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A Scoping Review and Research Synthesis of the Organisation and Delivery of Oral Healthcare in Long-Term Care Facilities

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(MARCH, 2006)

PI: Michael MacEntee (Dentistry, UBC)

Co-Investigators: Aminée Kazanjian, Jean Kozak, Sally Thorne

Agency: CIHR

Amt: $68.402

Duration: 1 year

It is unclear how best to organize oral healthcare for this population in the absence of a conceptual framework to guide the provision of care and the assessment of outcomes. Dental care is not covered by the Canada Health Act, consequently, there is little constructive discussion about the administrative or financial costs of integrating dental services with other LTC services. Most of the dental services available to LTC facilities focus solely on emergency care. There are no systematic exploration or evidence-based information addressing the organization, regulation, delivery, or evaluation of oral healthcare in LTC facilities. Moreover, the published literature is inconsistent and presents conflicting theories on how oral healthcare in LTC facilities occurs.

Our review and synthesis will be carried out in two parts. Firstly, the scoping review of national and international research studies and projects will provide information for health services and policy research communities (especially in dentistry, nursing, medicine, and sociology) about the gaps in research relating to the organization, financing, regulation, and delivery of oral healthcare to frail elders in LTC facilities. Secondly, the research synthesis will provide policy-makers, administrators, clinicians and advocacy groups with current evidence and possible solutions to address the education, regulation, financing, and operation of the professional and non-professional workforce involved in oral healthcare within LTC facilities.

The questions to be addressed are:

Scoping Review:

  • What is known in Canada and elsewhere about organizing, financing, operating and monitoring the quality of oral healthcare in LTC facilities?
  • What challenges the organization, governance, delivery and accountability of oral healthcare practices in LTC facilities?
  • What are the major gaps in knowledge that require primary research and syntheses?

Research Synthesis:

  • What models of oral healthcare are used currently in LTC facilities?
  • What combination of healthcare professionals provide the optimal dental service in LTC?
How can the objectives of policy-makers, facility administrators, nursing staff and dental professionals be combined to enhance the oral healthcare of frail residents in LTC?