RNAO coaches can help

Through collaborations with LTC homes, our team of coaches work towards improving resident care and promoting positive workplaces by implementing RNAO’s clinical and healthy work environment best practice guidelines.

Contact a coach

Identify where you can improve

Use RNAO's gap (opportunity) analysis tool to help identify where evidence-based best practice recommendations can improve your organization's current practice.

Oral health

Promotes daily oral hygiene and regular assessment to support optimal resident comfort and health. Includes checklists, care protocols, and staff education tools for consistent oral care practices. 

All resources

Document
An algorithm to guide oral assessment and intervention. The algorithm summarizes the recommendations to help oral care teams to understand how to implement them into practice. Registered Nurses’ Association of Ontario. (2020). Appendix F of Oral Health: Supporting Adults Who Require Assistance (2nd ed.). Toronto, Canada: Author.  (page 110).  
Document
The Oral Health Assessment Tool (OHAT), provides a systematic way to assess an oral cavity. Registered Nurses’ Association of Ontario (2020). Appendix J – Sample 2 of Oral Health: Nursing Assessment and Intervention. Toronto, Canada: Author. p. 118. Source: Chalmers, J., King, P., Spencer, A., Wright, F., & Carter, K. (2005). The oral health assessment tool – validity and reliability. Australian Dental Journal, 50(3). 191-199. Reprinted with the permission.
Document
This oral health care planning guideline provides information on a standard protective care regimen, additional oral care treatment, oral care and changed behaviour and palliative care considerations. An Oral Health Care Plan guide is included. Government of South Australia. (2008). Better oral health care in residential: Oral health care planning guidelines.  Source: Government of South Australia © 2012 SA Health
External link
This website from Dalhousie University focuses on oral health care resources as a result of oral health activities in long term care homes. Resources include a manual, education videos, oral care tool kits, assessment and care planning tools and guidelines for organizationally mapping oral care. Dalhousie University. (n.d.). Population Health Institute: Brushing up on mouth care. © Brushing Up on Mouth Care 2025
External link
This fact sheet from the Ontario Dental Hygienists’ Association provides signs and symptoms of dry mouth and treatment options. Topics covered include: how saliva functions, causes, risk factors, prevention, treatment and maintenance interventions.
Document
This tip sheet from Smart Tips for Stroke Care highlights key considerations for supporting eating and swallowing in individuals experiencing dysphagia after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario. 
External link
This tip sheet from Smart Tips for Stroke Care highlights key considerations for supporting eating and swallowing in individuals experiencing dysphagia after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario. 
Document
L'OHAT, également connu sous le nom d'examen abrégé modifié de l'état de la santé bucco-dentaire, fournit un moyen systématique d'évaluer la cavité buccale. Source: Chalmers, J., P. King, A. Spencer, F. Wright et K. Carter (2005). « The oral health assessment tool – validity and reliability. » Australian Dental Journal, 50(3), p. 191 à 199. Réimpression autorisée. Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Appendix J Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e édition. Toronto, ON, Canada.
Document
Ce document est un exemple de l'outil d'évaluation de la santé bucco-dentaire holistique et fiable de l'outil d'évaluation orale (THROAT). Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Appendix J Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e  édition. Toronto, On, Canada.  
External link
This website offers a workbook with 10 accompanying videos to help long-term care home staff to learn techniques to provide better oral care to their residents. ©2025 Minnesota Dental Association
External link
L'objectif de cette prochaine édition de la ligne directrice sur les pratiques exemplaires (LDPE) est de fournir aux infirmières, à l'équipe interprofessionnelle et aux soignants des recommandations fondées sur des données probantes pour la prestation de soins bucco-dentaires aux adultes (18 ans et plus) qui : (a) favoriseront une approche interprofessionnelle de la prestation soins bucco-dentaires, (b) améliorer la prestation des interventions de soins bucco-dentaires, et (c) conduire finalement à des résultats positifs en matière de santé bucco-dentaire pour les personnes. Le BPG se concentre sur la prestation de soins bucco-dentaires dans tous les établissements de santé aux adultes qui ont besoin d'aide pour les soins bucco-dentaires dans un continuum qui va de la mise en place de fournitures de soins bucco-dentaires à une assistance physique complète pour les soins bucco-dentaires. Cette LDPE fournit des recommandations pour soutenir la prestation de soins bucco-dentaires, y compris une supervision, une incitation et une assistance appropriées, tout en préconisant l'indépendance et l'autonomie de la personne. Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e  édition. Toronto (Ont.) : RNAO 2020 Ce travail est financé par le Ministère de la Santé et des Soins de longue durée.
