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Bellander L, Angelini E, Andersson P, Hägglin C, Wijk H. A preventive care approach for oral health in nursing homes: a qualitative study of healthcare workers' experiences. BMC Geriatr 2024; 24:803. [PMID: 39354356 PMCID: PMC11443800 DOI: 10.1186/s12877-024-05396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 09/19/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Oral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers' experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes. METHODS Healthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data. RESULTS Themes generated in the analysis were: (1) A structured process promotes communication and awareness and stresses the importance of oral health; (2) Oral care for frail older adults is challenging and triggers ethical dilemmas; (3) Unclear responsibilities, roles and routines in the organization put oral health at risk; (4) Differences in experience and competence among healthcare staff call for educational efforts. CONCLUSIONS The structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents' reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.
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Affiliation(s)
- Lisa Bellander
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden.
- Centre of Gerodontology, Public Dental Service, Region Västra Götaland, 40233, Gothenburg, Sweden.
| | - Eva Angelini
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden
| | - Pia Andersson
- Department of Oral Health, Faculty of Health Sciences, Kristianstad University, 29188, Kristianstad, Sweden
| | - Catharina Hägglin
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden
- Centre of Gerodontology, Public Dental Service, Region Västra Götaland, 40233, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, 41296, Gothenburg, Sweden
- Department of Quality Strategies, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
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Tuuliainen E, Nihtilä A, Komulainen K, Nykänen I, Hartikainen S, Tiihonen M, Suominen AL. Use of oral health care services among older home care clients in the context of an intervention study. Scand J Caring Sci 2024; 38:426-437. [PMID: 38389124 DOI: 10.1111/scs.13247] [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: 07/27/2023] [Revised: 01/10/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND An increasing number of care-dependent older people living at home need external support to receive regular dental care. OBJECTIVES To investigate the use of oral health care services among old home care clients who participated in an intervention study focusing on oral self-care and nutrition. MATERIALS AND METHODS This study employed data from the multidisciplinary Nutrition, Oral Health and Medication (NutOrMed) intervention study with a population-based sample of 245 home care clients (74% female) aged 75 or more divided in intervention (n = 140) and two control groups (n = 105). The data were collected through interviews at baseline and 6-month follow-up. RESULTS At baseline, 43% of participants reported visits to oral health care within the previous year. At 6-month follow-up, this proportion was 51%. In the intervention group, the corresponding figures were 46% and 53%, and in the controls 39% and 48%. Adjusted regression analyses showed that this change was statistically significant (p = 0.008). In addition, higher education and toothache or other discomfort related to teeth or dentures at baseline were associated with increased use after the 6-month follow-up (OR = 1.1, 95% CI = 1.0-1.2; OR = 3.4, 95% CI = 1.5-7.9) but being edentulous indicated the opposite (OR = 0.2, 95% CI = 0.1-0.4). Belonging to the intervention group was not associated with increased use. CONCLUSIONS In older adults, any efforts to raise awareness of oral health are of great potential to increase use of services.
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Affiliation(s)
| | - Annamari Nihtilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Social and Health Services, Espoo, Finland
| | - Kaija Komulainen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Irma Nykänen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Miia Tiihonen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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Tapager I, Westergaard CL, Øzhayat EB. Health status, care dependency and oral care utilization among older adults: a register-based study. Gerodontology 2024. [PMID: 38563253 DOI: 10.1111/ger.12748] [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] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND AND OBJECTIVES The aim of the study was to examine oral care utilisation among older Danes and to describe the extent to which oral care use is associated with the co-existence of challenges relating to general health and care dependency. MATERIALS AND METHODS The study used registry data covering the entire population of older adults (≥65 years) in seven municipalities in Denmark (N = 178 787 individuals). Oral care services utilisation was computed from administrative data on oral care contacts up to and including 2019, including both private oral care and a municipal oral care programme (MOCP). Various registry data sources were used to compute risk factors to describe oral care utilisation across indicators of general health and care dependency. RESULTS Indicators for poorer health were associated with larger proportions of individuals enrolled in the MOCPs and larger proportions of non-users of any type of oral care. Higher degrees of care dependency were associated with larger proportions of individuals enrolled in MOCPs and individuals with no use of any oral care services, with the exception of nursing home residents, who comprised a lower proportion of non-users than individuals receiving at-home care. Municipal oral care mainly enrolled older adults who were nursing home residents (60% of nursing home residents were enrolled). CONCLUSION Our findings support existing evidence on the link between oral care utilisation and general health and frailty. While the municipal care programmes assisted in covering oral care for those with the highest level of care dependency, future preventive strategies for ensuring care continuity for older adults that are increasing in frailty may want to focus on the earlier stages of frailty and of general health deterioration.
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Affiliation(s)
- Ina Tapager
- VIVE - The Danish Center for Social Science Research, Copenhagen, Denmark
| | | | - Esben Boeskov Øzhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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de Vasconcellos NBT, Fagundes MLB, Menegazzo GR, do Amaral Júnior OL, Hilgert JB, do Amaral Giordani JM. Association between frailty and oral health services use in Brazilian older adults. Gerodontology 2024; 41:46-53. [PMID: 37750043 DOI: 10.1111/ger.12716] [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] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To assess the association between frailty and oral health services use in Brazilian older adults. METHODS This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing (ELSI-Brazil) representative of Brazilians aged 50 or over. The outcome was oral health services used in the year prior to the interview. The main exposure variable was Frailty defined by the frailty phenotype. Age, skin colour, wealth, sex, education, type of service, health insurance, number of teeth and self-perceived oral health were included as covariates. Prevalence ratios (PR) with their respective 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. RESULTS 8405 individuals were included in this study. The prevalence of frailty was 7.5%. Regarding frailty status, the prevalence of dental service use was 47.0%, 48.5% and 4.5% for robust, pre-frail and frail individuals, respectively. Frail individuals had a 7% higher prevalence of not using dental (PR: 1.07; 95% CI: 1.01-1.13) than robust individuals. Frailty was independently associated with not using oral health services. CONCLUSION Given the complexity of the determinants of dental service use, frailty adds another dimension to be examined in older adults. Public health strategies considering a common risk factor approach should be endorsed.
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Affiliation(s)
| | | | | | | | - Juliana Balbinot Hilgert
- Departament of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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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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Turton B, Alqunaybit G, Tembhe A, Qari A, Rawal K, Mandel E, Calabrese J, Henshaw M. Estimation of Oral Disease Burden among Older Adults in LTC: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:248. [PMID: 38541250 PMCID: PMC10970488 DOI: 10.3390/ijerph21030248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 07/23/2024]
Abstract
Oral health is an essential part of healthy aging and very little data exists around the disease burden for older adults in a long-term care setting. The aim of this scoping review was to estimate the disease burden of dental caries, periodontal disease, and tooth loss among older adults in Long-Term Care (LTC). This scoping review was conducted in accordance with the Joanna Briggs Institute methodology. A detailed strategy was used to conduct a comprehensive search of electronic databases: PubMed, Embase, and Dentistry and Oral Sciences Source (DOSS). The Rayyan AI platform was used to screen abstracts for assessment by one of five co-investigators. Results indicate that only one in three might have a functional dentition upon entry into LTC, and among those who are dentate, most might expect to develop at least one new coronal and one new root caries lesion each year. There is a need to better document the disease experiences of this group to tailor approaches to care that might reduce the avoidable suffering as a result of dental caries and periodontal disease.
