Oral Health in the Long-Term Care Setting

A wealth of epidemiological evidence demonstrates that the oral health status of post-acute and long-term care (PALTC) patients is poor and that the oral care provided in the PALTC setting can be greatly improved. An equally abundant body of evidence supports the view that diseases of the oral cavity contribute to the total disease burden and illness of PALTC patients and that good oral care plays a role in improving health outcomes and quality of life in this population. Use of the guidance and tools found in this manual can assist PALTC facilities to:

• Develop and maintain an institutional culture that values oral health and instills a facility-wide commitment to achieving and maintaining an oral health care program;
• Identify oral health care resources in their communities and develop relationships with oral health professionals who have expertise in providing care to patients with special needs;
• Develop and implement an oral health plan, policies, and procedures, and an ongoing process for monitoring and evaluating the quality of oral health care;
• Integrate oral health care into the facility’s overall program of daily patient care;
• Develop and implement ongoing oral health training programs for both new and existing facility staff;
• Develop and maintain individualized oral hygiene care plans for every facility patient that are followed and reviewed at regular intervals.

Outcomes that facilities may achieve as a result of implementing the guidance and tools found in this manual include but are not limited to the following:

• Improved competence of caregiving staff in the provision of oral care and greater staff confidence in their ability to perform such care;
• Better management of patients who are resistant to oral care and a decrease in aggressive behaviors during oral care;
• Decreases in the number or proportion of patients who experience weight loss related to oral pain, poorly fitting dentures, or other oral conditions;
• Decreases in the number or proportion of patients diagnosed with serious oral infections or with extraoral infections subsequent to oral health conditions.

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