Oral care practices of long‐term care home residents and caregivers: Secondary analysis of observational video recordings

Abstract

Aims and Objectives To describe: the proportion of toothbrushing task steps long‐term care residents had an opportunity to complete; the duration and quality of toothbrushing by both residents and caregivers; and the feedback caregivers provided. Background Poor oral health is widespread among older adults in long‐term care homes, however little is known about their actual oral health practices. Design Secondary analysis of video recordings Methods 58 video‐recorded sessions were analyzed from two long‐term care homes in Canada. Eligible residents had at least one natural tooth, required oral care assistance, had Alzheimer's disease and understood English. Eligible caregivers spoke English and had worked for at least 1‐year with people with dementia. Toothbrushing success was identified by the resident's participation in, and completion of, nine toothbrushing steps. Total time spent brushing teeth was calculated by summing the duration of time spent brushing teeth. Quality was described by time spent brushing the facial vs the lingual or occlusal surfaces. Caregiver verbal feedback was pulled from transcripts and analyzed using content analysis. STROBE guidelines were used in reporting this study. Results The two steps residents most frequently completed or attempted were brushing their teeth (77% complete, 7% attempt) and rinsing their mouth (86% complete, 2% attempt). The average time spent brushing teeth was 60.33 seconds (SD = 35.15). In 66% of observed videos, tooth brushing occurred only on the facial tooth surfaces, with no time spent brushing the lingual or occlusal surfaces. Conclusion Caregivers are supporting residents to independently complete tooth brushing; however, the duration and quality of tooth brushing are not sufficient to ensure optimal oral health. Relevance to Clinical Practice Clear, detailed guidelines are required to ensure adequate oral care for long‐term care residents. Staff need to be aware that all surfaces should be brushed to ensure proper oral health.