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Affiliation(s)
- Bathsheba Turton
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA; (G.A.); (A.T.); (K.R.); (J.C.); (M.H.)
| | - Gheed Alqunaybit
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA; (G.A.); (A.T.); (K.R.); (J.C.); (M.H.)
| | - Amrita Tembhe
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA; (G.A.); (A.T.); (K.R.); (J.C.); (M.H.)
| | - Alaa Qari
- Faculty of Dentistry, Umm Al-Qura University, Makkah 02131, Saudi Arabia;
| | - Kadambari Rawal
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA; (G.A.); (A.T.); (K.R.); (J.C.); (M.H.)
| | - Ernest Mandel
- Hebrew Seniorlife, Harvard Medical School, Boston, MA 02131, USA;
| | - Joseph Calabrese
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA; (G.A.); (A.T.); (K.R.); (J.C.); (M.H.)
| | - Michelle Henshaw
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA; (G.A.); (A.T.); (K.R.); (J.C.); (M.H.)
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Baek W, Kang M. The moderating effect of oral health on the association between exercise and frailty in patients with musculoskeletal disorders: Findings from the Korean Longitudinal Study of Aging. Arch Gerontol Geriatr 2024; 117:105180. [PMID: 37690257 DOI: 10.1016/j.archger.2023.105180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE This study aimed to examine the effects of exercise and oral health on frailty and to investigate the moderating effect of oral health on the relationship between exercise and frailty among patients with musculoskeletal disorders. METHODS This descriptive, cross-sectional study used data from the seventh wave of the Korean Longitudinal Study of Aging. Frailty index based on 41 deficits across seven domains was used, and oral health was assessed using the Geriatric Oral Health Assessment Index. Hierarchical regression analysis was performed to confirm the moderating effect of oral health, and PROCESS macro model 1 by Hayes was applied to examine an inference test of the conditional effect of the moderator. RESULTS Data on 1,812 participants with musculoskeletal disorders (mean age 75.0 ± 8.6 years) was analyzed. Compared with no exercise, regular exercise (β= -2.39, 95% confidence interval [CI]= -3.42; -1.34) was significantly associated with lower frailty level. Good oral health (β= -0.38, 95% CI= -0.44, -0.32) was significantly associated with lower frailty level. A significant moderating effect of oral health on the relationship between regular exercise and frailty was detected (β= 0.18, 95% CI= 0.05, 0.30). CONCLUSIONS The beneficial effects of regular exercise on frailty were greater in participants with poor oral health than in those with good oral health. Healthcare providers should actively encourage older patients with musculoskeletal disorders and poor oral health to exercise regularly. Combined exercise and oral healthcare interventions may be the most effective strategy for managing frailty in older patients with musculoskeletal disorders.
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Affiliation(s)
- Wonhee Baek
- College of Nursing, Gyeongsang National University, South Korea
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van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GHD. The Dutch version of the Oral Health Assessment Tool: Translation and inter-rater reliability among community nurses. Int J Dent Hyg 2024; 22:140-147. [PMID: 37093920 DOI: 10.1111/idh.12678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES Translating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter-rater reliability among community nurses. METHODS The original version of the OHAT was translated following the five stages of the 'Guidelines for the Process of Cross-Cultural Adaptation'. After a forward and backward translation, consensus on the pre-final version was obtained in an expert panel discussion. This version was pre-tested on its comprehensibility among 31 nurses and hereafter finalized. Then, inter-rater reliability of the OHAT-NL was determined by two trained nurses during oral assessments of 37 care-dependent community-dwelling older people. Intraclass correlation coefficient (ICC) and the Cohen's kappa statistic for individual items were estimated. RESULTS Feedback from nurses in the pre-test did lead to minor changes of the OHAT-NL. Inter-rater reliability was good (ICC 0.79; 95% CI 0.63-0.89) on the total score. Agreement on item level ranged from fair to very good, the kappa ranged from 0.36-0.89. CONCLUSIONS OHAT is now available in Dutch having good inter-rater reliability among trained community nurses. Future research can further validate the OHAT-NL and develop intervention according to total OHAT-NL scores.
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Affiliation(s)
- Harm H J van Noort
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Anne Harderwijk
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Reinier Akkermans
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gert-Jan van der Putten
- Medical Department, Orpea Dagelijks Leven, Apeldoorn, The Netherlands
- Department of Oral Function and Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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Cao C, Liao S, Cao W, Guo Y, Hong Z, Ren B, Hu Z, Bai Z. Differences in the association of oral health knowledge, attitudes, and practices with frailty among community-dwelling older people in China. BMC Oral Health 2023; 23:782. [PMID: 37875820 PMCID: PMC10594714 DOI: 10.1186/s12903-023-03477-y] [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: 06/05/2023] [Accepted: 10/01/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Oral health and frailty are significantly related and should be well examined, especially in late life. Few studies have explored the relationship of oral health knowledge, attitudes, and practices with frailty and examined sociodemographic variations in this association. This study aimed to examine the association between oral health knowledge, attitudes, practices and frailty, with a special focus on comparing differences in their association among the Chinese community-dwelling older population. METHODS This study included 4218 community-dwelling older adults (aged ≥ 60 years) who participated in a cross-sectional survey. Sociodemographic characteristics, oral health knowledge, attitudes, practices, and frail status (non-frailty, pre-frailty, and frailty) were collected with a face-to-face questionnaire-based interview. Multivariate logistic regression models were used to evaluate the association of oral health knowledge, attitudes, and practices with frailty. RESULTS Of the 4218 participants, 36.2% (n = 1527) and 18.8% (n = 792) were classified as pre-frailty and frailty. Age, gender and educational attainments differences existed in the association of oral health knowledge with frailty. Urban-rural differences in the association of oral health knowledge and practices with frailty were also found. Specifically, oral health knowledge was significantly related to frailty only among participants aged 70-79 years (adjusted odds ratio [95% confidence interval]) (1.08 [1.02-1.15]), females (1.05 [1.00-1.10]), rural residents (1.06 [1.01-1.12]), and those who were primary school and lower education (1.06 [1.01-1.11]), whereas oral health practices were related to frailty only among urban participants (0.96 [0.92-1.00]). CONCLUSION This study confirmed the different associations of oral health knowledge and practices with frailty among community-dwelling older people in China. Further research is needed to better understand the abovementioned differences and public health strategies are required to improve oral health literacy and thereby contain the development of frailty in later life.
