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Wong FMF, Leung WK. Sustainability of an Educational Program on Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Follow-Up Study. Geriatrics (Basel) 2024; 9:84. [PMID: 38920440 PMCID: PMC11203192 DOI: 10.3390/geriatrics9030084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The importance of oral health in older adults, especially those in long-term care institutions (LTCIs), has been widely recognized. This study aimed to evaluate the sustainability of an oral health educational program (OHEP) for healthcare providers by measuring changes in their knowledge, attitudes, and practice (KAP) towards oral care provision 3 and 6 months after completing the OHEP. METHODS A pragmatic direct care nursing education trial with a control group was conducted to evaluate the sustainability of an OHEP by examining changes in KAP 3 and 6 months after the OHEP. The OHEP comprised both knowledge and skills related to oral care, whereas the control group received standard support in accordance with usual oral care practice. RESULTS The study included 20 healthcare providers in the intervention group and 20 in the control group. At 6 months post-OHEP, a significant difference in knowledge was observed between the two groups, with the intervention group maintaining a positive effect (mean 13.90). Conversely, the control group showed a significant decline in knowledge (from mean 14.25 to 12.10). Both groups showed an improvement in attitudes regarding oral health, with the intervention group exhibiting better results 3 months post-OHEP. Intervention group participants rated oral care as a higher priority. CONCLUSIONS An OHEP program for LTCI direct care staff provides enhanced knowledge and attitudes toward oral health care. Regular training in direct care and additional support may be needed to sustain optimal effects on oral care practice.
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Affiliation(s)
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
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Tiisanoja A, Anttonen V, Syrjälä AM, Ylöstalo P. High Anticholinergic Burden and Dental Caries: Findings from Northern Finland Birth Cohort 1966. JDR Clin Trans Res 2024:23800844241253250. [PMID: 38872382 DOI: 10.1177/23800844241253250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Anticholinergic drugs propose a threat for oral health by causing dry mouth. The aim of this cross-sectional study was to investigate whether a high anticholinergic burden was associated with the presence of initial caries lesions, manifested caries lesions, dental fillings, or tooth loss among 46-y-old people. METHODS The study population consisted of 1,906 participants from the Northern Finland Birth Cohort 1966 who underwent an oral health examination in 2012-2013. Socioeconomic and medical data were collected from questionnaires, medical records, and national registers. Nine previously published anticholinergic scales were combined and used to measure the high anticholinergic burden from the participants' medication data. Cariological status was determined according to the International Caries Detection and Assessment System, and the number of missing teeth (excluding third molars) was used as an indicator for tooth loss. The decayed, missing, and filled surfaces index was used to depict caries experience. Negative binominal regression models were used to estimate prevalence rate ratios (PRRs) and confidence intervals (CIs). RESULTS Fourteen percent of the participants (n = 276) used at least 1 anticholinergic drug and about 3% had a high anticholinergic burden (n = 61). After adjusting for confounding factors, participants with a high anticholinergic burden had a higher likelihood of having manifested carious lesions needing restorative treatment (PRR, 1.60; CI, 1.11-2.29) and more missing teeth (PRR, 1.59; CI, 1.13-2.24) when compared to participants without any or with a lower anticholinergic burden. CONCLUSIONS High anticholinergic burden was associated with a present caries experience and with tooth loss among the general middle-aged population. KNOWLEDGE TRANSFER STATEMENT The findings of this study suggest that middle-aged patients with a high anticholinergic burden may have a heightened risk of dental caries. These patients may benefit from targeted caries preventive regimes.
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Affiliation(s)
- A Tiisanoja
- Social and Health Services, Oulu, Finland
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
| | - V Anttonen
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
| | - A-M Syrjälä
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
| | - P Ylöstalo
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
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Bakker MH, de Smit MJ, Valentijn A, Visser A. Oral health assessment in institutionalized elderly: a scoping review. BMC Oral Health 2024; 24:272. [PMID: 38402181 PMCID: PMC10893687 DOI: 10.1186/s12903-024-04025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.
