The effect of provincial legislation on oral health in long-term care facilities.

Abstract

In Alberta, a provincial daily oral hygiene policy (OHP) for Long-Term Care Facilities (LTCF) was approved in 2018, and a mouth care training program (MCTP) was implemented in 2015. These initiatives require LTCFs to provide residents with twice-daily oral hygiene assistance and staff training. This study aimed to evaluate the provincial implementation scope, compliance rates, perceived impact on residents, and areas for improvement. A web-based survey was distributed to LTCF managers across Alberta, with 77 responses representing 11,653 residents. Overall, 66.2% of LTCF managers had implemented the OHP, and 50.6% implemented the MCTP. Managers implementing these policies showed a 14.3% increase in twice-daily oral hygiene provision, with 46% reporting improved oral cleanliness. Notably, 33.9% indicated improved resident quality of life, and 55.2% observed increased staff oral health knowledge. However, reliance on family/caregivers for oral hygiene products (79.2%) and poor attendance at external dental appointments (67.6%) were significant barriers reported by managers. Thus, while policy implementation has positively impacted residents and staff, gaps remain in resource availability and professional support. Future policies should focus on enhancing access to oral health professionals and providing in-house dental resources.