Introduction Oral health is essential to the well‐being of older adults, yet it remains deprioritised in residential aged care (RAC). Poor oral health is linked to pain, malnutrition and an increased risk of systemic conditions such as cardiovascular disease and pneumonia. Despite its importance, there are no mandated oral health standards in RAC, leading to inconsistent practices and service gaps. The Royal Commission into Aged Care Quality and Safety, a public inquiry into Australia’s aged care sector, exposed systemic deficiencies including the inadequate prioritisation of oral health. Methods A qualitative approach using reflexive thematic analysis was employed, with the Exploration, Preparation, Implementation, Sustainment (EPIS) framework applied as a sensitising lens to contextualise findings within implementation processes. Data were drawn from Melbourne hearing transcripts of the Royal Commission into Aged Care Quality and Safety held from 15 to 17 July 2020. The study adhered to the Standards for Reporting Qualitative Research (SRQR) to ensure transparency and methodological rigour. Results The analysis identified six themes reflecting key barriers and facilitators to oral health integration in RAC. Barriers included low organisational readiness, insufficient workforce training, inadequate funding and the absence of enforceable policies. Facilitators included sustainable funding models, structured oral health assessments and interdisciplinary collaboration. Embedding oral health practitioners within RAC interdisciplinary teams was identified as a key strategy to enhance service delivery and preventive oral health care. Conclusion The findings indicate that challenges to oral health integration in RAC are predominantly structural, driven by a lack of enforceable standards, fragmented funding and limited workforce capacity. Embedding oral health practitioners within care models, aligning funding with accreditation requirements and strengthening partnerships between RAC facilities and dental services are identified as critical implementation priorities. Future research should focus on evaluating and scaling implementation strategies that support the long‐term integration of oral health care and improve outcomes for older Australians.
Pritchard et al. (Thu,) studied this question.