Oral Care in a Icelandic Nursing home

Objectives: Results from a Clinical Oral examination of Nursing home (NH) residents, showed 78,9% needed basic treatment. The aim of the study was to establish an overview of education of NH employees, oral hygiene practises and potential barriers to oral care (OC).
Methods: A study was carried out among employees (N=52) with a questionnaire, distributed by NH administrators to participants working as health care workers or nurses in one NH in Reykjavík
Results: Background reveals nearly all subjects being female (n=50; 96,2%), mean age = 37,4 years; (SD= 15,9). A majority, 62%, had high school education and 38% had finished health-care education in colleges or universities. Most had worked less than six years (59,6%; n=31) but 25% had 16 years or more of work experience in NH. A total of 49 (94%) had received formal practical training in oral hygiene, 32,7% (n=17) had received formal theoretical education in same. A few had watched educational material distributed by the Directorate of Health in Iceland (25%, n=13) available to educators and the public in 2008. Even though 94% of employees had practical training to provide oral care, 16% (n=8) reported lack of experience as a barrier. The majority of employees (89,6%) performed daily oral hygiene of residents, using manual tooth-brushing, sponge or cotton to wipe the mouth and clean teeth. A total of 45 reported barriers to OC as being: resistance of residents (53,3%; n=24), lack of experience performing OC (17,7%; n=8), unwillingness of residents to allow help in oral hygiene practises (13,3%; n=6), absence of resources to provide the OC (8,9%; n=4) and two (4,4%) reported other obstacles.
Conclusions: OC education could benefit employees. The resistance of residents is of concern. Review of current OC protocols should be carried out, since oral hygiene is a cost-effective means to reduce morbidity related to OH.