Evolving aspects of oral care in older adults: a systematic review and Meta-synthesis

The global aging population has heightened the need for comprehensive oral care in older adults, yet evolving aspects such as preventive strategies, technological advancements, and interdisciplinary approaches remain underexplored. This systematic review and qualitative meta-synthesis aimed to synthesize qualitative evidence on perceptions, experiences, barriers, facilitators, and impacts of oral care in older adults, guided by the Socio-Ecological Model. Following PRISMA and ENTREQ guidelines, a systematic search was conducted in MEDLINE (PubMed), Embase, CINAHL, PsycINFO, Scopus, and Web of Science for qualitative studies published from January 2000 to December 2025. Eligibility criteria were defined using the SPIDER framework, focusing on older adults (aged ≥ 60) and stakeholders. Two reviewers independently screened records, extracted data, and appraised quality using CASP. Thematic synthesis was performed using NVivo to generate higher-order themes. From 1,416 records, 49 studies were included, involving diverse participants from multiple countries. Four overarching themes emerged: [1] Meaning-Making and Beliefs Surrounding Oral Health (e.g., cognitive biases, links to general health, responsibility); [2] Barriers to Accessing and Maintaining Oral Care (e.g., financial, physical, systemic); [3] Facilitators, Strategies, and Ethical Considerations in Oral Care Delivery (e.g., interprofessional collaboration, education, autonomy); and [4] Oral Health as a Determinant of Quality of Life and Human Dignity (e.g., functional, psychosocial, broader implications). A conceptual model illustrated the cyclical evolution of oral care. Oral health in older adults is influenced by multifaceted perceptions and systemic factors, impacting well-being. Findings advocate for interprofessional models, policy reforms, and education to address gaps and promote equitable, holistic care. Future research should explore digital interventions and multilingual syntheses.