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Affiliation(s)
- Chenglin Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Shengdong Liao
- Academic Affairs Office, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Wenwen Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Ying Guo
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Zixuan Hong
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Bohua Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, 523808, China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1QU, UK
| | - Zhi Hu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China.
| | - Zhongliang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China.
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1QU, UK.
- Key Laboratory of Public Health Social Governance, Philosophy and Social Sciences of Anhui Province, Hefei, Anhui, 230032, China.
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Liu S, Guo Y, Hu Z, Zhou F, Li S, Xu H. Association of oral status with frailty among older adults in nursing homes: a cross-sectional study. BMC Oral Health 2023; 23:368. [PMID: 37287021 PMCID: PMC10249201 DOI: 10.1186/s12903-023-03009-8] [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: 10/23/2022] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The oral status of an individual is a vital aspect of their overall health. However, older adults in nursing homes have a higher prevalence of frailty and poor oral health, particularly in the context of global aging. The objective of this study is to explore the association between oral status and frailty among older adults residing in nursing homes. METHODS The study involved 1280 individuals aged 60 and above from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used to evaluate physical frailty, while the Oral Health Assessment Tool was used to assess oral status. The frequency of tooth brushing was classified as never, once a day, and twice or more a day. The traditional multinomial logistic regression model was used to analyze the association between oral status and frailty. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated while controlling for other confounding factors. RESULTS The study found that the prevalence of frailty among older adults living in nursing homes was 53.6%, while the prevalence of pre-frailty was 36.3%. After controlling for all potential confounding factors, mouth changes requiring monitoring (OR = 2.10, 95% CI = 1.34-3.31, P = 0.001) and unhealthy mouth (OR = 2.55, 95% CI = 1.61-4.06, P < 0.001) were significantly associated with increased odds of frailty among older adults in nursing homes. Similarly, both mouth changes requiring monitoring (OR = 1.91, 95% CI = 1.20-3.06, P = 0.007) and unhealthy mouth (OR = 2.24, 95% CI = 1.39-3.63, P = 0.001) were significantly associated with a higher prevalence of pre-frailty. Moreover, brushing teeth twice or more times a day was found to be significantly associated with a lower prevalence of both pre-frailty (OR = 0.55, 95% CI = 0.34-0.88, P = 0.013) and frailty (OR = 0.50, 95% CI = 0.32-0.78, P = 0.002). Conversely, never brushing teeth was significantly associated with higher odds of pre-frailty (OR = 1.82, 95% CI = 1.09-3.05, P = 0.022) and frailty (OR = 1.74, 95% CI = 1.06-2.88, P = 0.030). CONCLUSIONS Mouth changes that require monitoring and unhealthy mouth increase the likelihood of frailty among older adults in nursing homes. On the other hand, those who brush their teeth frequently have a lower prevalence of frailty. However, further research is needed to determine whether improving the oral status of older adults can change their level of frailty.
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Affiliation(s)
- Siyue Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Yicong Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Shaojie Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
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Schuller AA, Hoeksema AR. Determinants and barriers for visiting a dental clinic among (frail) older individuals. Acta Odontol Scand 2023; 81:227-234. [PMID: 36112367 DOI: 10.1080/00016357.2022.2118166] [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] [Indexed: 11/01/2022]
Abstract
AIMS With increasing age, the proportion of older individuals visiting a dental clinic decreases. The aim was to gain insight into a) whether frailty or dental status were associated with visiting a dental clinic and b) their perceived barriers to accessing oral health care. METHODS Individuals eligible for the yearly influenza vaccination in Winschoten, The Netherlands, were invited to participate in a questionnaire survey about dental visits and perceived barriers to such visits. RESULTS A total of 1027 individuals aged 60+ completed the questionnaire - 80% of the non-frail, 71% of the mildly frail and 60% of the moderately to severe frail individuals visited a dental clinic in the previous year. Dental status was the crucial determinant for not visiting a dental clinic. Edentate individuals were more likely to drop out of the dental care system than dentate individuals or individuals with partial prostheses. A higher proportion of moderately and severe frail people were edentate than non-frail or mildly frail people. Barriers to visiting a dentist were making an appointment, costs, and services available. Conclusions: Dental clinicians should pay attention to the barriers that they can influence. The influenza vaccination seems to be an interesting momentum for identifying people who have dropped out of the oral healthcare system.
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Affiliation(s)
- Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center, Groningen, The Netherlands
- TNO Child Health, Leiden, The Netherlands
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12
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Fogelholm N, Leskelä J, Manzoor M, Holmer J, Paju S, Hiltunen K, Roitto HM, Saarela RK, Pitkälä K, Eriksdotter M, Buhlin K, Pussinen PJ, Mäntylä P. Subgingival microbiome at different levels of cognition. J Oral Microbiol 2023; 15:2178765. [PMID: 36844899 PMCID: PMC9946326 DOI: 10.1080/20002297.2023.2178765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Oral health and declining cognition may have a bi-directional association. We characterized the subgingival microbiota composition of subjects from normal cognition to severe cognitive decline in two cohorts. Memory and Periodontitis (MINOPAR) include 202 home-living participants (50-80 years) in Sweden. Finnish Oral Health Studies in Older Adults (FINORAL) include 174 participants (≥65 years) living in long-term care in Finland. We performed oral examination and assessed the cognitive level with Mini Mental State Examination (MMSE). We sequenced the 16S-rRNA gene (V3-V4 regions) to analyse the subgingival bacterial compositions. The microbial diversities only tended to differ between the MMSE categories, and the strongest determinants were increased probing pocket depth (PPD) and presence of caries. However, abundances of 101 taxa were associated with the MMSE score. After adjusting for age, sex, medications, PPD, and caries, only eight taxa retained the significance in the meta-analyses of the two cohorts. Especially Lachnospiraceae [XIV] at the family, genus, and species level increased with decreasing MMSE. Cognitive decline is associated with obvious changes in the composition of the oral microbiota. Impaired cognition is accompanied with poor oral health status and the appearance of major taxa of the gut microbiota in the oral cavity. Good oral health-care practices require special deliberations among older adults.
