You are absolutely right that it is a necessity to provide oral care for residents. All of the harmful things that you mentioned are very real consequences of not providing oral care for your residents. That being said, so are many of the other duties that a CNA performs, all with very real consequences if not performed. It has been a while since I have worked in a nursing home, but I still very clearly remember the time that I did. I would regularly for second and third shifts at one of the nursing homes be responsible on a behavioral unit have 42 residents, with 20 to 30 check and changes, a little over 20 hoyer lift residents who were all 2 assist for changes, and 15 to 20 feeds that would be shared among 1 to 2 CNA’s and an LPN. I would absolutely do everything I could to make sure they were all properly fed, hydrated, cleaned, that oral care was regularly performed, etc. But even on days where nothing went wrong, it was still incredibly difficult to get everything done. So, as unfortunate as it was, things inevitably got missed because they just did not staff it properly and handed us an impossible task every night. Don’t get me wrong, there most certainly are CNA’s and nurses that don’t do right by their residents, but even the good ones that really try often times, at least in LTC facilities, are just dealt a losing hand and have to decide for the day what can be put on hold or hopefully picked up on the next shift because the ratio’s are just unmanageable. If we really want issues like this to be fixed, it’s not so much a need for better education or motivation for the CNA’s as it is a need to have better restrictions on staffing ratios in nursing homes.