Older Adults' Oral Health in Institutional Care: Caregiver and Resident Perspectives on Challenges and Coping Strategies

ABSTRACT Background Older adults in nursing homes experience complex oral health needs, yet oral care is often under‐prioritised in long‐term care settings. In Malaysia, evidence examining oral health practices within nursing homes remains limited, particularly in relation to daily oral care and service delivery. Objective To explore oral health challenges and coping strategies among older residents and caregivers in Malaysian nursing homes and to identify system‐level factors influencing daily oral care. Methods A qualitative study was conducted using in‐depth interviews with 10 residents and five focus group discussions, together with one individual interview, involving a total of 21 caregivers across six nursing homes (five private and one government) in Selangor. Data were analysed using reflexive thematic analysis following Braun and Clarke's approach. Trustworthiness was enhanced through triangulation of resident and caregiver data, peer debriefing and cross‐checking transcripts against field notes. Results Five themes described oral health experiences in nursing homes. Residents reported challenges related to functional decline, denture discomfort and mild cognitive limitations. Structural and institutional barriers constrained access to oral care and dental services. Caregivers played a critical role in maintaining daily oral care but encountered challenges related to limited training, workload pressures and behavioural resistance, which may compromise residents' quality of life. Both residents and caregivers adopted adaptive coping strategies, while support from families, facilities and structured training acted as key facilitators. Conclusion Oral health in Malaysian nursing homes is shaped by the interaction of resident capacity, caregiver preparedness and institutional context. Strengthening caregiver training, ensuring consistent oral care resources and integrating routine dental services into long‐term care are critical to improving oral health outcomes for residents.