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Affiliation(s)
- Nele Fogelholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jaakko Leskelä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Muhammed Manzoor
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jacob Holmer
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Susanna Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Hanna-Maria Roitto
- Department of Neurosciences, University of Helsinki, Helsinki, Finland.,Internal medicine and rehabilitation, Division of Geriatrics, Helsinki University Hospital Helsinki, Finland.,Population health unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Kt Saarela
- Department of Social Services and Health Care, Oral Health Care, Helsinki, Finland
| | - Kaisu Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Kåre Buhlin
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Päivi Mäntylä
- School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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13
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Nakai S, Suzuki F, Okamoto S, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kasahara T, Nakamura M, Takazawa C, Kannon T, Tajima A, Tsuboi H, Ogino N, Konoshita T, Takamura T, Nakamura H. Association between Bone Mineral Density and Oral Frailty on Renal Function: Findings from the Shika Study. Healthcare (Basel) 2023; 11:314. [PMID: 36766889 PMCID: PMC9913924 DOI: 10.3390/healthcare11030314] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
The association between oral frailty (OFr) and body action has been investigated, but its association with systemic function remains unclear. Therefore, this cross-sectional study examined the association between OFr with decreased bone mineral density (BMD) and renal function in residents of Shika town, Ishikawa Prefecture, Japan aged ≥40 years. This study included 400 inhabitants. The OFr total score was assessed using three oral domains in the Kihon Checklist (a self-reported comprehensive health checklist), the number of teeth, and brushing frequency per day. Measurements were the estimated glomerular filtration rate (eGFR) and the osteo-sono assessment index (OSI). Using a two-way analysis of covariance (p = 0.002), significantly lower OSI was indicated in the eGFR < 60 and OFr group than in the eGFR of < 60 and non-OFr group after adjusting for age, body mass index, and drinking and smoking status as confounding factors. Multiple logistic regression analysis confirmed this relationship (p = 0.006). Therefore, lower BMD seems to be associated with lower renal function only when accompanied by OFr. Further longitudinal studies are needed to confirm these results.
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Affiliation(s)
- Shingo Nakai
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama 963-8611, Japan
| | - Shigefumi Okamoto
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa 920-0942, Japan
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong 180000, Vietnam
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, 14-1 Mukaimotorimachi, Komatsu 923-0961, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, 2500 Hassaka-cho, Hikone 522-8533, Japan
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kohasu, Oko-cho, Nankoku 783-8505, Japan
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan
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14
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Borg-Bartolo R, Roccuzzo A, Molinero-Mourelle P, Schimmel M, Gambetta-Tessini K, Chaurasia A, Koca-Ünsal RB, Tennert C, Giacaman R, Campus G. Global prevalence of edentulism and dental caries in middle-aged and elderly persons: A systematic review and meta-analysis. J Dent 2022; 127:104335. [PMID: 36265526 DOI: 10.1016/j.jdent.2022.104335] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/16/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of the study was to analyze data collected from studies worldwide on the prevalence of edentulism and dental caries, in community-dwellers aged ≥ 45 years. DATA Inclusion criteria; participants aged ≥ 45 years, community-dwellers. Exclusion criteria; participants aged < 45 years, in nursing homes, data obtained from dental clinics or pre-2005. The quality assessment tool by The National Heart, Lung and Blood Institute for Observational Cohort and Cross-sectional studies was used. Meta-analysis using the random-effects model (95% confidence interval) was done with data on participants who were edentulous and/or had active dental caries and stratified by regions of the world, age and Gross National Income per capita. Limitations in the data arose from several factors such as design of the studies included differences in socioeconomic status and access to health care among different countries. SOURCES Embase, MEDLINE via Pubmed and Scopus, manual searches, from January 2016, restricted to English. Experts from different countries were contacted to identify National oral health surveys (NOHS) conducted from 2010 onwards. STUDY SELECTION Eighty-six papers and seventeen NOHS were selected for data extraction. Majority of the studies (n = 69) were cross-sectional and of fair quality. 1.1%-70%, 4.9% - 98% prevalence of edentulism and dental caries, respectively. 22%, 45% estimated random-effects pooled prevalence of edentulism and dental caries, respectively. CONCLUSIONS Within the limitations of this study, the findings indicate that untreated dental caries and tooth loss are prevalent on a global level with wide variations among different countries, age groups and socioeconomic status. CLINICAL SIGNIFICANCE The findings demonstrate the reality of the new cohort of older adults, with higher tooth retention implying more dental caries incidence and the need for different care strategies to ensure better oral health. Large variations and difficulty in making comparisons among different countries highlight the need for more standardized, regular research.
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Affiliation(s)
- R Borg-Bartolo
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern 3012, Switzerland.
| | - A Roccuzzo
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern 3012, Switzerland; Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland.
| | - P Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - M Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - K Gambetta-Tessini
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Chile
| | - A Chaurasia
- Faculty of Dental Sciences, King George's Medical, India
| | - R B Koca-Ünsal
- Department of Periodontology, Faculty of Dentistry, University of Kyrenia, Cyprus
| | - C Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern 3012, Switzerland
| | - R Giacaman
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Chile
| | - G Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, Bern 3012, Switzerland; Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Italy.
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15
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Guo J, Chen Y, Dai Y, Chen Q, Wang X. Influencing factors of care dependence in patients with coronary heart disease after percutaneous coronary intervention-A cross-sectional study. Nurs Open 2022; 10:241-251. [PMID: 35997202 PMCID: PMC9748071 DOI: 10.1002/nop2.1299] [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: 08/23/2021] [Revised: 06/07/2022] [Accepted: 06/27/2022] [Indexed: 01/04/2023] Open
Abstract
AIM Care dependence has been scarcely investigated in coronary heart disease patients after percutaneous coronary intervention. This study aimed to investigate the association between frailty, self-efficacy, combined effects of frailty and self-efficacy, mental health, and care dependence in coronary heart disease patients after percutaneous coronary intervention. DESIGN Cross-sectional study. METHODS Data from 400 patients after percutaneous coronary intervention were collected from 2017-2020. Logistic regression model and mediating analysis were used to identify the association between frailty, self-efficacy, combined effects of frailty and self-efficacy, and care dependence. RESULTS Patients with frailty and self-efficacy tended to have severe care dependence symptoms. There was no correlation between frailty symptoms, self-efficacy, and care dependence in patients without symptoms of anxiety or depression. But in patients with anxiety or depression symptoms, there is a strong correlation between frailty symptoms, lower self-efficacy, and care dependence. Mental health played an inhibitory effect on frailty and care dependence.