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Affiliation(s)
- M H Bakker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
| | - M J de Smit
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Valentijn
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- Department of Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Wong FMF, Shie HWH, Kao E, Tsoi HM, Leung WK. Educational Programme on Knowledge, Attitudes, and Practice of Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Case-Control Study. Geriatrics (Basel) 2024; 9:16. [PMID: 38392103 PMCID: PMC10888457 DOI: 10.3390/geriatrics9010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/30/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Much attention has been paid to advocate proper oral care/hygiene provision by healthcare providers in long-term care institutions (LTCIs). This study aimed to evaluate the effects of an oral health education (OHE) programme (intervention) on knowledge, attitudes, and practice (KAP) of healthcare providers in providing oral care/hygiene to older residents in LTCIs. METHODS A case control study was conducted at two LTCIs, with one assigned as the intervention group and the other as the control group. A KAP survey was administered before and after the intervention, and oral status was assessed by standardized clinical photographs taken before and after oral hygiene provision on three older residents. RESULTS A total of 40 healthcare providers (20 in intervention and 20 in control groups) participated, with the attitudes and overall KAP significantly improved in the intervention group after the OHE programme. Interestingly, the knowledge of those in the control LTCI was significantly declined at re-evaluation (mean scores were from 17.25 to 14.30), indicating inadequate oral health and care training despite having more experience in taking care of older people. Significant differences in practice were observed between the two groups after the OHE programme (p = 0.006). The three older residents exhibited poor oral health and multiple oral problems. CONCLUSIONS This study revealed that the OHE programme effectively improved attitudes of the healthcare providers and provided a sustaining effect on attitude towards oral health and oral care. However, there were still inadequacies in oral hygiene provision by some healthcare providers, possibly due to unattended oral diseases and hygiene needs, as well as personal and environmental barriers that merit further investigation. Regular evaluation and enforcement of oral care/hygiene provision in LTCIs are necessary to maintain oral health and prevent dental and gum diseases in older residents. Immediate referral for dental treatment is recommended for older people with signs of dental/oral disease(s).
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Affiliation(s)
| | | | - Enoch Kao
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Hoi Mei Tsoi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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5
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Sandvik RKNM, Husebo BS, Selbaek G, Strand G, Patrascu M, Mustafa M, Bergh S. Oral symptoms in dying nursing home patients. Results from the prospective REDIC study. BMC Oral Health 2024; 24:129. [PMID: 38273300 PMCID: PMC10811859 DOI: 10.1186/s12903-024-03901-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The mouth is a central organ for communication and fluid intake, also for dying nursing home patients. This study describes the prevalence and severity of oral symptoms from nursing home admission until the day of perceived dying and the day of death. METHODS A prospective, longitudinal cohort study including 696 patients who were admitted to 47 Norwegian nursing homes in 35 municipalities. During the first year of their stay, 189 died (27%), of whom 82 participants were assessed on the day they were perceived as dying and 134 on the day of death. Mouth care, nutrition, and bedsores were assessed with the Residents' Assessment Instrument for nursing homes (RAI-NH) and palliative care (RAI-PC). Pain intensity was assessed with the Mobilization-Observation-Behaviour-Intensity-Dementia-2 Pain Scale (MOBID-2). RESULTS The proportion of patients with ≥ 6 oral symptoms increased from 16% when perceived as dying to 20% on the day of death (P = 0.001). On the day of death, xerostomia (66%), dysphagia (59%), and mastication problems (50%) were the most frequently observed oral symptoms. Only 16% received mouth care every hour and 12% were in pain during this procedure. Compared to people without dementia, those with a diagnosis of dementia at admission (N = 112, 86%) had xerostomia and mastication problems more frequently (50% vs. 73%; 32% vs. 56% (P = 0.038), respectively) on the day of death. CONCLUSIONS The high extent of oral symptoms such as xerostomia, dysphagia, and mastication problems underline the need for systematic assessment and improved oral palliative care for dying nursing home patients with dementia. TRIAL REGISTRATION Clinicaltrials.gov NCT01920100 08/08/2013. First submission to BMC oral 15/03/2023.
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Affiliation(s)
- Reidun K N M Sandvik
- Department of Health and Caring sciences, Faculty of Health and Social Sciences, Western University of Applied Sciences, Haukelandsbakken 15, Bergen, N-5009, Norway.