External link
Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022. © King’s Printer for Ontario, 2012-24  
Document
This is a comprehensive collection of audits to review oral care in long term care. It contains instructions and audits on: dental equipment; Denture and denture supplies; Oral care supplies in residents’ care caddie; Oral care practices; POC/Flowsheet; Actual Resident Assessment of oral care; Admission Process; Levels of assistance and behaviours; Annual Assessment; Quarterly Assessment; Annual evaluation of oral care education; and Resident and Family Information. MacDonald, I. (2016). Oral Care Auditing Tool. Toronto, ON: Registered Nurses Association of Ontario - Oral Care Community of Practice 2015-16.  
External link
This RNAO-sponsored webinar is 34 minutes long, with a focus on dementia oral care.  
External link
This is a link to a series of six videos that discusses why oral care is important and demonstrates appropriate oral care techniques for the various stages of dementia.  
External link
This is a link to a series of six videos that describes the specialized oral care required for patients with the challenges of xerostoma (dry mouth), dysphasia (difficulty swallowing) and mucositis (inflamed oral tissues).  
External link
This is a link to webinar series on thirteen different oral health topics that can be used for staff education. These include topics on oral health such as: diabetes, dementia, dry mouth, stroke, palliative care, bad breath, care planning, infection control, dentures, 2-toothbrush technique, tools, and oral assessment (OHAT).  
Document
This booklet is a group of tools that long term care or other health care organizations can use to collect baseline data on the status of oral care. Tools included are: RAI-MDS indicators; audits for oral supplies and care on charts; and an oral health knowledge survey. MacDonald, I. (2015). Oral health baseline data collection tools. Toronto, ON: Registered Nurses Association of Ontario.  
Document
A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations. Registered Nurses Association of Ontario (2022). Opportunity Analysis Oral Health Supporting Adults Who Require Assistance. Toronto, ON.
External link
This 25-minute video shows a range of unhealthy changes and common abnormalities that can be found during oral assessments of residents living in long term care homes.  
External link
This 30-minute video demonstrates how to brush another persons teeth and describes interventions for various oral care problems found in residents in long term care. It is Part 3 of the RNAO Long-Term Care Best Practices Program - Oral Assessment Series (3 parts).  
External link
This best practice guideline (BPG) Oral Health: Supporting Adults Who Require Assistance Second Edition replaces the RNAO BPG Oral Health: Nursing Assessment and Intervention, which was released in 2008. The purpose of this next edition BPG is to provide nurses, the interprofessional team and caregivers with evidence-based recommendations for the provision of oral care for adults (18 years of age and older) that will: (a) promote an interprofessional approach to providing oral care, (b) enhance the delivery of oral care interventions, and (c) ultimately lead to positive oral health outcomes for persons.  The BPG focuses on providing oral care across health settings to adults who require assistance with oral care in a continuum that ranges from the set-up of oral care supplies to full physical assistance with oral care. This BPG provides recommendations to support the delivery of oral care—including appropriate supervision, prompting and assistance—while still advocating for the person’s independence and autonomy.  Registered Nurses’ Association of Ontario (2020). Oral Health: Supporting Adults Who Require Assistance. (2nd ed.). Toronto, ON: Author This work is funded by the Government of Ontario.    
Document
This document provides two examples of oral care plans for long-term care.  Registered Nurses’ Association of Ontario. (2020). Appendix K of Oral Health: Supporting Adults Who Require Assistance (2nd ed.). Toronto, Canada: Author.  (pages 120-121).   
External link
This Canadian Dental Hygienist Association document (2015), offers points on the connection between oral and overall health. Oral health can influence other body systems, while therapies for chronic diseases can have an impact on the oral cavity. Nurses can use this fact sheet while talking to residents and families about the importance of oral hygiene.   Source: Canadian Dental Hygienists Association(2015). 