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Affiliation(s)
- Juan Guo
- Department of CardiologySuzhou Hospital of Anhui Medical University (Suzhou Municipal Hospital of Anhui Province)SuzhouAnhui ProvinceChina
| | - Youyou Chen
- Department of CardiologyBozhou People's HospitalBozhouAnhui ProvinceChina
| | - Yu Dai
- Department of General SurgerySuzhou Hospital of Anhui Medical University (Suzhou Municipal Hospital of Anhui Province)SuzhouAnhui ProvinceChina
| | - Qin Chen
- Department of NursingSuzhou Hospital of Anhui Medical University (Suzhou Municipal Hospital of Anhui Province)SuzhouAnhui ProvinceChina
| | - Xiyong Wang
- Department of OncologySuzhou Hospital of Anhui Medical University (Suzhou Municipal Hospital of Anhui Province)SuzhouAnhui ProvinceChina
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16
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Weening-Verbree LF, Schuller AA, Zuidema SU, Hobbelen JSM. Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127251. [PMID: 35742500 PMCID: PMC9223830 DOI: 10.3390/ijerph19127251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the impact of the implementation of an Oral Care Program on home care nurses’ attitudes and knowledge about oral health (care) and the impact on older people’s oral health. A pre–post study, without a control group, was conducted. A preventive Oral Care Program (OCP) was designed, focusing on home care nurses and older people, in collaboration with dental hygienists. Implementation was measured with questionnaires at baseline and after 6 months for home care nurses; for older people, implementation was measured at baseline and after 3 months with the Oral Health Assessment Tool and a questionnaire about oral (self) care between January 2018 and September 2019. Although the study design has limitations, the oral health of older people improved significantly after 3 months and the OCP was most beneficial for people with full dentures. The OCP improved knowledge and attitude of home care nurses. The program fitted well with the daily work routines of home care nurses. Individual-centered care plans for older people, education of home care nurses and the expertise of the dental hygienists have added value in home care nursing. Future implementations should focus on older people with natural teeth.
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Affiliation(s)
- Lina F. Weening-Verbree
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands;
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, A. Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands;
- Correspondence:
| | - Annemarie A. Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, A. Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands;
- TNO the Netherlands Organisation for Applied Scientific Research, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, FA21, P.O. Box 196, 9700 AD Groningen, The Netherlands;
| | - Johannes S. M. Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands;
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, FA21, P.O. Box 196, 9700 AD Groningen, The Netherlands;
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17
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Nicolae FM, Bennardo F, Barone S, Șurlin P, Gheorghe DN, Burtea D, Pătrascu Ș, Râmboiu S, Radu AP, Ungureanu BS, Turcu-Știolica A, Didilescu AC, Strâmbu VDE, Șurlin VM, Gheonea DI. The Need for Oral Hygiene Care and Periodontal Status among Hospitalized Gastric Cancer Patients. J Pers Med 2022; 12:684. [PMID: 35629110 PMCID: PMC9147473 DOI: 10.3390/jpm12050684] [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: 03/18/2022] [Revised: 04/14/2022] [Accepted: 04/22/2022] [Indexed: 11/16/2022] Open
Abstract
Poor oral hygiene leads to the accumulation of dental plaque, thus contributing to the initiation of periodontal disease (PD). Local infections can lead to systemic inflammatory responses, which are essential mediators for the evolution of systemic conditions or cancer tumorigenesis. Often, patients hospitalized with life-threatening and incapacitating disorders such as gastric cancer (GC) might lose interest in keeping their mouth healthy. This study evaluates oral hygiene, periodontal status, and the need for oral care and medical personnel to assist in achieving it in patients hospitalized with GC. This study was carried out on 25 patients with a diagnosis of GC, divided into two groups (GP-14 patients from the Gastroenterology Department, and SP-11 patients from the 1st Department of Surgery). Patients were examined on the day of admission (T0), the day of the medical procedure of endoscopy or surgery (T1), and the day of discharge (T2), recording the number of absent teeth, dental plaque (PI), bleeding on probing (BOP), probing depths (PPD), frequency of toothbrushing, and if the oral hygiene had been self-performed or assisted. Data were subjected to statistical analysis. Our results showed that, in both the GP and the SP group, there were strong and statistically significant correlations between PI and BOP measured on the last day of hospitalization and the period of hospitalization after the medical procedure. Longer hospital stays and the presence of surgery were risk factors for changing toothbrushing frequency. Results also highlight the need for a dentist to diagnose and eventually treat periodontal disease before and after hospitalization, and for a trained nurse who should help take care of the patient's oral hygiene during hospitalization.
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Affiliation(s)
- Flavia Mirela Nicolae
- Department of Periodontology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.M.N.); (D.N.G.)
| | - Francesco Bennardo
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; or
| | - Selene Barone
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; or
| | - Petra Șurlin
- Department of Periodontology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.M.N.); (D.N.G.)
| | - Dorin Nicolae Gheorghe
- Department of Periodontology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.M.N.); (D.N.G.)
| | - Daniela Burtea
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.B.); (B.S.U.); (D.I.G.)
| | - Ștefan Pătrascu
- Department 1st of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (Ș.P.); (S.R.); (V.M.Ș.)
| | - Sandu Râmboiu
- Department 1st of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (Ș.P.); (S.R.); (V.M.Ș.)
| | - Adrian Petru Radu
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.P.R.); (V.D.E.S.)
| | - Bogdan Silviu Ungureanu
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.B.); (B.S.U.); (D.I.G.)
| | - Adina Turcu-Știolica
- Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | | | - Victor Dan Eugen Strâmbu
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.P.R.); (V.D.E.S.)
| | - Valeriu Marin Șurlin
- Department 1st of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (Ș.P.); (S.R.); (V.M.Ș.)
| | - Dan Ionuț Gheonea
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.B.); (B.S.U.); (D.I.G.)
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18
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Bots-VantSpijker PC, van der Maarel-Wierink CD, Schols JMGA, Bruers JJM. Oral Health of Older Patients in Dental Practice: An Exploratory Study. Int Dent J 2022; 72:186-193. [PMID: 34238570 PMCID: PMC9275187 DOI: 10.1016/j.identj.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Some older people stop visiting the dentist when they get older. This study aims to identify the characteristics and oral health status of older people who do visit community dental practices. METHODS In this exploratory cross-sectional study, the oral health of Dutch community-dwelling older people was assessed. A random sample of general dental practitioners and older people who visit the dental practice was drawn. The dentists were asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to complete a questionnaire. Data were described for 3 distinct groups of older people. Statistical measures for distribution and dispersion were used to describe the oral health of community-dwelling older patients in relation to the age. RESULTS A total of 373 (40.4%) dentist registration forms and 372 (40.3%) patient questionnaires were returned. Data were available for 364 (39.4%) dentist-patient couples. Amongst the patients, 52.8% were female and most had a high socioeconomic status. About 65.7% had one or more problems related to general health, and 75.2% used medication. Regarding the overall oral health status, the average number of teeth was 20, 3.5% were edentulous. Oral health problems were more common in the older patient group (aged 75+), in whom frailty was also most common. CONCLUSIONS Older people who visit community dental practices are still relatively healthy, non-frail, and highly educated. Even in this group, there is a turning point in both general and oral health from the age of 75.