| | - Bettina S Husebo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
- Department of Global Public Health and Primary Care, Neuro-SysMed Center, University of Bergen, Bergen, Norway
| | - Geir Selbaek
- The Norwegian National Centre for Ageing and Health (Ageing and Health), P.O. box 2136, Tønsberg, 3103, Norway
- Faculty of medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Gunhild Strand
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Monica Patrascu
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
- Department of Global Public Health and Primary Care, Neuro-SysMed Center, University of Bergen, Bergen, Norway
- Department of Automatic Control and System Engineering, Complex Systems Laboratory, University Politehnica of Bucharest, Bucharest, Romania
| | - Manal Mustafa
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Sverre Bergh
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, P.O. box 68, Ottestad, 2313, Norway
- The Norwegian National Centre for Ageing and Health (Ageing and Health), P.O. box 2136, Tønsberg, 3103, Norway
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Stuhec M, Hahn M, Taskova I, Bayraktar I, Fitzgerald I, Molitschnig L, Tatarević A, Lindner N, Agnoletto L, da Costa FA. Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health. Int J Clin Pharm 2023; 45:1286-1292. [PMID: 37755642 PMCID: PMC10600282 DOI: 10.1007/s11096-023-01643-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023]
Abstract
A large proportion of the world's disease burden is attributable to mental illnesses. Although effective interventions are available, many patients still have limited access to evidence-based treatments. Aside from access, treatment gaps, including inappropriate medication selection and monitoring, are also routinely recognised. Mental health clinical pharmacists can help address these gaps and enable patients to receive optimised pharmaceutical care, particularly appropriate medication selection and monitoring. The European Society of Clinical Pharmacy (ESCP) Special Interest Group on Mental Health was established to improve standardised service provision in mental health settings across Europe. The Special Interest Group identified significant barriers (predominantly associated with reimbursement and position within the multidisciplinary team) to effective pharmaceutical care amongst those with mental illnesses. This commentary presents recommendations to address these gaps through improved mental health clinical pharmacy service provision.
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Affiliation(s)
- Matej Stuhec
- Department of Pharmacology, Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia.
- Department of Clinical Pharmacy, Ormoz Psychiatric Hospital, Ormoz, Slovenia.
| | - M Hahn
- Department of Mental Health, Varisano Hospital Frankfurt Hoechst, Frankfurt, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - I Taskova
- Psychiatric Hospital Bohnice, Prague, Czech Republic
- Department of Applied Pharmacy, Faculty of Pharmacy, Masaryk University, Brno, Czech Republic
| | - I Bayraktar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - I Fitzgerald
- Pharmacy Department, St Patrick's University Hospital, Dublin 8, Ireland
- School of Pharmacy, University College Cork, Cork, Ireland
| | - L Molitschnig
- Pharmacy Department, Hospital of Elisabethians, Graz, Austria
| | | | - N Lindner
- Pharmacy Department, Vienna General Hospital-Medical University Campus, Vienna, Austria
| | - L Agnoletto
- Hospital Pharmacy, Rovigo Hospital, Rovigo, Italy
| | - F Alves da Costa
- Research Institute for Medicines, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
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Mulligan R, Suarez Durall P. Geriatric Phenotypes and Their Impact on Oral Health. Clin Geriatr Med 2023; 39:235-255. [PMID: 37045531 DOI: 10.1016/j.cger.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Older adults have multiple morbidities that can impact oral, systemic, and psychological health. Although each disorder requires consideration from the provider before treatment, by assessing the common phenotypic presentations of older adults, we can better understand, select, and coordinate treatment modifications that would need to be considered and implemented for dental care.
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Affiliation(s)
- Roseann Mulligan
- Herman Ostrow School of Dentistry of the University of Southern California, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA.
| | - Piedad Suarez Durall
- Herman Ostrow School of Dentistry of the University of Southern California, University Park Campus, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA
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Abstract
PURPOSE OF REVIEW Elderly patients with schizophrenia (SCH) are treated with antipsychotics and are often on different comedications, including polypharmacy (five or more medications). Evidence-based guidelines and randomized controlled trials do not include patients on polypharmacy, something that represents a 'gap' between evidence-based recommendations and clinical prescribing patterns. In this context, narrative reviews are needed to help clinicians in daily practice. RECENT FINDINGS Antipsychotic treatment efficacies in meta-analyses are similar in the elderly with SCH compared with the general population (medium effect size). Long-term cohort studies show that antipsychotic treatment reduces overall mortality, hospitalizations, and cardiovascular death. These studies are limited because polypharmacy was not studied. The prevalence of antipsychotic use as potentially inappropriate medications was very high in nursing homes (25%). The prevalence of antipsychotic polypharmacy was 40%. Different strategies to manage these problems are available, including collaboration with clinical pharmacists, leading to reduced polypharmacy and better adherence to treatment guidelines. SUMMARY Elderly patients with SCH on polypharmacy are less frequently studied, although they represent many patients with SCH. Different potentially inappropriate medication lists and collaboration with clinical pharmacists represent effective strategies for medication optimization. More studies are needed on this topic (e.g., prospective nonrandomized studies).
