the Government last week acknowledged this matter, and I don't think there will be many people who disagree with assertions such as, and I quote,

'During a respiratory virus pandemic, dentistry has been one of the most complex areas of primary care delivery to scale back, provide and recover.'

This is due in part because so many of its procedures generate aerosols, and also the proximity of the dentist to their patient in dental care delivery. This has led to many dentists only fulfilling requests for emergency treatment, so check-ups have had to be put on hold for the time being. I fear that this is especially the case in care homes.

To get to the crux of this debate, we must rewind the clock back to 2014, when the Older People’s Commissioner for Wales published a report called 'A Place to Call Home?'. This was a review into the quality of care that older people receive in care homes. The report found that dental care was lacking in many areas and many care homes. In establishing its conclusions, the report used evidence from the British Dental Association, which highlighted that there are high levels of unmet dental need in care home residents, and with many only receiving dental care when they develop a problem.

Pressure such as this thankfully led to the last Government's Gwên am Byth oral health programme in 2015, which aimed to improve oral hygiene and mouth care for older people living in care homes, through the development of a consistent all-Wales approach. It aimed to plug the shortfalls in dental care for older people in a care homes, by ensuring that an up-to-date mouth care policy is in place; by training staff in mouth care; and by keeping a register of that training. It also aims to ensure that residents have regular mouth care assessments that lead to an individual care plan, and that they are referred to a dental team if necessary.

In 2019, it was announced that funding for this programme was to be doubled to £0.5 million a year to ensure that the programme was rolled out fully in all care homes in Wales during 2020-21. This was obviously welcome. Good dental care is crucial to so many aspects of health. In the last few years, there has been mounting evidence that gum disease may be linked to dementia. Even for people with dentures, good oral hygiene is vital, as bad practice can lead to aspiration pneumonia. But, since the update we received from the previous health Minister on 23 December 2019, we have had no further updates or Government statements on the matter.

If I think that a week is a long time in politics, an awful lot can happen in two years—and this is especially true when you consider the events of the last two years. Within a few weeks of the last update of the Gwên am Byth programme in December 2019, news started to emerge about coronavirus, and this has obviously dominated the health agenda ever since. In the last 18 months, coronavirus has changed so much of what we know, but this is especially true of the care home sector.

Now, I was hoping that the Government statement of last week would mention oral care in care homes, but it did not. There was mention of COVID, controls and contracts. There was mention of targets, timescales and tools. There was mention of vulnerable groups, various measures and valuable aspirations, but no specific mention of oral health in care homes. And given that the last update we have on the Gwên am Byth programme predates the pandemic, I would like to put this issue back on the agenda with this debate.

In a blog from last year, Tom Bysouth, the chair of the Welsh general dental practice committee of the British Dental Association said that at-risk groups have become, and I quote, 'a ticking time bomb' since the outbreak of the pandemic. He said that Gwên am Byth was put on hold along with Designed to Smile, which is aimed at children. He said that vulnerable adults and children should not become the lost groups in this pandemic when it comes to dental care, and I agree completely.

In the meantime, I only have anecdotal evidence to draw upon, like the experiences I spoke about at the beginning of this debate. We all know that oral hygiene is vital. We know that advances have been made—there are fewer dentures in glasses of water at the sides of beds, compared to a few short decades ago. This is due to advances in dental care. My fear is that this has been greatly set back during the pandemic. I raise this matter here in the Siambr today not to criticise the Government, nor residential care homes, nor dental practitioners, who work so hard, but to ensure that dental care for older people is on the agenda, that it is being actively investigated and that contingency plans are being drawn up to react to the sweeping changes that this global pandemic has had on social care. These plans are needed. If they're in the process of being planned, we need to hear about them.

We drum into our children the importance of brushing their teeth. In fact, when we first get teeth, the people who look after us drum into us that we must brush our teeth. This should be the case throughout our lives. We should be helping our older people in care homes to maintain those childhood habits. That's why it's so important that this topic remains on the agenda. In addition, we know that a person's oral health can deteriorate in a short space of time, so we must consider how top-class dental care can be delivered to care home residents during a pandemic. I hope that this is something we can all agree on. I hope we can work together to bring back the momentum on this important issue. And I do hope that we can provide more than just a smile. Diolch yn fawr.