There are great risks of diseases in the ageing population, and oral diseases are no exception. Poor oral health has profound negative impacts on the quality of life. It is therefore crucial to include the oral health perspective in the care for older adults. To meet the challenges associated with oral health in the ageing population, a formative intervention was launched. The intervention, called the TAIK project (=“Dental hygienist in a municipality organization”, in Swedish: Tandhygienist i kommunal verksamhet), meant that six dental hygienists served non-clinically as oral health consultants in five Swedish municipal organizations. The intervention formed an infrastructure and platform for work that benefits the ageing population and created a new basis for decisions regarding oral health in homecare. The aim of this paper is to explore how aspects of collaboration in an interprofessional and interorganizational intervention may lead to expansive learning. Expansive learning forms the theoretical framework of this study. The dental hygienists and the local head nurses were interviewed individually in-depth. Reflection documents from the dental hygienists were also part of the analyzed data. The conclusion is that the formative intervention was reliant of change which created a foundation for reciprocal understanding that led to expansive learning between dental care and municipal healthcare, with resilience and empowerment as crucial factors.

Frail older adults often have poor oral health. In Sweden, oral care cards are designed to be used as an interprofessional tool for documenting the oral health status of older adults with extensive care needs and to describe oral care recommendations. The aim of this study was to explore nursing and dental professionals’ experiences and perceptions of oral care cards. Nursing and dental care staff were interviewed in groups or individually. The recorded data were transcribed verbatim and analyzed using qualitative content analysis. A theme emerged: Navigating an oral care responsibility that is not anchored in the nursing and dental care context. The theme was elucidated in three categories: “Accessibility and usefulness”, “Coordination between nursing and dental care”, and “Ethical approach”. The participants perceived a lack of surrounding frameworks and collaboration concerning oral care and the use of oral care cards. An oral care card could ideally facilitate interprofessional and person-centered oral care. However, oral health does not seem to have found its place in the nursing care context. Further research is needed to investigate how oral care cards ought to be developed and designed to support oral health care work.

Background: Participation by all actors involved in health planning is a prerequisite for person-centred care and healthy ageing. Understanding the multiple knowledge needs and the values that shape oral health assessments in home settings is important both to enable participation in oral health planning and to contribute to healthy ageing. Objective: The aim of this study was to investigate decisional needs during oral health assessments in ordinary home settings from the perspectives of older adults, home health care nurses and dental hygienists. Methods: Data was collected in ordinary home settings through 24 team-based oral assessments and 39 brief, semi-structured interviews including older adults (n = 24), home health care nurses (n = 8) and dental hygienists (n = 7). Data was analysed using content analysis with a deductive approach. The analysis was guided by the Ottawa Decision Support Guide. Results: The analysis revealed that all participants considered participation in decision-making important but until now, older adults might not have participated in making decisions regarding oral health issues. The older adults considered participation important because the decisions had a strong impact on their lives, affecting their health. The professionals considered decision-making important for knowing what step to take next and to be able to follow up and evaluate previous goals and treatments. Organizational and personal barriers for shared decision-making among home health care nurses and dental hygienists were identified. Of the 24 older adults, 20 had different oral health conditions that objectively indicated the need for treatment. An initial important decision concerned whether the older adult wanted to make an appointment for dental care, and if so, how. Another decisional conflict concerned whether and how assisted oral care should be carried out. Conclusion: It is important for key participants in ordinary home settings to participate in interprofessional teams in home health care. To further anchor this in theory, conceptual models for professionals from different care organizations (municipal care, dental care) need to be developed that also involve older adults as participants. Future research could bridge theory and practice by including theories of learning while exploring interorganizational oral health planning in home settings.

