The role of biobehavioral, environmental, and social forces on oral health disparities in frail and functionally dependent nursing home elders

The purpose of this article is to review the litera-ture on and discuss how interactions between bio-behavioral aging, nursing home environments, and social forces shaping current health care policies have contributed to oral health disparities in frail and func-tionally dependent elders who reside in nursing homes. Emerging empirical evidence suggests links between poor oral health with dental plaque deposi-tion and systemic disease, such as nursing home– acquired pneumonia. The majority of nursing home residents lack either the functional ability or the men-tal capacity to perform their own mouth care and therefore must rely on others to perform mouth care for them. Certified nursing assistants (CNAs), who pro-vide the majority of care activities, were unsure how t