Abstract
BackgroundPeople in residential aged care facilities (RACF) are at very high risk of developing complex oral diseases and dental problems. A multidisciplinary approach incorporating oral health professionals and RACF staff is important for improving and sustaining oral health in RACFs. However, difficulties exist with access to oral health services for RACFs, particularly those in regional and rural areas. This study investigated the impact and experience of an integrated oral health program utilising tele-dentistry and Oral Health Therapists (OHT) in RACFs in a rural setting within Australia.MethodsA mixed method comparison study was undertaken. Two hundred fifty-two clinical audits were completed across nine facilities with and without access to the integrated oral health program. Twenty-seven oral health quality of life surveys were completed with eligible residents. One focus group discussions (FGD) and eight interviews were completed with RACF staff. Thematic analysis was conducted on the transcribed FGDs and IDIs. Quantitative data were analysed using descriptive statistics.ResultsAudits showed an improved compliance to Australian Aged Care Quality Accreditation Standards for oral health in the facilities with access to the integrated program compared to those without the program. Thematic analysis revealed that facilities with the integrated program reported improvements in importance placed on OH, better access to OH services and training, and decreased disruption of residents, particularly those with high care needs.ConclusionsThe integrated oral health program incorporating OHTs and tele-dentistry shows potential to improve the oral health outcomes of residents of RACFs. Improvements for managing oral health of residents with high care needs were observed. RACFs without easy access to an oral health service will also likely benefit from the increased support and training opportunities that the program enables.
Highlights
People in residential aged care facilities (RACF) are at very high risk of developing complex oral diseases and dental problems
The purpose of this paper is to investigate the impact and experience of this integrated approach to oral health compared to current standard care within regional and rural RACFs
A total of 252 audits were completed across the nine facilities and included 111 audits at facilities with the integrated oral health program and 141 audits at facilities without the integrated oral health program
Summary
People in residential aged care facilities (RACF) are at very high risk of developing complex oral diseases and dental problems. Poor oral health impacts on the quality of life and general health of older people [1, 2]. It causes pain and disfigurement, and is linked to poor nutrition, diabetes, cardiovascular disease, respiratory disease and mortality [2,3,4,5,6,7,8,9]. Evidence suggests that RACF staff often lack knowledge of the specific oral hygiene requirements of older people, have limited time for adequate oral care and may have poor attitude and awareness towards oral health [23,24,25,26]. Having dedicated RACF staff to focus on oral health has been met with challenges due to competing demands and appropriateness of skills [19, 27]
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