Exploring Oral Health Practices and Barriers Among Nurses and Nursing Assistants in Long-Term Care Facilities: A Cross-Sectional Survey

Background: Oral health (OH) is integral to general health, well-being, and quality of life; however, in long-term care (LTC) settings, it is often neglected due to residents’ functional limitations, high care dependency, and the prioritization of underlying medical conditions by healthcare staff. Previous studies have highlighted this issue and identified multiple barriers to OH promotion in institutional settings. Objectives: To assess OH practices among nurses (NUR) and nursing assistants (NA) in LTC units and to identify barriers compromising effective oral care delivery. Methods: An observational, cross-sectional, descriptive study was conducted across five LTC facilities in Porto, Portugal. A structured survey was administered to 145 healthcare workers out of a total of 259 eligible participants, yielding a response rate of 55.98%. Data were collected via Google Forms and analyzed using IBM SPSS Statistics v.26. Descriptive statistics, analysis of variance, the Mann–Whitney U test, and Chi-square tests were applied, with a significance level of 0.05. Results: The main primary barriers to OH promotion included poor patient cooperation (74.6%), lack of dentists (74.6%), insufficient material (62.7%), limited time (45.8%) and inadequate staffing (40.7%). Chlorhexidine (94.50%) and oral sponges (70%) were the most frequently used resources, whereas other methods were underutilized. No statistically significant differences were observed between professional groups, irrespective of prior training. Although 48.5% of NUR and 51.5% of NA reported not perceiving barriers, substantial gaps in practice were identified. Only 1.9% of untrained NA reported consulting evidence-based scientific sources, compared with 44.7% of untrained NUR. Conclusions: Despite limited perceived barriers, significant deficiencies in OH practices persist in LTC settings, highlighting the need for structured, interdisciplinary training programs to improve oral care delivery.