INSIGHTS

The new Aged Care Act and oral health: what changed on 1 November 2025

The new Aged Care Act commenced on 1 November 2025, replacing aged care legislation dating back to 1997. For facility managers and clinical leads, two changes matter most day to day: the Act is rights-based, and the strengthened Quality Standards commenced with it. This article walks through what changed, where oral and dental care expectations now sit, and what is worth re-checking in your policies.

Passed in 2024, commenced 1 November 2025

The legislation itself is not new news. It passed almost a year before it took effect. The Department of Health, Disability and Ageing records that "the Australian Parliament passed the Aged Care Act 2024 as the new law for government-funded aged care in Australia on 25 November 2024." Commencement came later: "The new Act started on 1 November 2025 and aligns with the launch of the new Support at Home program."

The new Act replaced three pieces of legislation at once: the Aged Care Act 1997, the Aged Care (Transitional Provisions) Act 1997, and the Aged Care Quality and Safety Commission Act 2018. That has a small but practical consequence for providers: any policy, procedure or agreement in your document set that cites "the Aged Care Act 1997" is now citing repealed law. It is a quick first check, and it often surfaces documents that have not been reviewed in years.

The reason for the rebuild goes back to the Royal Commission into Aged Care Quality and Safety, which found the previous legislation was no longer fit for purpose because it was "structured around providers and how to fund them, rather than around the people accessing services and what they need."

A rights-based Act, and what providers must demonstrate

The department describes the new Act plainly: "It puts the rights of older people at the centre of the aged care system." The mechanism for that is a Statement of Rights written into the Act itself: "this outlines the rights that older people in the aged care system should expect when seeking or accessing government-funded aged care services."

For providers, the important word is demonstrate. Among the simplified obligations and registration conditions is the requirement that "a provider must demonstrate they understand the Statement of Rights and have practices in place to ensure the delivery of funded aged care services is compatible with the Statement of Rights." Having a rights poster in the foyer is not the same thing as having practices you can evidence.

The rights framing and the new standards are one package, not two separate reforms. The department notes the Act "underpins responses to 58 Royal Commission recommendations," including the strengthened Aged Care Quality Standards and "stronger powers for the Aged Care Quality and Safety Commission." Everything below flows from that.

The strengthened Quality Standards commenced with the Act

The Aged Care Quality and Safety Commission (ACQSC) is explicit about the link: "The strengthened Quality Standards are part of the new Aged Care Act 2024 and they applied from 1 November 2025. They're more detailed and measurable than the previous Quality Standards, which were in place before the start of the new Act." There are seven: the individual; the organisation; the care and services; the environment; clinical care; food and nutrition; and the residential community.

Each standard now has a consistent internal structure: an Intent, an Expectation statement, Outcomes ("which describe what providers will be assessed against"), and Actions, "which describe what providers can do to meet the outcome." The government has committed to reviewing the standards "every 5 years so that they continue to improve with best practice," so this structure is the durable frame, not a transition arrangement.

Assessment against them is concrete. The Commission states: "We do audits to assess if a provider is meeting the strengthened Quality Standards," and providers are rated against all the outcomes of each standard as "conformance, minor non-conformance, major non-conformance." Because ratings sit at outcome level, your evidence needs to map to outcomes, not just to the standard as a whole. For a walkthrough of how oral and dental care threads through the standards, see our article on what the strengthened Quality Standards expect for oral and dental care.

Where oral health now lives: Standard 5, Clinical care

Under the new framework, oral and dental expectations are concentrated in Standard 5. Scope first: the ACQSC states that "Standard 5 applies to Australian Government-funded aged care providers registered in: Category 5 – nursing and transition care, Category 6 – residential care (including respite)," and that "Outcome 5.1 Clinical governance also applies to providers registered in Category 4 that provide care management or restorative care management services." If you run a residential facility, all of Standard 5 applies to you.

