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UBC Theses and Dissertations

The implementation of oral health regulation in long-term care facilities Jiang, Caroline Yueh Wen


Background: Poor oral health in long-term care (LTC) facilities is rampant and currently there is no effective strategy for improving daily oral healthcare in most of them. The government of British Columbia has implemented an oral health regulation for joint responsibility between dental professionals and LTC administrators to maintain the daily oral healthcare of residents in their care; however, it seems that conflicting priorities persist and are a barrier to achieving optimal oral health for residents. Research Questions: How has the governmental regulation on oral healthcare in LTC been developed, implemented and sustained? Methods: I conducted a secondary analysis of open-ended interviews with 14 LTC administrators undertaken before the regulation was implemented. Subsequently I conducted similar interviews with five government officials and five administrators to explore how the regulation was developed and implemented. Participants for interviews were selected purposefully to obtain a comprehensive response to my questions. I used a constant comparison technique to analyze relationships between the various perspectives, and I determined the trustworthiness of my findings by triangulating them with published literature on this topic, and by allowing participants to comment on them. Results: Before the regulation was implemented administrators emphasized a need for constant reminders, continuing education and administrative accountability to maintain the daily oral healthcare in LTC facilities. Government officials developed the regulation so that facility residents would receive a clinical examination annually by a dental professional. However, LTC administrators seemed unaware of this regulation, and when brought to their attention did not expect it to be assessed by government inspectors. This disregard for regulation was confirmed by the inspectors who explained that they do not enquire about daily oral healthcare of residents unless there is a written recommendation from a dental professional for treatment of specific mouth problems. Conclusions: The regulation to manage oral healthcare in LTC facilities is not being implemented or sustained as intended because of inadequate collaboration between dental professionals, administrators, and government inspectors.

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