Background/Purpose: Accessing oral health care can be more difficult for adults with intellectual disabilities with reports of poorer levels of oral health. This investigation identifies factors influencing engagement in day-to-day oral and dental health care for adults with intellectual disabilities. Method: A survey, containing questions about facilitators and barriers to maintaining oral health and hygiene, was completed with adults with intellectual disabilities and their caregivers (N = 372). Results: Data were analysed using thematic network analysis. Two global themes were identified; "Personal and lifestyle influences," mentioned more often as barriers to oral care, included physical, sensory, cognitive, behavioural and affective factors and "social and environmental factors," mentioned more as facilitators, included caregiver support, equipment and adaptations used and oral hygiene routine. Conclusions: Numerous individual, social and environmental factors influence oral care. A coordinated organisational response is advocated involving collaboration between dental and intellectual disability services and training for caregivers and people with intellectual disabilities.