Within Standard 5, oral health sits in two outcomes. Outcome 5.5, Safety of clinical care services, requires that "the provider must identify, monitor and manage high impact and high prevalence risks in the delivery of clinical care services to ensure the delivery of safe, quality clinical care services and to reduce the risk of harm to individuals." Oral health is one of the named risks, with its own dedicated action.

That action, 5.5.7, is worth quoting in full because it is effectively a three-part oral health program: "The provider implements processes to maintain oral health and prevent decline by: a) facilitating access to a dentist or other oral health practitioner for oral health assessments at the commencement of care, regularly and when required b) monitoring and responding to deterioration in oral health c) assisting with daily oral hygiene needs."

Outcome 5.4, Comprehensive care, adds the connective tissue. Action 5.4.3 requires that the provider "refers and facilitates access to relevant registered health practitioners and medical, rehabilitation, allied health, oral health, specialist nursing and behavioural advisory services to address the individual's clinical needs." Action 5.4.5 requires processes to "monitor clinical conditions and reassess when there is a change in diagnosis or deterioration in behaviour, cognition, mental, physical or oral health, and at transitions of care." And under 5.5, Action 5.5.2 requires processes "to support safe chewing and swallowing when the individual is eating, drinking, taking oral medicines and during oral care." This connects oral care directly to dysphagia and swallowing safety procedures.

None of this prescribes a particular assessment instrument. In practice, a structured nurse-led screening tool is one way to cover the "monitoring and responding to deterioration" part of the picture. See our plain-English guide to the Oral Health Assessment Tool (OHAT) for how that tool is structured and how results are meant to connect to care plans and referrals.

What a clinical lead should re-check in their policies

The ACQSC's Standard 5 provider fact sheet, dated October 2025, signals where assessors will look. It names oral health as one of four focus areas of the standard: "This Standard helps you focus on how you: manage clinical information systems, keep medication safe, reduce and manage clinical risks, care for oral health." It also lists oral and dental care among the example policies and procedures providers are expected to make available to older people in their care, explaining clinical safety in areas such as pain assessment and management, oral and dental care, nutrition and hydration, and continence.

Working from the actions above, a practical re-check list for a clinical lead:

• Legislative references. Replace citations of the Aged Care Act 1997 and the previous Quality Standards throughout your policy set, and check your documents reference the current source texts: the standards document is dated August 2025 and the Standard 5 fact sheet October 2025.
• Dental access pathway (5.5.7a). Does your admission workflow actually facilitate access to a dentist or other oral health practitioner at commencement of care, and is there a schedule for "regularly and when required" afterwards, or does the policy stop at "on request"?
• Deterioration triggers (5.4.5). Does your reassessment policy explicitly list deterioration in oral health as a trigger, alongside behaviour, cognition, mental and physical health, and transitions of care?
• Daily oral hygiene (5.5.7c). Is assistance with daily oral hygiene recorded as it is delivered, or assumed within general personal care notes? Assumed care is hard to evidence at audit.
• Referral follow-through (5.4.3). The action says refer and facilitate access. Is there a mechanism that tracks each oral health referral through to an outcome, rather than a recommendation that sits in the progress notes?
• Safe swallowing during oral care (5.5.2). Do your dysphagia and swallowing procedures cover oral care and oral medicines, not just meals?
• Evidence mapped to outcomes. Audit ratings are given against outcomes, so organise your oral health evidence against Outcomes 5.4 and 5.5 specifically.

Where Smile Advisor fits

Several items on that list depend on regular oral health checks and a documented trail between them. Smile Advisor provides a screening layer for the periods between dental visits: a carer takes a few guided photos on a smartphone; a registered dental clinician reviews them and returns a clear screening report; when a dental visit is recommended, it becomes a tracked referral with urgency attached, so follow-through can be evidenced; and daily oral care can be recorded as it happens. This is screening, not diagnosis. It does not replace assessment or treatment by a dentist, a structured nurse assessment, or your own clinical governance. See how Smile Advisor supports compliance for detail.

Published 10 August 2026.