Integration of Oral Health in Long-Term Care Facilities: Burden, Barriers, and Interventions

Oral health is integral to person-centered Long-Term Care (LTC), with oral diseases linked to frailty, malnutrition, aspiration pneumonia, and reduced quality of life.

Therefore, the study aimed to synthesize recent evidence on the burden of oral disease in LTC and key barriers, and to review existing interventions that support sustainable oral health integration.

This study is a narrative review of peer-reviewed literature from PubMed, Scopus, Web of Science, and Google Scholar that used terms related to “long-term care” and “oral health,” limited to English-language studies addressing epidemiology, practice, interventions, or policy in LTC settings.

Across LTC facilities, residents exhibit high treatment needs, hyposalivation, and impaired oral function, including downstream associations with dysphagia, pneumonia, and poor health-related quality of life. Persistent barriers include low organizational priority, workforce and time constraints, limited staff training, and dementia-related care resistance. Promising strategies include professional oral health management programs, structured nursing-led protocols using practical screening tools (e.g., Oral Assessment Guide and Oral Health Assessment Tool), and interprofessional education (e.g., MOTIVATE).

At the system level, embedding dental professionals and aligning financing with oral nutrition benefits are associated with improved functional outcomes and facility performance. Cohort data link dental care utilization to lower LTC costs.

Integrating oral health into LTC is feasible and beneficial but demands policy-supported models that combine routine assessment, reimbursed protocols, and sustained interprofessional training to improve function, nutrition, respiratory outcomes, and equity in care.