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Affiliation(s)
- Pieternella C Bots-VantSpijker
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology (NVGd), Bunnik, The Netherlands; Department Oral Public Health (OPH), Acadamic 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 (NVGd), 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 (NVGd), Bunnik, The Netherlands; Caphri - Dept. Health Services Research and Dept. Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Josef J M Bruers
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology (NVGd), Bunnik, The Netherlands; Department Oral Public Health (OPH), Acadamic 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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Parisius KG, Wartewig E, Schoonmade LJ, Aarab G, Gobbens R, Lobbezoo F. Oral frailty dissected and conceptualized: A scoping review. Arch Gerontol Geriatr 2022; 100:104653. [DOI: 10.1016/j.archger.2022.104653] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/26/2022] [Accepted: 02/04/2022] [Indexed: 01/28/2023]
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van der Heijden EM, Klüter WJ, van der Maarel-Wierink CD, Gobbens RJJ. Exploring associations between multidimensional frailty and oral health in community-dwelling older people. A pilot study. SPECIAL CARE IN DENTISTRY 2022; 42:361-368. [PMID: 35014046 PMCID: PMC9545350 DOI: 10.1111/scd.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 12/02/2022]
Abstract
Objective To determine the associations between four validated multidimensional self‐report frailty scales and nine indices of oral health in community‐dwelling older persons. Materials and Methods This pilot study was conducted in a sample of 208 older persons aged 70 years and older who visited two dental practices in the Netherlands. Frailty status was measured by four different self‐report frailty questionnaires: Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Sunfrail Checklist (SC), and the Sherbrooke Postal Questionnaire (SPQ). Oral health was assessed by two calibrated examiners. Results The prevalence of frailty according to the four frailty measures TFI, GFI, SC, and SPQ was 32.8%, 31.5%, 24.5%, and 49.7%, respectively. The SC correlated with four oral health variables (DMFT, number of teeth, percentage of occlusal contacts, Plaque Index), the TFI with three (number of teeth, percentage of occlusal contacts, Plaque Index), the GFI only with DPSI, and the SPQ with the number of teeth and the number of occlusal contacts. Conclusion Of the studied multidimensional frailty scales, the SC and TFI were correlated with most oral health variables (four and three, respectively). However, it should be noticed that these correlations were small. Clinical relevance The SC and TFI might help to identify older people with risk of poor oral health so that preventive care can be used to ensure deterioration of oral health and maintenance of quality of life. Vice versa early detection of frailty by oral care professionals could contribute to interprofessional management of frailty.
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Affiliation(s)
| | - Wim J Klüter
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,College of Dental Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Claar D van der Maarel-Wierink
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Robbert J J Gobbens
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Janakiram C, Ayoob A, Neelamana S. Impact of oral frailty on general frailty in geriatric population: A scoping review. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312360. [PMID: 34886085 PMCID: PMC8656978 DOI: 10.3390/ijerph182312360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022]
Abstract
Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.
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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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Slashcheva LD, Karjalahti E, Hassett LC, Smith B, Chamberlain AM. A systematic review and gap analysis of frailty and oral health characteristics in older adults: A call for clinical translation. Gerodontology 2021; 38:338-350. [PMID: 34331353 DOI: 10.1111/ger.12577] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice. BACKGROUND Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews. METHODS Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis. RESULTS Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis. CONCLUSION Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.
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Affiliation(s)
- Lyubov D Slashcheva
- Department of Dental Specialties, Mayo Clinic, Rochester, MN, USA.,Apple Tree Dental, Rochester, MN, USA
| | - Erika Karjalahti
- Roseman University College of Dental Medicine, Henderson, NV, USA
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Oral hygiene and health-related quality of life in institutionalized older people. Eur Geriatr Med 2021; 13:213-220. [PMID: 34313976 PMCID: PMC8860786 DOI: 10.1007/s41999-021-00547-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/16/2021] [Indexed: 11/18/2022]
Abstract
Aim We evaluated oral hygiene level and its association with oral health and general health-related quality of life (HRQoL) among older residents in long-term care facilities. Findings Only one-fifth of residents had good oral hygiene. Poor oral hygiene was associated with poor oral health and diminished HRQoL. Message Oral hygiene, oral health, and HRQoL may be improved with oral care education of caregivers, professional cooperation, and regular oral healthcare of older residents in long-term care facilities. Purpose We evaluated the level of oral hygiene and its association with oral health status and need for oral treatment among older residents in long-term care facilities. In addition, the association between oral hygiene level and health-related quality of life (HRQoL) was explored. Methods This cross-sectional study assessed 231 dentate residents in long-term care facilities (71% female, mean age 81 years, 70% had dementia). Nurses assessed residents and completed questionnaires on participants’ background information, diagnoses, oral healthcare habits, and HRQoL with the 15D instrument. Two qualified dentists performed clinical oral examinations (number of teeth, plaque index, periodontal condition, open caries lesions, and dry mouth). We used a modified plaque index (PI) to measure the level of oral hygiene (good, moderate, and poor) and calculated the clinical Asymptotic Dental Score (ADS) to determine the oral inflammation burden. Results Of the residents, 21% had good, 35% moderate, and 44% poor oral hygiene according to PI. Poor oral hygiene was associated with poorer cognitive status (P = 0.010) and higher oral inflammation burden (P < 0.001). Moreover, poor oral hygiene was associated with poorer HRQoL in a correlation analysis adjusted for age and gender. Conclusions Oral hygiene of older individuals in long-term care is insufficient. Poor oral hygiene is a marker for poor HRQoL. Residents also have a high burden of oral inflammatory diseases and a need for dental care. Older residents’ oral hygiene and HRQoL may be improved with oral care education of caregivers and regular dental check-ups.
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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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Salmi R, Närhi T, Suominen A, Suominen AL, Lahti S. Perceived oral health and oral health behaviours among home-dwelling older people with and without domiciliary care. Gerodontology 2021; 39:121-130. [PMID: 33565677 DOI: 10.1111/ger.12542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/14/2021] [Accepted: 01/17/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim was to compare the perceived oral health and oral health behaviours of home-dwelling older people with and without domiciliary care. BACKGROUND Oral health is poor in long-term care, but less is known about perceived oral health of home-dwelling older people receiving domiciliary care. MATERIALS AND METHODS Data from the Health 2000 and Health 2011 surveys (BRIF8901) were used. Interview participants were at least 70 years old and living at home with or without domiciliary care (n = 1298 in 2000 and n = 1027 in 2011). Differences in perceived oral health (subjective oral health, pain, eating difficulties) and oral health behaviours (hygiene, use of services) were compared based on the use of domiciliary care and stratified by gender. Differences between groups were compared with the chi-square test. RESULTS In 2011, compared to non-clients, domiciliary care clients more often had poor subjective oral health (40.3% vs. 28.9%, P = .045). In both surveys, they also used oral health services less recently (2000, 76.4% vs. 60.9%; and 2011, 61.1% vs. 46.6%) and more often had difficulties chewing hard food (2000, 50.6% vs. 34%, P < .001; and 2011, 38.4% vs. 20.7%, P < .001) than non-clients. In 2000, clients had more difficulty eating dry food without drinking (39.5% vs. 21.6%, P < .001) and cleaning their teeth and mouth (14.3% vs. 1.1%, P < .001) than non-clients. Women clients in 2011 brushed their teeth less often than non-clients (43.5% vs. 23.7%, respectively, P = .001). CONCLUSION Domiciliary care clients have poorer perceived oral health, and greater difficulties with eating and oral hygiene maintenance than non-clients.