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Affiliation(s)
- Matej Stuhec
- Faculty of Medicine Maribor, European Union, Maribor, Slovenia
- Department of Clinical Pharmacy, Ormoz Psychiatric Hospital, European Union, Ormoz, Slovenia
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9
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Arany S, Kopycka-Kedzierawski DT, Caprio TV, Watson GE. Anticholinergic medication: Related dry mouth and effects on the salivary glands. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:662-670. [PMID: 34593340 DOI: 10.1016/j.oooo.2021.08.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/11/2021] [Accepted: 08/21/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Salivary glands are among the most sensitive target organs of medications with anticholinergic (AC) properties, interrupting the neural stimulation of saliva secretion and reducing saliva flow. Hyposalivation results in dry mouth, leading to dental caries, intraoral infection, orofacial pain, problems with speaking and swallowing, and diminished oral health--related quality of life. Current understanding of the pharmacokinetics of AC medications and their effect on muscarinic receptors in the salivary glands were reviewed to assist clinicians in predicting salivary damage in patients with AC medication-induced dry mouth. STUDY DESIGN We summarized the literature related to the mechanisms and properties of AC medications, anticholinergic adverse effects, and their effect on salivary function and management strategies to prevent oral health damage. RESULTS Although a large number of studies reported on the frequencies of medication-induced dry mouth, we found very limited data on predicting individual susceptibility to AC medication--caused hyposalivation and no prospective clinical studies addressing this issue. CONCLUSION Dry mouth is most frequently caused by medications with AC properties, which interrupt the neural stimulation of saliva secretion. Interdisciplinary care should guide pharmacotherapeutics and dental interventions should aim in preventing AC salivary adverse effects and reducing the oral health burden from AC medication-induced dry mouth.
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Affiliation(s)
- Szilvia Arany
- Specialty Care, Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, NY, USA.
| | - Dorota T Kopycka-Kedzierawski
- Department of Community Dentistry and Oral Disease Prevention, University of Rochester, Rochester, NY, USA; Center for Oral Biology, University of Rochester, Rochester, NY, USA
| | - Thomas V Caprio
- Division of Geriatrics and Aging, Department of Medicine, University of Rochester, Rochester, NY, USA
| | - Gene E Watson
- Center for Oral Biology, University of Rochester, Rochester, NY, USA; Department of Dentistry, University of Rochester, Rochester, NY, USA; Department of Environmental Medicine and Pharmacology and Physiology, University of Rochester, Rochester, NY, USA
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Bots-VantSpijker PC, van der Maarel-Wierink CD, Schols JMGA, Bruers JJM. Assessed and perceived oral health of older people who visit the dental practice, an exploratory cross-sectional study. PLoS One 2021; 16:e0257561. [PMID: 34559825 PMCID: PMC8462729 DOI: 10.1371/journal.pone.0257561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/05/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To assess the oral health of older people who visit the community dental practice from both the dentists' and the patients' perspective. MATERIALS AND METHODS In this exploratory cross-sectional study the oral health of Dutch community dwelling older people was assessed. A representative sample of general dental practitioners was asked to randomly and prospectively select one older patient and describe this patient using a specially-developed registration form; in addition the patient was requested to complete a questionnaire. The oral health of older people was described from the perspective of the dentists and the perspective of the older people themselves based on the definition of oral health from the World Dental Federation (FDI]. Relations between oral health of older people and dentist and older patient characteristics were analysed using Spearman's rank correlation coefficient (rho) and an ordinal regression model. RESULTS In total, 923 dentists were asked to participate in the study; data was available for 39.4% dentist-patient pairs. Dentists assessed the oral health of older patients as good or acceptable in 51.4% of the cases while this was the case in 76.2% of older patients themselves. The assessment of the dentist gets more negative with high treatment intensity and with older patients having certain diseases and more medication, while the assessment is more positive for older patients who visit the dentist on a regular basis. Older people's assessment of their oral health gets more negative by being female and with high treatment intensity, having certain diseases and higher use of medication. CONCLUSIONS AND CLINICAL RELEVANCE Chronically illness as expressed by the number of diseases and the use of medication, seems to be a risk factor for poor oral health. Older patients themselves assess their oral health differently, mostly more positive, than their dentist.
