Registed Nurses' Association of Ontario

Evidence Booster: Best Practice Guideline Implementation to Improve Oral Health Care

In 2010, the global economic impact of dental diseases amounted to US$442 billion. Across OECD countries, 5% (average) of total health expenditures originate from treatment of oral diseases. Recent findings suggest oral diseases account for productivity losses of over $1 billion per year in Canada alone.1 Improvements in oral health would result in substantial economic benefits by reducing treatment costs and by decreasing productivity losses in the labour market.

Practice Changes

The LTC-BPSO implemented several strategies to support implementation of the BPG. A dental hygienist trained all registered nurses on completing an oral health assessment. Following the education, nurses assessed oral care for all new admissions to the facility within seven days and on an annual basis, utilizing the Oral Health Assessment Tool (OHAT). Based on the results, an individualized plan of care was developed and documented. Annual review of the care plan is conducted when necessary to support ongoing monitoring of oral health. Volunteers in the LTC-BPSO became involved by ensuring that dental hygiene equipment is available and labeled for everyone on a monthly basis. These practice changes supported an integrated  approach to oral  health care optimizing all resources including volunteers.

To support practice changes, the LTC-BPSO implemented several strategies including: establishing an Oral Health Care (OHC) team to examine policies and facilitate practice standardization, education from the Confederation College of Dental Hygiene for all staff, placement of education resources on computers for ongoing competency development, standardized assessments completed by a registered nurse on admission, and documentation of oral care on flow sheets. The OHC team continues to promote interprofessional collaboration among health-care providers to ensure sustainability. Monthly audits are conducted to ensure oral health admission assessments are completed on all residents. Documentation records help ensure that oral care is provided at least twice per day.