Oral Health in Residential Aged Care

Home Readiness Assessment Tool

RACH Use Only – Do not send to John Badwater Consulting

If there are any issues with accessing fields or completing the document, please contact John Badwater on 0466 354 574 or email john@badwater.com.au

Table of Contents Introduction 3 Instructions 3 Home Details 4 1. Facilitating access to a dentist or other oral health practitioner for oral health assessments at the commencement of care, regularly and when required 5 Oral Health Assessments 5 Dentist Referral Pathways 5 2. Monitoring and responding to deterioration in oral health 8 3. Assisting with daily oral hygiene needs 9 Home Manager Review 11 John Badwater Consulting, is independent of any public or private oral health or dental service. The information within this document does not provide instructions on how oral health should be maintained, but is about processes that are generally used to deliver daily oral care, assessments and access to dentists. This tool is to be used as an assessment of currently processes to be completed by a senior clinical manager or registered nurse. Once completed, it should be forwarded to the home manager for review and it’s content, preferably, discussed with the person who completed it. Once the content is discussed, it can be regarded as a decision tool to engage John Badwater Consulting to assist RACH staff to access to services and information including: Free accredited online training for nurses and care workers Reference materials and forms for daily care, reporting of deterioration and oral health assessments Development of urgent and non-urgent referral pathways

Introduction

This tool has been developed for clinical staff in residential aged care homes (RACH) to review the current processes for oral health and access to dental care, and identify any improvements that can be made to ensure that the residents receive the best daily care and access to services. The focus is on achieving a standard of care that ensures that each resident is able to enjoy good oral hygiene with clean teeth and/or dentures and are free of disease and pain that impacts on their enjoyment of eating, drinking and even smiling. Processes should be in place to monitor any deterioration in a resident’s mouth and teeth, to ensure that they can receive an oral health assessment from an appropriately trained person and, if necessary, treatment by a dentist.

The Australian residential aged care industry is regulated by the Australian Government Aged Care Safety and Quality Commission (ACSQC). Quality assessors visit homes on a periodic bases to ensure that the site operates in accordance with a set of standards that have been specifically developed to ensure that the residents receive an appropriate level of care. Other standards the provider operates in accordance

The final report of the Royal Commission into Aged Care Quality and Safety was published in 2021 and included several recommendations, several of which were related to oral health. Following the recommendations, the ACSQC developed Strengthened Quality Standards to be implemented from 1 July 2025, in accordance with the New Aged Care Act that passed parliament on 25 November 2024.

Specific to daily oral care, assessments and access to dental services is Standard 5.5.7 which states:

The provider implements processes to maintain oral health and prevent decline by:

facilitating access to a dentist or other oral health practitioner for oral health assessments at the commencement of care, regularly and when required;

monitoring and responding to deterioration in oral health;

assisting with daily oral hygiene needs.

Instructions

This document is in template form, so save now! You can return to it if unable to complete it in one go. Remember to save after completing, editing or deleting text. If you reopen the template version you will have to start from the beginning.

Only the areas provided for a response can be completed. There is no limit to the amount of text written.

The sections, below, are designed to align with Standard 5.5.7. A clinical manager or registered nurse should complete all sections. An opportunity to include additional notes is available at the end of each section. The completed document should be forwarded to the RACH manager for review and, preferably, discussion with the clinical manager or RN.

This document is for internal purposes only and should not be forwarded to John Badwater Consulting.

Home Details

Complete all fields below, providing as much information as possible. There is no limit on the size of the fields. When completed, save and email to the Home Manager.

Name of RACH
Location
Number of beds
Current occupancy
Form completed by
Position title
Form completed date

Name of Clinical System
If Paper, location of files
System admin name
System support name

Facilitating access to a dentist or other oral health practitioner for oral health assessments at the commencement of care, regularly and when required

Oral Health Assessments

Are there any members of staff qualified to complete an oral health assessment on a resident?	☐ Yes ☐ No ☐ Not Sure

Names of staff qualified to complete an oral health assessment and date of most recent training completed.

If applicable, provide details of dentists, GPs or other oral health professionals engaged to complete oral health assessments.

Are all new residents given an oral health assessment on arrival?	☐ Yes ☐ No ☐ Not Sure

How often do existing residents receive an oral health assessment?

Other comments related to oral health assessments and those who complete them.

Dentist Referral Pathways

What is the procedure for dentist referrals for non-urgent cases?

What is the procedure for dentist referrals for urgent cases?

Where can staff access instructions for an emergency dental referral?

What is the procedure for arranging dental checkups for residents who choose to remain as a patient with their own dentist?

What is the procedure for a resident who has a dentist outside the local area?

How many eligible residents are on a public dental waiting list?

How often do residents attend a check-up with a dentist?

What is the procedure for residents who need to attend a hospital as a dental inpatient?

Do you maintain a list of emergency public and private dentists?	☐ Yes ☐ No ☐ Not Sure

Do you use the services of visiting dentists?	☐ Yes ☐ No ☐ Not Sure

Do you have a dedicated dentist room with chair onsite?	☐ Yes ☐ No ☐ Not Sure

If you don’t have a dentist room, describe where visiting dentists perform treatments?

Other comments related to dentist referrals

Monitoring and responding to deterioration in oral health

Describe the procedure where a person providing daily oral care notices changes in a resident’s mouth, teeth or eating habits.

Describe the process for creating and implementing an oral health care plan.

Describe the decision process for determining whether a dental referral is required.

Other comments related to monitoring and responding to deterioration in oral health.

Assisting with daily oral hygiene needs

Which staff role/s provide daily oral care to residents?

How many times a day is oral care provided?

Are any residents not receiving daily oral care? If so, provide reason/s.

How do staff record oral care in the resident’s clinical record?

Where can staff access information for providing daily oral care?

Describe how care workers are trained to provide residents with daily oral care?

How often is a resident’s toothbrush changed?

What type of toothpaste is used to clean residents’ teeth?

Describe how dentures are cleaned and how often?

How are dentures stored at night?

How are dentures labelled?

What is the procedure for dealing with damaged, broken or missing dentures?

Other comments related to daily oral care and those providing it.

Additional Comments

To be completed by the person completing this form, or someone assisting

Name
Additional Comments

Home Manager Review

This section is to be completed by the Home Manager on receipt of the completed form. The purpose is to identify any aspects of the current processes and procedures that do not comply with the strengthened standard. This will assist with the decision to undertake any necessary improvements, or determine whether redesign is required.

Complete the notes for each item

1.Facilitating access to a dentist or other oral health practitioner for oral health assessments at the commencement of care, regularly and when required
Oral Health Assessments
Dentist Referral Pathways

2.Monitoring and responding to deterioration in oral health

3.Assisting with daily oral hygiene needs

Home Manager summary, recommendations and decision whether to engage with John Badwater Consulting

Home Manager Name
Date of Review