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Affiliation(s)
- Pieternella C. Bots-VantSpijker
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Claar D. van der Maarel-Wierink
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Jos M. G. A. Schols
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Caphri/Department of Family Medicine and Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Josef J. M. Bruers
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
- Royal Dutch Dental Association (KNMT), Utrecht, The Netherlands
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Provision of Oral Health Care by Dentists to Community-Dwelling Older Patients. Int Dent J 2021; 72:169-178. [PMID: 34281699 PMCID: PMC9275299 DOI: 10.1016/j.identj.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/18/2021] [Accepted: 05/18/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Research into oral health care for older people has shown that dental care in general decreases with increasing age and frailty and, therefore, oral health care provision may be complex. The aim of this study is to identify the oral health care dentists provide to community-dwelling older people and which barriers they experience in doing this. METHODS In this cross-sectional study, a representative sample of dentists in the Netherlands was asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to fill out a questionnaire. The relationship between experienced barriers in providing oral health care to older patients and characteristics of the dentists and the patients was studied by means univariate and multivariate logistic regression analysis. RESULTS In total, 923 dentists were asked to participate in the study. Data were available for 39.4% dentist-patient pairs. In most cases (87.4%), oral health care was focussed on conservation of the dentition. In all, 14.0% of the dentists experienced barriers in providing oral health care for older people. Some patient factors increase the risk of experiencing barriers, eg, the more difficult behaviour of older patients and the greater disease burden. CONCLUSIONS Oral health care was mostly focussed on conservation of the dentition, and dentists especially experience barriers in oral health provision to older patients if they are already frail.
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12
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Abstract
Older adults have multiple morbidities that can impact oral, systemic, and psychological health. Although each disorder requires consideration from the provider before treatment, by assessing the common phenotypic presentations of older adults, we can better understand, select, and coordinate treatment modifications that would need to be considered and implemented for dental care.
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Affiliation(s)
- Roseann Mulligan
- Herman Ostrow School of Dentistry of the University of Southern California, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA.
| | - Piedad Suarez Durall
- Herman Ostrow School of Dentistry of the University of Southern California, University Park Campus, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA
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13
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Chen L, Gu L, Li X, Chen W, Zhang L. Oral health matters in cognitive impaired aged residents in geriatric care facilities: A cross-sectional survey. Nurs Open 2021; 8:792-798. [PMID: 33570297 PMCID: PMC7877127 DOI: 10.1002/nop2.683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/21/2020] [Accepted: 10/26/2020] [Indexed: 01/06/2023] Open
Abstract
AIMS To investigate the oral health status of aged residents and explore the possible factors associated with oral health and the effect of cognitive impairment (CI) on it in geriatric care facilities (GCF) using oral health assessment tool (OHAT) in Shanghai, China. BACKGROUND Oral health is closely associated with overall health. Problems like missing teeth, dental caries, dental pain, periodontal diseases, oral infections and dysphagia are common in GCFs. Furthermore, residents in GCFs with CI are becoming a dominant group and this prevalence increases with age. Detection of oral problems earlier and taking oral care actions is required for these special populations. METHODS The study was an observational cross-sectional study conducted in 42 GCFs. Data were collected from 657 subjects, including oral health assessment (OHAT), cognitive impairment (Mini-Mental State Examination, MMSE) and respondents' characteristics. The subjects were divided into CI group and non-CI group based on MMSE. Oral health conditions were compared between the two groups. RESULTS Oral health status in the CI group was significantly worse than that in the non-CI group (p < .001) with four OHAT dimensions (tongue (p = .0007), saliva (p = .0011), natural teeth (p = .0155) and oral cleanliness (p < .001)). The worst dimension was natural teeth. Debris and plaque index (p < .001), oral odour (p < .001), chewing function (p = .0151) and swallowing function (p = .0405) were worse in CI group than those in non-CI group. In the CI group, providing oral care was a protective factor in oral health (OR = 0.600 95CI% (0.39-0.92)) and wearing dentures was a risk factor (OR = 2.09, 95CI% (1.31-3.32)), while the similar effects were not found in non-CI group. CONCLUSIONS Oral health status among aged residents in GCFs in China was worse among individuals with CI. Caregivers in GCFs should focus more on seniors' oral health with CI. RELEVANCE TO CLINICAL PRACTICE Residents who are suffering from CI are more vulnerable to have oral problems. Regular and proper oral health check-ups in daily nursing work to define oral problems of residents are significant. Nursing staff should pay more attention to oral assessment and effective intervention.
