Medical Practitioners' Views on Barriers in Collaboration with Dentists in Long-Term Care Settings

In long-term care settings (LTCs), oral health care often remains fragmented from other geriatric care services. Medical practitioners (MPs) typically take the lead in addressing medical aspects of geriatric care plans, making it essential for them to understand the importance of oral health and to collaborate with dental professionals. However, little is known about MPs' perceptions toward oral health management in LTCs. This qualitative study aimed to gain an in-depth understanding of MPs' views on oral health management in LTCs and explore challenges in collaborating with dental professionals in Singapore.

Participants were recruited using a purposive sampling strategy, initially through targeted outreach to those with experience in LTCs, followed by snowball sampling to identify additional participants until data saturation was achieved. One-to-one interviews with participants were conducted via teleconferencing using a semi-structured interview guide. The transcripts were analyzed using a hybrid (inductive and deductive) thematic analysis supported by NVivo data management software.

Participants (n = 13) felt that oral health care was currently not well-integrated into the existing LTC system. They frequently encountered oral health issues but arranged for dental appointments only when their patients complained of acute symptoms. Key barriers identified were (1) a cultural misconception within the eldercare community that poor oral health was an inevitable part of aging, (2) systemic barriers related to the inadequate geriatric oral health care services and infrastructure, and (3) knowledge gaps in geriatric oral health management among MPs. These factors collectively hindered effective collaboration with dental professionals in LTCs.

Participants emphasized the lack of oral health care integration in LTCs, identifying cultural, systemic, and internal barriers. Strengthening collaboration with dental professionals in LTCs, implementing oral health education for the eldercare community, and introducing domiciliary services could address these challenges and support more effective geriatric care, with insights for similar systems globally.Knowledge Transfer Statement:This qualitative study highlighted a critical gap in oral health care integration within eldercare described by the MPs in this study in Singapore's long-term care settings. Although findings are context specific, they may offer insights for aging nations facing similar challenges. Overcoming misconceptions about aging and oral health, improving systems, and educating MPs are key to fostering interdisciplinary collaboration and enhancing eldercare. Addressing these barriers could improve the overall well-being of care-dependent older adults.