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Affiliation(s)
- Riikka Salmi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland.,Welfare Division, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
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Sekundo C, Bölk T, Kalmus O, Listl S. Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening. J Clin Med 2021; 10:E287. [PMID: 33466797 PMCID: PMC7830157 DOI: 10.3390/jcm10020287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76-0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82-132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.
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Affiliation(s)
- Caroline Sekundo
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Tobias Bölk
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Olivier Kalmus
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Stefan Listl
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 Nijmegen, The Netherlands
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Oliveira TFSD, Embaló B, Pereira MC, Borges SC, Mello ALSFD. Oral health of homebound older adults followed by primary care: a cross sectional study. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.220038.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract Objective to characterize the life, health, and oral health conditions of homebound older people registered in the primary care teams and oral homecare provided. Method cross-sectional, household based study with a convenience sample, in Florianópolis, southern Brazil. Data collection through a questionnaire and clinical oral examination which included sociodemographic variables, condition of teeth and mucosa, oral hygiene, access to dental care and dentist providing homecare. Absolute and relative frequency analysis and bivariate analysis (chi-square, CI=95%) were performed. Results 123 older people participated with mean age of 81.3 years, 62.6% were women. Living with a caregiver were 87%, 60% were domiciled for up to 5 years, and 89.4% were frail. Regarding the presence of teeth, 56.1% were edentulous and 40.5% had from 1 to 8 teeth. Root remains were observed in 12.8%, untreated caries lesions in 25.2%, visible biofilm in 69.9%, tooth mobility in 57.7% and mucosal lesions in 8.9% of the elders; 45.5% needed help with oral hygiene and 24.4% did not perform daily mouth cleaning. The difficulty in accessing dental care due to homeboundness was reported by 32.5% and home visits provided by the dentist occurred in only 16.3%. Conclusion the oral health of the older adults studied is poor due to the presence of oral problems that require intervention. There is dependence on third parties for oral care, which is not consistently guaranteed at home. The study points to the need for dental homecare provided by public health services.
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Factors Associated with Knowledge, Attitudes, and Practices Related to Oral Care Among the Elderly in Hong Kong Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218088. [PMID: 33147890 PMCID: PMC7672548 DOI: 10.3390/ijerph17218088] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022]
Abstract
Background: The oral health of elderly populations is a significant concern, as it is closely linked to general health and health-related quality of life. Poor oral health exacerbates oral diseases, leading to an increased risk of non-communicable diseases and self-care dependence, particularly in the elderly, worldwide. Knowledge, attitudes, and practices (KAP) play influential roles in individual oral care. However, the evidence of KAP related to oral care among the elderly is still inadequate. Objective: This study aimed to examine KAP and their associated factors related to oral care among the elderly community. Methods: A cross-sectional descriptive design was used. The eligible subjects were recruited, using convenience sampling and snowball sampling. Results: A total of 385 elderly individuals were included, and 51.4% were women. The mean age was 71.66 (SD 6.28). Knowledge was reportedly poor, as more than 50% elderly answered several questions incorrectly. The mean attitude and practices scores were 44.94 (SD 6.33) and 68.90 (SD 10.44), respectively. There was a significant correlation among knowledge, attitudes, and practices (p < 0.001). Multivariable regression analysis revealed numerous factors had remarkably significant association with knowledge [R2 = 0.30, F (4,380) = 11.96, p < 0.001], attitudes [R2 = 0.28, F (6,378) = 9.27, p < 0.001], and practices [R2 = 0.31, F (5,379) = 12.34, p < 0.001], particularly education levels, full-time employment, and self-care independence. Conclusions: Based on the KAP theoretical model, KAP are closely interrelated. Identified factors associated with KAP are useful to understand at-risk groups. Elderly individuals at lower education levels, with poor family support and inadequate self-care independence, have poor KAP related to oral care. Therefore, this study improves insight for health promotion developers, suggesting that more attention should be paid to at-risk elderly groups’ oral health. To enhance participation in dental care and improve oral care performance in the elderly, educational program containing oral health knowledge should be offered to at-risk groups. Family support and involvement are also important for improving oral care among elderly individuals.
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Lexomboon D, Gavriilidou NN, Höijer J, Skott P, Religa D, Eriksdotter M, Sandborgh-Englund G. Discontinued dental care attendance among people with dementia: A register-based longitudinal study. Gerodontology 2020; 38:57-65. [PMID: 32954536 DOI: 10.1111/ger.12498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the factors that increase the risk of discontinuing dental care utilisation after dementia is diagnosed in a population in Stockholm County, Sweden. BACKGROUND As the progression of dementia results in a deteriorating ability to maintain good oral health, it is important to identify people at risk of discontinued dental care after being diagnosed with dementia. MATERIALS AND METHODS This study is a register-based longitudinal study. Data were extracted from the Swedish Dementia Registry (SveDem), the Swedish National Patient Register, the Dental Health Register and the Municipal Dental Care Register (Stockholm County Council). The data included people using both general public dental services and care-dependent individuals. Dental visits three years before and after dementia had been diagnosed were analysed. RESULTS In total, 10 444 people were included in the analysis, of which 19% did not have dental visits recorded after they were diagnosed with dementia. A logistic regression model, adjusted for relevant factors, showed that the factors associated with a greater risk for discontinued dental attendance were fewer remaining teeth (OR = 0.96, 95% CI = 0.95, 0.97) and living alone compared to living with another adult (OR = 1.23, 95% CI = 1.05, 1.43). People with Parkinson's disease dementia had a lower risk (OR = 0.40, 95% CI = 0.19, 0.84) than people with Alzheimer's disease. CONCLUSION Patients, dental and healthcare personnel, and family members should all be aware of these risk factors so that appropriate support and oral care for people with dementia can be delivered.