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Affiliation(s)
- Lan Chen
- Education and Scientific Research Department of Clinical NursingChanghai Hospital affiliated to Naval Medical UniversityShanghaiChina
| | - Liyan Gu
- Education and Scientific Research Department of Clinical NursingNO. 905 Hospital of the NavyShanghaiChina
| | - Xianchen Li
- Clinical Research CenterShanghai General HospitaShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical NursingChanghai Hospital affiliated to Naval Medical UniversityShanghaiChina
| | - Lingjuan Zhang
- Education and Scientific Research Department of Clinical NursingChanghai Hospital affiliated to Naval Medical UniversityShanghaiChina
- Shanghai Quality Control Center of Geriatric CareShanghaiChina
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Thapa R, Chimoriya R, Arora A. The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review. BMC Geriatr 2021; 21:35. [PMID: 33422009 PMCID: PMC7797120 DOI: 10.1186/s12877-020-01989-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 12/25/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Globally, oral health status of the geriatric population residing in nursing homes is poor. The integration of non-dental professionals is vital to monitor oral health, early identification and triaging of oral health problems, and timely referral to dental professionals. The aims of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of their psychometric properties. METHODS This review was conducted as per the PRISMA guidelines. CINHAL (EBSCO), Medline (Ovid), and EMBASE (Ovid) were searched systematically. Two reviewers independently screened the title, abstract, and full text of the studies as per the eligibility criteria. Studies describing oral health assessment instruments used to assess oral health of nursing home residents by non-dental professionals were included. Using a methodological framework, each instrument was evaluated for purpose, content, and psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness. Additionally, the reporting quality assessment of each included study was performed according to the SURGE guidelines. RESULTS Out of the 819 screened articles, 10 studies were included in this review. The 10 identified instruments integrated 2 to 12 categories to assess oral health, which was scored on a 2 to 5-point scale. However, the measurement content varied widely, and none were able to comprehensively measure all aspects of oral health. Three measurement approaches were identified: performance- based assessment, direct inspection of the oral health status, and interview measures. Only eight instruments provided quality assessment on the basis of validity, reliability, feasibility and generalisability, whereas three instruments- Brief Oral Health Status Examination, Dental Hygiene Registration, and Oral Health Assessment Tool reported good methodological quality on at least one assessment criteria. CONCLUSIONS None of the instruments identified in this review provided a comprehensive assessment of oral health, while three instruments appeared to be valid and reliable. Nonetheless, continuous development of instruments is essential to embrace the complete spectrum of oral health and address the psychometric gaps.
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Affiliation(s)
- Rojina Thapa
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Ritesh Chimoriya
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
- School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia.
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
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15
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Tan EC, Lexomboon D, Häbel H, Fastbom J, Eriksdotter M, Johnell K, Sandborgh-Englund G. Xerogenic Medications as a Predictor for Dental Health Intervention in People with Dementia. J Alzheimers Dis 2020; 75:1263-1271. [DOI: 10.3233/jad-200148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Edwin C.K. Tan
- The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | | | - Henrike Häbel
- Institute of Environmental Medicine, Division of Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Johan Fastbom
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Maria Eriksdotter
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden
- Theme Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Sandborgh-Englund
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Center for Geriatric Dentistry, Stockholm Sweden
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16
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Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults. J Am Med Dir Assoc 2019; 19:1039-1046. [PMID: 30471798 DOI: 10.1016/j.jamda.2018.10.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 11/24/2022]
Abstract
Good oral health in old age is particularly important for maintaining adequate oral function, preventing pain and discomfort, controlling localized or systemic inflammation, sustaining social interaction, and preserving quality of life. Given that oral health is an integral part of general health and well-being, and that major chronic systemic and oral diseases share common risk factors, oral health prevention and promotion should be embedded within routine medical assessment and care provision. The role of medical physicians, particularly primary care physicians, geriatricians, and elderly care physicians, in community and long-term care facilities in assessing and promoting oral health in frail older adults is critical and has been emphasized in recent European recommendations. All physicians should appreciate the importance of oral health and incorporate an initial oral health screening into routine medical assessment and care. A short interview with patients and carers on current oral health practices may help to assess the risk for rapid oral health deterioration. The interview should be followed by an oral health assessment, using validated tools, for nondental health care providers. Based on these findings, the physician should decide on necessary follow-up procedures, which may include oral health counseling and/or dental referral. Oral health counseling should include advice on daily oral, mucosal, and denture hygiene; denture maintenance; dietary advice; smoking cessation; limitation of harmful alcohol consumption; management of xerostomia; and frequent dental review. To enable physicians to perform the tasks recommended in this publication, appropriate teaching at both undergraduate and postgraduate levels must be delivered in addition to provision of appropriate continuing education courses.