Implementation resources

Document
This tip sheet from Smart Tips for Stroke Care highlights key considerations for supporting eating and swallowing in individuals experiencing dysphagia after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario. 
External link
This tip sheet from Smart Tips for Stroke Care highlights key considerations for supporting eating and swallowing in individuals experiencing dysphagia after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario. 
External link
L'objectif de cette prochaine édition de la ligne directrice sur les pratiques exemplaires (LDPE) est de fournir aux infirmières, à l'équipe interprofessionnelle et aux soignants des recommandations fondées sur des données probantes pour la prestation de soins bucco-dentaires aux adultes (18 ans et plus) qui : (a) favoriseront une approche interprofessionnelle de la prestation soins bucco-dentaires, (b) améliorer la prestation des interventions de soins bucco-dentaires, et (c) conduire finalement à des résultats positifs en matière de santé bucco-dentaire pour les personnes. Le BPG se concentre sur la prestation de soins bucco-dentaires dans tous les établissements de santé aux adultes qui ont besoin d'aide pour les soins bucco-dentaires dans un continuum qui va de la mise en place de fournitures de soins bucco-dentaires à une assistance physique complète pour les soins bucco-dentaires. Cette LDPE fournit des recommandations pour soutenir la prestation de soins bucco-dentaires, y compris une supervision, une incitation et une assistance appropriées, tout en préconisant l'indépendance et l'autonomie de la personne. Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e  édition. Toronto (Ont.) : RNAO 2020 Ce travail est financé par le Ministère de la Santé et des Soins de longue durée.
External link
Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022. © King’s Printer for Ontario, 2012-24  
External link
This best practice guideline (BPG) Oral Health: Supporting Adults Who Require Assistance Second Edition replaces the RNAO BPG Oral Health: Nursing Assessment and Intervention, which was released in 2008. The purpose of this next edition BPG is to provide nurses, the interprofessional team and caregivers with evidence-based recommendations for the provision of oral care for adults (18 years of age and older) that will: (a) promote an interprofessional approach to providing oral care, (b) enhance the delivery of oral care interventions, and (c) ultimately lead to positive oral health outcomes for persons.  The BPG focuses on providing oral care across health settings to adults who require assistance with oral care in a continuum that ranges from the set-up of oral care supplies to full physical assistance with oral care. This BPG provides recommendations to support the delivery of oral care—including appropriate supervision, prompting and assistance—while still advocating for the person’s independence and autonomy.  Registered Nurses’ Association of Ontario (2020). Oral Health: Supporting Adults Who Require Assistance. (2nd ed.). Toronto, ON: Author This work is funded by the Government of Ontario.    

Education resources

Document
This oral health care planning guideline provides information on a standard protective care regimen, additional oral care treatment, oral care and changed behaviour and palliative care considerations. An Oral Health Care Plan guide is included. Government of South Australia. (2008). Better oral health care in residential: Oral health care planning guidelines.  Source: Government of South Australia © 2012 SA Health
External link
This website from Dalhousie University focuses on oral health care resources as a result of oral health activities in long term care homes. Resources include a manual, education videos, oral care tool kits, assessment and care planning tools and guidelines for organizationally mapping oral care. Dalhousie University. (n.d.). Population Health Institute: Brushing up on mouth care. © Brushing Up on Mouth Care 2025
External link
This fact sheet from the Ontario Dental Hygienists’ Association provides signs and symptoms of dry mouth and treatment options. Topics covered include: how saliva functions, causes, risk factors, prevention, treatment and maintenance interventions.
Document
This tip sheet from Smart Tips for Stroke Care highlights key considerations for supporting eating and swallowing in individuals experiencing dysphagia after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario. 
External link
This tip sheet from Smart Tips for Stroke Care highlights key considerations for supporting eating and swallowing in individuals experiencing dysphagia after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario. 
External link
This website offers a workbook with 10 accompanying videos to help long-term care home staff to learn techniques to provide better oral care to their residents. ©2025 Minnesota Dental Association
External link
This RNAO-sponsored webinar is 34 minutes long, with a focus on dementia oral care.  
External link
This is a link to a series of six videos that discusses why oral care is important and demonstrates appropriate oral care techniques for the various stages of dementia.  
External link
This is a link to a series of six videos that describes the specialized oral care required for patients with the challenges of xerostoma (dry mouth), dysphasia (difficulty swallowing) and mucositis (inflamed oral tissues).  
External link
This is a link to webinar series on thirteen different oral health topics that can be used for staff education. These include topics on oral health such as: diabetes, dementia, dry mouth, stroke, palliative care, bad breath, care planning, infection control, dentures, 2-toothbrush technique, tools, and oral assessment (OHAT).  
External link
This 25-minute video shows a range of unhealthy changes and common abnormalities that can be found during oral assessments of residents living in long term care homes.  
External link
This 30-minute video demonstrates how to brush another persons teeth and describes interventions for various oral care problems found in residents in long term care. It is Part 3 of the RNAO Long-Term Care Best Practices Program - Oral Assessment Series (3 parts).  
External link
This Canadian Dental Hygienist Association document (2015), offers points on the connection between oral and overall health. Oral health can influence other body systems, while therapies for chronic diseases can have an impact on the oral cavity. Nurses can use this fact sheet while talking to residents and families about the importance of oral hygiene.   Source: Canadian Dental Hygienists Association(2015). 

