Evaluation of a routine in Swedish dental care practice intended to support frail older patients in preserving their regular dental care contact: A mixed-methods study

<b>Objective:</b> To evaluate how a routine for maintaining dental care contact for frail older patients is used and experienced by dental professionals in Public Dental Service in the west of Sweden. <b>Basic research design:</b> The overall study design consisted of mixed methods. The quantitative part included an analysis of register data regarding the number of registrations to the routine during 2018-2023 and a survey in 2021 to one representative at each clinic. The qualitative part included interviews conducted with employees (n = 12) from 11 different dental care clinics. The data was analysed with qualitative content analysis. <b>Clinical setting:</b> The study was performed in the west of Sweden, including a total of 105 Public Dental Service clinics. <b>Participants:</b> Personnel at Public Dental Service clinics in the west of Sweden. <b>Results:</b> Between 2018 and 2023, register data showed variation in the use of the routine across dental clinics (0-457 cases per clinic). The survey found that the routine was used at 80% of the clinics, with 78% of the informants reporting it worked well, although 41% saw room for improvement. Qualitative findings revealed inconsistent interpretation and adaptation of the routine. Challenges included unclear frailty criteria, administrative load, time constraints and complex instructions. Ethical concerns centred on patient autonomy and integrity. <b>Conclusions:</b> This is the first scientific evaluation of a routine designed to support frail older patients in maintaining a previous regular dental care contact. Findings reveal inconsistent implementation across clinics and staff, potentially leading to unequal care for a frail population.