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Wong FMF, Ng YTY, Leung WK. Oral Health and Its Associated Factors Among Older Institutionalized Residents-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214132. [PMID: 31717812 PMCID: PMC6861909 DOI: 10.3390/ijerph16214132] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/16/2022]
Abstract
The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. Objective: The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Methods: Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender, educational level, acquired systemic conditions or dementia/cognitive impairment). Results: Twenty-five surveys (or study series) from 19 countries were included. The level of evidence reported by these studies was generally moderate to strong. The reported oral cleanliness and health of the surveyed institutionalized elderly were poor (>50% of residents had calculus; denture hygiene index > 80%). Gum (approximately 30% of dentate residents had moderate to severe periodontitis), teeth (decayed, missing or filled teeth >20), mucosa (>10% had mucosal lesions) and denture problems (up to 40%) were prevalent and were associated with a poor OHRQoL, especially in females, socially deprived residents or those with mild or above cognitive impairment. Those with a poor OHRQoL might show signs of poor nutrition. Conclusions: This report reviewed evidence-based knowledge on oral health, the OHRQoL and the associated factors among elderly institutional residents. Further research is needed to confirm these observations. For improved oral health, a better OHRQoL and the general well-being of older residents, clinical trials are needed, targeting modifiable factors, such as social inequality, oral healthcare accessibility, and/or nursing home service quality. The relationship between oral health, the OHRQoL and nutrition in this at-risk population also warrants exploration.
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Affiliation(s)
- Florence M. F. Wong
- School of Nursing, Tung Wah College, Hong Kong SAR, China
- Correspondence: ; Tel.: +852-3468-6838
| | - Yannies T. Y. Ng
- North District Hospital, Hospital Authority, Hong Kong SAR, China;
| | - W. Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
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Štuhec M, Potočin I, Stepan D, Ušaj L, Petek Šter M, Beović B. Potential drug interactions with antibacterials in long-term care facilities analyzed by two interaction checkers. Int J Clin Pharm 2019; 41:932-938. [PMID: 31172409 DOI: 10.1007/s11096-019-00855-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 05/28/2019] [Indexed: 10/26/2022]
Abstract
Background Residents in long-term care facilities take many medications concomitantly, including antibacterials, which increases the risk of drug-drug interactions. Objectives The aims of the study were to investigate the prevalence of severe potential interactions between antibacterials and other medications in Slovenian long-term care facilities and to compare the performance of two different drug-drug interaction checkers in these settings. Setting Residents in long-term care facilities in Slovenia. Method A point-prevalence study was conducted from April 2016 to June 2016. Residents' characteristics, antibacterial treatment, and concomitant medications were obtained from their medical charts. Potential drug-drug interactions were determined using Lexicomp Online™ 3.0.2 and the online Drugs.com Drug Interactions Checker. The study only included potential drug-drug interactions categorized as type MA (major interactions) by the Drugs.com checker and as type X (should be avoided) by Lexicomp Online™. The study calculated the differences in the number of type X and MA potential drug-drug interactions between different antibacterial classes and between the two drug-drug interactions checkers. Main outcome measure Number of medications per patient, number of potential drug-drug interactions with antibacterial, and differences between two drug-drug interactions checkers. Results Eighty (68.4%) of Slovenian general long-term care facilities with 13,032 residents responded to the invitation. 317 (2.4%) of the residents received antibacterial treatment and 212 residents were included in the analysis. On average, they received 10.9 medications (SD = 3.9). Antibacterials were involved in 24.1% type MA potential drug-drug interactions and 26.4% type X potential drug-drug interactions. A significant difference in the total number of potential drug-drug interaction between the two checkers was found for all antibacterials, co-trimoxazole and fluoroquinolones (p < 0.005). Type X and MA potential drug-drug interactions were more common with fluoroquinolones than with beta-lactams or co-trimoxazole (p < 0.005). Conclusion Potential interactions between antibacterials, especially fluoroquinolones and other drugs, were common in long-term care facility residents treated with antibacterials. Differences in the number of potential drug-drug interactions between the two checkers indicate that if available the use of several sources of information is recommended in clinical practice. The results call for a collaborative approach to address the risks of drug-drug interactions.
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Affiliation(s)
- Matej Štuhec
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.,Department for Clinical Pharmacy, Psychiatric Hospital Ormoz, Ormoz, Slovenia.,Department of Pharmacology, Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia
| | - Ines Potočin
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Dora Stepan
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Lea Ušaj
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Marija Petek Šter
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Bojana Beović
- Department of Infectious Diseases, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. .,Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1525, Ljubljana, Slovenia.