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Affiliation(s)
| | | | - Jonas Höijer
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pia Skott
- Academic Center for Geriatric Dentistry, Stockholm, Sweden.,Department of Orofacial Medicine, Folktandvården Stockholms Län AB, Stockholm, Sweden
| | - Dorota Religa
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Maria Eriksdotter
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), 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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Lee JH, Lee SY, Han K, Han JS. Relationship between oral health behaviour and handgrip strength: a cross-sectional study with 7589 Korean adults. Acta Odontol Scand 2020; 78:438-444. [PMID: 32141362 DOI: 10.1080/00016357.2020.1735516] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: This cross-sectional study investigated the relationship between handgrip strength and oral health behaviours among Koreans.Methods: The data of 7589 individuals (3384 men and 4205 women) aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2015 were analyzed. Oral health behaviour was assessed based on the number of daily toothbrushing sessions and the use of secondary oral-care products. The association between oral-health behaviour and handgrip strength was investigated adjusting for confounders. Multivariable logistic regression analysis was performed (α = 0.05).Results: The proportion of participants diagnosed with sarcopenia was significantly higher in the group with poor oral-health behaviours. After adjusting for confounders including age, the adjusted odds ratios and 95% confidence intervals of female participants with low handgrip strength in groups toothbrushing thrice or more per day, twice per day, and once or less per day were 1 (reference), 1.18 (0.99-1.4), and 1.24 (0.89-1.71), respectively. There were significantly more participants with low handgrip strength in the group that did not use secondary oral products for both sexes.Conclusions: Oral health behaviour is associated with handgrip strength among adults. Poor oral self-care habits may constitute a risk indicator for low muscle strength.
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Affiliation(s)
- Jae-Hyun Lee
- Department of Prosthodontics, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Su-Young Lee
- Department of Prosthodontics, Seoul St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Suk Han
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Coker E, Ploeg J, Kaasalainen S. Relying on nursing staff for oral hygiene care: A qualitative interpretive description study. Geriatr Nurs 2020; 41:891-898. [PMID: 32636022 DOI: 10.1016/j.gerinurse.2020.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
Nurses may not prompt or offer assistance with oral hygiene care activities to patients who do not ask for help because they appear independent in their ability to perform their oral hygiene care. That is, nurses may be inclined to preserve patient autonomy over ensuring adequate oral hygiene outcomes. The purpose of this qualitative Interpretive Description study was to explore, with older patients in post-acute settings, their perspectives and experiences with being autonomous or relying on nursing staff for oral hygiene care. Bedside interviews with 21 patients revealed that: (a) their oral hygiene had deteriorated since hospitalization; (b) nurses may not be aware of patients' oral health values or offer help unless asked; and (c) patients are generally open to being asked if they need help with oral care, being prompted to complete oral care, being asked if they have completed oral care, and having nurses ensure adequate oral care.
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Affiliation(s)
- Esther Coker
- Hamilton Health Sciences - St. Peter's Hospital, 88 Maplewood Avenue, Hamilton L8M 1W9, Ontario, Canada.
| | - Jenny Ploeg
- Professor and Scientific Director, Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Sharon Kaasalainen
- Professor School of Nursing, McMaster University, Hamilton, Ontario, Canada
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Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study. BMC Oral Health 2020; 20:63. [PMID: 32111212 PMCID: PMC7048098 DOI: 10.1186/s12903-020-1036-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/04/2020] [Indexed: 01/26/2023] Open
Abstract
Background Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran. Methods A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors. Results Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence. Conclusion A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.
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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: 96] [Impact Index Per Article: 19.2] [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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Salmi, R, Lahti, S, Tolvanen, M, Suhonen, R, Närhi, T. Oral health assessment in domiciliary care service planning of older people. SPECIAL CARE IN DENTISTRY 2019; 39:485-490. [DOI: 10.1111/scd.12403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/15/2019] [Accepted: 06/19/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Riikka Salmi,
- Department of Prosthetic Dentistry and Stomatognathic PhysiologyUniversity of Turku City of Turku Finland
| | - Satu Lahti,
- Department of Community DentistryUniversity of Turku City of Turku Finland
- Turku Clinical Research CentreTurku University Hospital City of Turku Finland
| | - Mimmi Tolvanen,
- Department of Community DentistryUniversity of Turku City of Turku Finland
| | - Riitta Suhonen,
- Departement of Nursing ScienceUniversity of Turku City of Turku Finland
- Welfare DivisionTurku University Hospital City of Turku Finland
| | - Timo Närhi,
- Department of Prosthetic Dentistry and Stomatognathic PhysiologyUniversity of Turku City of Turku Finland
- Clinic of Oral DiseasesTurku University Hospital City of Turku Finland
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Shahrabani S. Factors affecting oral examinations and dental treatments among older adults in Israel. Isr J Health Policy Res 2019; 8:43. [PMID: 31077257 PMCID: PMC6511173 DOI: 10.1186/s13584-019-0312-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Routine dental examinations are important for early diagnosis and treatment of dental problems among older adults in order to improve their quality of life and avoid costly future treatments. In Israel, a significant percentage of adults do not seek dental care. Methods The study is based on a 2017 telephone survey conducted among people aged 50–75 from different population groups in Israel to examine their health beliefs and attitudes toward dental treatments. Results The results show that among older adults the decision to undergo routine dental checkups is affected by socio-demographic status and health beliefs regarding dental health. Lower age, higher income levels, and Jewish religion predicted higher chances of frequent checkups. In addition, those who saw the benefits of routine checkups, believed that dentists were readily available, and had higher levels of health motivation were more likely to seek out routine dental care. Conclusions According to the recent dental reform in Israel, people aged 75 and over are eligible for subsidized dental treatments. To enhance the frequency of dental checkups among older adults, it is recommended to provide this subsidized coverage for adults under age 75. In addition, planning dental health services for individuals in this age group should be based upon their accepted beliefs and values. Moreover, systematic health education through the media and health maintenance organizations should specifically target this population group to encourage them to undergo dental checkups more frequently.
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Affiliation(s)
- Shosh Shahrabani
- The Economics and Management Department and Head of Research Authority, The Max Stern Yezreel Valley College, P.O. 19300, Emek Yezreel, Israel.
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Steel BJ. Oral hygiene and mouth care for older people in acute hospitals: part 1. Nurs Older People 2017; 29:26-31. [PMID: 29124917 DOI: 10.7748/nop.2017.e947a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 12/24/2022]
Abstract
The oral health of older people in acute hospitals has rarely been studied. Hospital admission provides a prime opportunity for identification and rectification of problems, and oral health promotion. This two-part article explores oral hygiene and mouth care provision for older adults in acute hospitals. The first article presents the findings of a literature review exploring oral and dental disease in older adults, the importance of good oral health and mouth care, and the current situation. Searches of electronic databases and the websites of relevant professional health service bodies in the UK were undertaken to identify articles and guidelines. The literature shows a high prevalence of oro-dental disease in this population, with many known detrimental effects, combined with suboptimal oral hygiene and mouth care provision in acute hospitals. Several guidelines exist, although the emphasis on oral health is weaker than other aspects of hospital care. Older adults admitted to acute hospitals have a high burden of oro-dental disease and oral and mouth care needs, but care provision tends to be suboptimal. The literature is growing, but this area is still relatively neglected. Great potential exists to develop oral and mouth care in this context. The second part of this article explores clinical recommendations.
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Affiliation(s)
- Ben J Steel
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
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