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. 2025 May-Jun;45(3):e70062.
doi: 10.1111/scd.70062.

Exploring Oral Care in Long-Term Care Homes: An Institutional Ethnography

Arlynn Brodie  1 , Sienna Caspar  2 , Tammy Hopper  1 , Sharon Compton  1 , Susan Slaughter  1
Affiliations

Exploring Oral Care in Long-Term Care Homes: An Institutional Ethnography

Arlynn Brodie et al. Spec Care Dentist. 2025 May-Jun.

Abstract

Aims: Oral health of long-term care (LTC) residents remains a concern despite many years of evidence-based interventions. This study aimed to explore the social organization of care contributing to poor oral health of residents in LTC homes.

Materials and methods: Institutional ethnography (IE) was used from the healthcare aide (HCA) standpoint. The oral care provided by HCAs in the LTC homes was explored through observations and interviews that focused on HCAs' interactions with institutional texts. Data analysis included text-work-text (TWT) mappings to illustrate how oral care was socially organized.

Results: HCAs determined how and when to provide oral care for residents. Standardized assessments designed by the regulatory health authority to assist LTC homes in complying with care standards were insufficiently detailed to guide the oral care provided by HCAs. HCAs lacked knowledge about oral care beyond tooth-brushing and denture care.

Conclusions: In the absence of effective institutional texts, HCAs used their discretion, relying on their personal experiences, to inform the oral care provided for residents. This study helps to understand the organizational factors that contribute to poor oral health and offers alternative intervention strategies.

Keywords: institutional ethnography; long‐term care; older adults; oral care; texts.

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Figures

FIGURE 1
FIGURE 1
Oral care text‐work‐text concept map.
FIGURE A1
FIGURE A1
ADL mouth care plan.
See this image and copyright information in PMC

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References

    1. Yoon M. N., Ickert C., Slaughter S. E., Lengyel C., Carrier N., and Keller H., “Oral Health Status of Long‐Term Care Residents in Canada: Results of a National Cross‐Sectional Study,” Gerodontology 35, no. 4 (2018): 359–364. - PubMed
    1. Andersson P., Renvert S., Sjogren P., and Zimmerman M., “Dental Status in Nursing Home Residents With Domiciliary Dental Care in Sweden,” Community Dental Health 34, no. 4 (2017): 203–207. - PubMed
    1. Bilder L., Yavnai N., and Zini A., “Oral Health Status Among Long‐Term Hospitalized Adults: A Cross Sectional Study,” PeerJ 423 (2014): 1–12. - PMC - PubMed
    1. Albrecht M., Kupfer R., Reissmann D. R., Mühlhauser I., and Köpke S., “Oral Health Educational Interventions for Nursing Home Staff and Residents,” Cochrane Database of Systematic Reviews (Online) 9, no. 9 (2016): CD010535. - PMC - PubMed
    1. Weening‐Verbree L., Huisman‐de Waal G., van Dusseldorp L., van Achterberg T., and Schoonhoven L., “Oral Health Care in Older People in Long Term Care Facilities: A Systematic Review of Implementation Strategies,” International Journal of Nursing Studies 50, no. 4 (2013): 569–582. - PubMed