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Lexomboon D, Tan ECK, Höijer J, Garcia-Ptacek S, Eriksdotter M, Religa D, Fastbom J, Johnell K, Sandborgh-Englund G. The Effect of Xerostomic Medication on Oral Health in Persons With Dementia. J Am Med Dir Assoc 2018; 19:1080-1085.e2. [DOI: 10.1016/j.jamda.2018.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/17/2018] [Accepted: 05/20/2018] [Indexed: 12/11/2022]
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The impact of a preventive and curative oral healthcare program on the prevalence and incidence of oral health problems in nursing home residents. PLoS One 2018; 13:e0198910. [PMID: 29894494 PMCID: PMC5997339 DOI: 10.1371/journal.pone.0198910] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 05/29/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS To assess the impact of an oral healthcare program in nursing homes on the initial treatment backlog and residents' oral health stability. MATERIALS AND METHODS The study is a longitudinal cohort study in nursing home residents in Flanders, Belgium, to evaluate the oral healthcare programme Gerodent. The program consisted of: (1) the introduction of an oral healthcare team, (2) oral health education, (3) the implementation of oral health guidelines and protocols, and (4) regular visits of a mobile dental team. Data were extracted from the oral health records of 381 residents from 21 nursing homes who received treatments from the mobile dental team between October 2010 and March 2014 (mean follow-up period of 22.5 months). Oral health and treatment need between baseline and follow-up were compared. RESULTS The mean age at baseline was 82.4 years and the mean number of consultations per resident was 3.61 during the follow-up period. The proportion of residents with an oral treatment need was reduced from 65.9% to 31.3%. Among residents with natural teeth, there was significantly lower prevalence of caries (from 70.5% at baseline to 36.5% at follow-up; p<0.001), residual roots (from 54.2% to 25.1%; p<0.001), and need for fillings (from 31.9% to 17.1%; p<0.001) or extractions (from 64.3% to 31.6%; p<0.001). In the group with partial or full dentures (n = 223), 38.1% needed a repair, rebasing or renewal of their existing dentures at baseline and the respective figure at follow-up was 9.0% (p<0.001). In terms of oral health stability, 53% of the residents had no incident restorative and prosthetic treatment need throughout the follow-up period. A lower number of natural teeth at baseline (p<0.001) and a shorter follow-up period (p = 0.002) were associated with higher chances of oral health stability. CONCLUSION The oral healthcare program Gerodent significantly reduced the treatment backlog and contributed to a considerable proportion of residents being stable in terms of oral health without any incident treatment needs.
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Consumption of green tea but not coffee is associated with the oral health-related quality of life among an older Japanese population: Kyoto-Kameoka cross-sectional study. Eur J Clin Nutr 2018; 73:577-584. [PMID: 29789709 DOI: 10.1038/s41430-018-0186-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/06/2017] [Accepted: 02/13/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES The consumption of both green tea and coffee is known to induce positive health effects; however, it remains unclear whether there is an association between the consumption of these beverages and oral health-related quality of life (OHRQoL). Thus, the present study investigated the relationship between the consumption of green tea and coffee and OHRQoL. SUBJECTS/METHODS We analyzed cross-sectional baseline data in 2012. The subjects were 7514 Japanese participants (3563 men, 3951 women; ≥65 years of age). Each subject completed a validated self-administered questionnaire that included items on the frequency of the consumption of green tea and coffee. OHRQoL was evaluated using the self-reported General Oral Health Assessment Index (GOHAI), which assesses oral health problems in older adults. A GOHAI score <50 points was defined as a poor OHRQoL. RESULTS Following adjustment for age, body mass index, total energy intake, alcohol, smoking, medication use, coffee, and fruit and vegetable consumption, increased consumption of green tea showed a strong positive association with the GOHAI score in both men and women (Ptrend < 0.001 in both). In contrast, after adjusting for all factors, no statistically significant association was observed between coffee consumption and the GOHAI score in men (Ptrend = 0.538) or women (Ptrend = 0.607). The respective multivariate-odds ratios (95% confidence intervals) for a poor OHRQoL associated with green tea consumption frequencies of none, <1 cup/day, 1-2 cups/day, and ≥3 cups/day were 1.00, 1.01 (0.80-1.27), 0.95 (0.74-1.21), and 0.78 (0.61-0.99) (Ptrend = 0.024) in men, and 1.00, 1.19 (0.90-1.57), 0.98 (0.74-1.29), and 0.86 (0.67-1.12) (Ptrend = 0.014) in women. CONCLUSIONS Regardless of sex, green tea consumption was positively associated with the GOHAI score. Therefore, ≥3 cups/day of green tea may reduce the risk of a poor OHRQoL, especially in men.
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