The Relationship Between the Awareness of Nursing Staff in Geriatric Institutions and the Dental Health of Residents: A Systematic Review

Background: Oral health is frequently neglected among institutionalized older adults, despite its association with systemic morbidity and reduced quality of life. Residents of nursing homes and long-term care facilities often depend on nursing staff for daily oral hygiene. Although staff-focused oral-care programs are widely implemented, the extent to which nursing staff awareness directly influences resident oral-health outcomes remains insufficiently clarified. Aim: To examine the relationship between nursing staff awareness-defined as knowledge, attitudes, perceptions, confidence, or training related to oral health-and oral-health outcomes among institutionalized older adults. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. Electronic databases (PubMed, CINAHL, Web of Science, and Google Scholar) were searched for studies published between January 2000 and October 2025. Eligible studies included institutionalized older adults and evaluated nursing staff awareness alongside resident-level oral-health outcomes. Methodological quality was appraised using validated design-specific tools. Due to heterogeneity in study designs and outcome measures, findings were synthesized using structured narrative analysis. Results: Eleven studies met the inclusion criteria. Most employed quasi-experimental or pre-post designs, while only a minority used controlled methodologies. Staff-focused oral-care interventions were consistently associated with improvements in plaque accumulation, gingival status, mucosal condition, and denture hygiene. However, nursing staff awareness was inconsistently measured and frequently inferred rather than directly assessed, limiting causal interpretation. Conclusion: Structured staff-focused oral-care programs are associated with improved resident oral-health outcomes. Nonetheless, direct empirical evidence linking nursing staff awareness to clinical outcomes remains limited. Robust research designs incorporating validated awareness measures are required to clarify this relationship.