Background: Patient participation is key in person-centred care, emphasizing individual choices in treatment. Oral health, integral to overall well-being, is sometimes a neglected part of health. This intervention introduces a novel approach to strengthen person-centred care in homecare settings, employing collaborative, interprofessional teamwork and shared documentation across care organizations. This protocol outlines the design of a cluster-randomized controlled trial (RCT) in Sweden, comparing traditional oral assessments with an interorganizational, team-based oral health care planning model facilitated by a shared digital platform for documentation. The overall aim is to evaluate a person-centred interprofessional and interorganizational model for oral health care planning supported by a digital platform to enable healthy ageing. Methods/design: The intervention, co-designed with older adults, academic institutions, healthcare providers in public dental care, and municipal organizations, will undergo ethical approval. The RCT will randomize older adults, dental hygienists (DHs) and nursing assistants (NAs) into two groups. The intervention group will attend a two-day workshop on a person-centred, three-step team-based model, while the control group will continue using standard procedures. Thereafter, the three-step collaborative model will be compared to standard procedures. Primary outcomes will be measured using the Revised Oral Assessment Guide (ROAG) and the General Oral Health Assessment Index (GOHAI). Secondary outcomes include health economic evaluations, participation rates and quality of care assessments. Qualitative studies from theoretical perspectives of change and learning based on interviews with key stakeholders will be conducted in both the test and control groups. Discussion: Taking a co-produced approach where theory and practice shape the research iteratively, a person-centred health care planning model supported by a shared digital platform for home settings is evaluated. Anticipated outcomes include improved oral assessments and a deeper understanding of effective person-centred care practices. The co-produced approach of the intervention is also expected to further develop knowledge regarding co-production within domains of healthy ageing from an oral health perspective. As such, the intervention shapes and fosters co-produced person-centred care and healthy ageing. Trial registration: ClinicalTrials.gov NCT06310798. Registered on 13 March 2024.

Objective: To explore the experiences and perceptions of oral care cards among strategic‐level leaders within municipal and dental care organisations. Background: Oral health is integral to overall well‐being, especially in older adults, who frequently rely on caregiving services. In Sweden, paper‐based oral care cards are intended to enhance communication and coordination across municipal and dental care, yet their practical effectiveness remains underexplored. Leaders are crucial for facilitating integrated person‐centred care; exploring a strategic‐level leadership perspective on these cards is therefore important for developing comprehensive cross‐organisational oral health care strategies for ageing populations. Materials and Methods: Using a qualitative, exploratory design, data were collected through semi‐structured group interviews with leaders in municipal and dental care, as well as with senior researchers in nursing/person‐centred care and the oral health domain. In total, 20 participants took part in the interviews. Inductive content analysis was employed. Results: Participants called for a more cohesive, cross‐organisational framework to improve the scope and usefulness of oral care cards. Three main categories emerged: (1) the necessity of a dynamic, adaptable process that accommodates changing oral health needs; (2) the importance of integrating oral care cards into existing workflows through coordinated leadership; and (3) the potential of oral care cards to promote reciprocal learning, person‐centred care and preventive strategies. Conclusion: Oral care cards hold considerable promise for strengthening oral health among older adults. Long‐term sustainability in a digitalising care system likely requires a hybrid approach, where paper‐based cards function as low‐threshold bedside prompts while key information is mirrored in secure digital infrastructures to enable follow‐up, shared access and accountability.

Objective: To appraise the quality of theories, conceptual models, and theoretical frameworks about SDM for oral healthcare practices. Background: Shared decision‐making (SDM) is crucial to person‐centred care. Yet little is known about how (and if) patient engagement in SDM is conceptualised in oral healthcare. Methods: We conducted a theory analysis of theories, conceptual models, and frameworks. We searched Medline, Scopus, and CINAHL. Eligible theories/conceptual models/frameworks had to specifically focus on SDM in oral healthcare. Eligible papers were analysed using Walker and Avant's theory analysis steps and mapped onto the 8 core elements of SDM. Main Findings: Of 195 citations, two conceptual models specific to oral healthcare were identified. The SDM System on Dental Restorations ( SDMS‐DR ; South Korea) focuses on decisions between dentists and patients about restorative treatment. The Four + one Habits Model for dental visits ( 4 + 1 HB ; Norway) is an approach for SDM across oral healthcare decisions, more broadly. Both conceptual models focus on the patient‐professional encounter and met 4 (SDMS‐DR) and 6 (4 + 1HB) of the 8 core elements of SDM. The SDMS‐DR provided no reference to the patients' expertise. The 4 + 1HB presented SDM as a standardised linear process rather than a dynamic process. Neither has been empirically tested, and they do not acknowledge the broader healthcare system within which the encounters take place. Conclusion: We identified two conceptual models that incorporated some elements of SDM for oral healthcare. Neither was evaluated, and both focus exclusively on the patient‐oral healthcare professional encounter, without consideration of intersectional, multidisciplinary healthcare services.