Achieving Consensus on Oral Health in Aged Care: Findings From an Australian e-Delphi Study

To establish expert consensus on the critical factors shaping implementation of oral health assessment in Australian residential aged care (RAC) using an e-Delphi approach.

A modified electronic Delphi (e-Delphi) process, informed by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, was conducted over two iterative survey rounds to refine expert perspectives. 60 experts were purposively sampled from oral health, aged care, policy, and implementation science. Quantitative responses were summarized with descriptive statistics, while qualitative feedback was analyzed through reflexive thematic analysis.

Consensus was reached on the importance of mandating oral health care in national aged care accreditation standards, embedding oral health into broader aged care policies and requiring systematic oral health assessments as part of routine care. Participants highlighted workforce shortages, insufficient training, limited practitioner access, and organizational readiness as key barriers. Enablers included workforce development, simplified and standardized assessment tools, mobile and outreach dental services, policy mandates, and cultural change recognizing oral health as integral to person-centered care. Round two resolved areas of initial uncertainty, with consensus achieved on all outstanding items.

This study provides the first consensus-based priorities for embedding oral health assessment tools in RAC, signaling sector-wide readiness for reform. Applying the EPIS framework, the findings highlight that enforceable accreditation standards must be paired with workforce training, oral health champions, and practical tools to ensure sustainable uptake. These insights offer an evidence-informed roadmap for policymakers and service providers, reframing oral health from a peripheral task to a regulated element of clinical governance and quality care.