Barriers and Facilitators Concerning Involuntary Oral Care for Individuals with Dementia: A Qualitative Study

Many individuals with dementia show care-resistant behavior toward oral care, while care providers are often reluctant to provide it involuntarily, risking negative health outcomes. This study aims to identify the barriers and facilitators of providing involuntary oral care for individuals with dementia who show care-resistant behavior. In total, 32 semi-structured one-on-one interviews with healthcare providers were conducted. Through the interviews, multiple barriers and facilitators were identified and divided into four main themes, each containing multiple sub-themes: (1) communication (between dental and non-dental care providers, and amongst non-dental care providers themselves), (2) logistics (materials, transportation, and staff and time), (3) knowledge (training, awareness of oral health problems, and assessment of severity of oral health problems), and (4) oral care provision (psychology care providers, attitude concerning involuntary oral care, ethical and legal considerations, and sedation). Our study shed more light on the barriers and facilitators regarding involuntary oral care provision to older individuals with dementia. Multiple recommendations were provided, including designating nurses to help monitor oral health, involving dental professionals in multidisciplinary team meetings, discussing a shift in attitude concerning oral care, providing clear guidelines and protocols for sedation and daily oral care provision, and performing more research into involuntary oral care.