Evaluation resources

Evaluation resources
Document
This is a comprehensive collection of audits to review oral care in long term care. It contains instructions and audits on: dental equipment; Denture and denture supplies; Oral care supplies in residents’ care caddie; Oral care practices; POC/Flowsheet; Actual Resident Assessment of oral care; Admission Process; Levels of assistance and behaviours; Annual Assessment; Quarterly Assessment; Annual evaluation of oral care education; and Resident and Family Information. MacDonald, I. (2016). Oral Care Auditing Tool. Toronto, ON: Registered Nurses Association of Ontario - Oral Care Community of Practice 2015-16.  
Document
This booklet is a group of tools that long term care or other health care organizations can use to collect baseline data on the status of oral care. Tools included are: RAI-MDS indicators; audits for oral supplies and care on charts; and an oral health knowledge survey. MacDonald, I. (2015). Oral health baseline data collection tools. Toronto, ON: Registered Nurses Association of Ontario.  

BPG appendices

Document
An algorithm to guide oral assessment and intervention. The algorithm summarizes the recommendations to help oral care teams to understand how to implement them into practice. Registered Nurses’ Association of Ontario. (2020). Appendix F of Oral Health: Supporting Adults Who Require Assistance (2nd ed.). Toronto, Canada: Author.  (page 110).  
Document
The Oral Health Assessment Tool (OHAT), provides a systematic way to assess an oral cavity. Registered Nurses’ Association of Ontario (2020). Appendix J – Sample 2 of Oral Health: Nursing Assessment and Intervention. Toronto, Canada: Author. p. 118. Source: Chalmers, J., King, P., Spencer, A., Wright, F., & Carter, K. (2005). The oral health assessment tool – validity and reliability. Australian Dental Journal, 50(3). 191-199. Reprinted with the permission.
Document
L'OHAT, également connu sous le nom d'examen abrégé modifié de l'état de la santé bucco-dentaire, fournit un moyen systématique d'évaluer la cavité buccale. Source: Chalmers, J., P. King, A. Spencer, F. Wright et K. Carter (2005). « The oral health assessment tool – validity and reliability. » Australian Dental Journal, 50(3), p. 191 à 199. Réimpression autorisée. Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Appendix J Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e édition. Toronto, ON, Canada.
Document
Ce document est un exemple de l'outil d'évaluation de la santé bucco-dentaire holistique et fiable de l'outil d'évaluation orale (THROAT). Association des infirmières et infirmiers autorisés de l’Ontario (AIIAO). Appendix J Santé buccodentaire : Soutenir les adultes qui ont besoin d’aide. 2e  édition. Toronto, On, Canada.  
Document
This document provides two examples of oral care plans for long-term care.  Registered Nurses’ Association of Ontario. (2020). Appendix K of Oral Health: Supporting Adults Who Require Assistance (2nd ed.). Toronto, Canada: Author.  (pages 120-121).