Brushing Up on Mouth Care

Facilitating uptake of a daily oral care program in continuing care

Logo - Brushing Up on Mouth CarePurpose: To to translate the knowledge we have gained in the Oral Care in Continuing Care Settings project in order to facilitate uptake of these resources in other relevant settings.

This knowledge translation (KT) project follows from outcomes and KT activities arising from the Oral Care in Continuing Care Settings: Collaborating to improve polices and practices (2008-2012) study funded through the Nova Scotia Health Research Foundation.

Why oral health research?

Mouth care is an integral part of personal care, yet daily mouth care is known to be inadequate for those who depend on others to carry out tasks of daily living. Oral health is often given low priority in the long-term care sector. Studies consistently indicate that oral health status amongst dependent older adults is poor. This places them at risk for oral diseases and dysfunction, affects overall health and negatively impacts quality of life, diminishing the pleasures of eating, speaking and social interactions.

How were these oral health resources developed?

The 'Oral Care in Continuing Care Settings' project engaged personal care providers, nurse managers and directors of care to develop, implement and evaluate a comprehensive daily oral care program in three long-term care facilities and an adult day hospital in rural Nova Scotia. Outputs included relevant, user friendly and accessible resources (print, video and web-based materials) to educate and support the range of unregulated personal care providers (i.e. personal care workers, residential care aides and continuing care assistants) who provide personal care for dependent older adults. This comprehensive hands-on educational resource package was titled"Brushing Up on Mouth Care". This resource package includes:

The study involved an extensive network of decision makers and knowledge users across Nova Scotia. More than 30 presentations were made to share findings and showcase the educational resources. As a result, there has been an overwhelming and urgent demand for these resources from across Canada and internationally.

Where will these oral health resources be shared?

These resources will be shared throughout Nova Scotia with 3 target audiences:

  1. long-term care facilities,
  2. home support agencies and
  3. continuing care assistant education programs.

We will also share our resources nationally by connecting with dental associations, relevant health sectors, and others with a known interest in care for dependent older adults.

How will these oral health resources be shared?

The “Brushing Up on Mouth Care” resources will be modified to ensure relevance to the three target audiences. A nurse educator will work with the project coordinator and content experts from the research team and the continuing care and education sectors to develop a facilitator’s guide. Based on a train-the-trainer approach, the facilitator’s guide will provide an education plan and teaching tools to assist potential facilitators to train care staff about oral care and to how to use the ‘Brushing Up on Mouth Care’ resources to improve oral care.

Physician Leaders and Directors of the Care from Continuing Care sector in Nova Scotia will identify prospective facilitators from within each of the long-term care facilities, home support agencies and Continuing Care Assistant education programs across Nova Scotia.

A nurse educator will lead several train-the-trainer sessions across Nova Scotia. Training sessions will include hands-on demonstrations of proper brushing, flossing, and rinsing techniques, as well as approaches to manage challenging behaviours. These sessions will also be delivered in a webinar format for facilitators who are unable to attend a live training session. To enable the sharing of knowledge beyond Nova Scotia, webinar sessions will be available and advertised to a national audience. Finally, this training session will be developed into an educational video and posted on the project website along with the facilitator guide and all other ‘Brushing Up on Mouth Care’ materials.

Team List


  • Mary McNally (PI)
    Faculty of Dentistry, Dalhousie University

  • Debora Matthews
    Faculty of Dentistry, Dalhousie University

  • Joanne Clovis
    School of Dental Hygiene, Faculty of Dentistry, Dalhousie University

  • Ruth Martin-Misener
    School of Nursing, Dalhousie University


  • Paige Moorhouse
    Capital District Health Authority & Faculty of Medicine, Dalhousie University

  • Christopher Wyatt
    Faculty of Dentistry,
    University of British Columbia

  • Sandra Crowell
    Atlantic Health Promotion Research Centre, Dalhousie University