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Educating nursing staff about how to provide oral care is promising to improve oral hygiene among older adults in long-term care and those requiring an extended hospital stay

Coker E, Ploeg J, Kaasalainen S  The effect of programs to improve oral hygiene outcomes for older residents in long-term care: A systematic review  Research in Gerontological Nursing. 2014; 7(2): 87-100.

Review question

What is the effect of educational programs targeting nursing staff to improve oral care and oral hygiene among frail older adults residing in long-term care or those who require an extended hospital stay?


Poor oral health among older adults can lead to periodontal disease (i.e., diseases that affect the tissues that support and anchor the teeth). Periodontal diseases can contribute to other potentially deadly diseases such as stroke and atherosclerosis, as well as lead to poor glycemic control in diabetes.

Older adults with mental and/or physical disabilities residing in long-term care facilities or in extended-stay hospital facilities often rely on nursing staff to ensure their oral health needs are met (e.g. brushing and flossing).

Educational programs may enhance the knowledge and skills of nursing staff in order to improve oral care and patient outcomes.

How the review was done

Several electronic databases were searched for literature published up until July 2013. Studies were included if they evaluated an educational intervention targeting nursing staff who provide oral care to older adults with mental and/or physical disabilities residing in long-term care or extended hospital settings.

A total of 1,771 titles were identified. Twelve studies were deemed eligible and included in the review.

The authors of the review did not report on sources of funding that supported their work.

What the researchers found

Three types of educational interventions targeted nursing staff: stand-alone in-service education sessions; educational sessions where nurses were trained to train other nurses; and active involvement of a dental hygienist to supplement nursing care.

In many cases, the educational interventions also included additional components such as individualized care plans, staff training on special protocols, staff who specialize and focus primarily on oral health, and availability of supplies and tools.

Findings suggested that educational approaches may have a positive effect on the oral health of older adults living in long-term care or extended-stay hospital settings. However, it wasn’t clear if one approach was better than another, or how different interventions should be combined to improve outcomes.


Educational interventions targeted at nursing staff may help to improve oral care and oral health outcomes among older adults in long-term care or extended-stay hospital settings. However, existing studies are difficult to compare, which makes it challenging to draw strong conclusions.

More attention should be paid to ensuring educational interventions are implemented and evaluated properly in order to improve our understanding of how they influence oral health.

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