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Tanaka K, Kikutani T, Takahashi N, Tohara T, Furuya H, Ichikawa Y, Komagata Y, Mizukoshi A, Ozeki M, Tamura F, Tominaga T. A prospective cohort study on factors related to dental care and continuation of care for older adults receiving home medical care. Odontology 2024:10.1007/s10266-024-00984-4. [PMID: 39141260 DOI: 10.1007/s10266-024-00984-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/17/2024] [Indexed: 08/15/2024]
Abstract
Information on the effects of dental treatment must be identified and factors that hinder the continuation of dental treatment must be identified to provide appropriate domiciliary dental care (DDC). This study aimed to clarify the treatment outcomes of DDC for older adults and the factors that impede the continuation of such care. This prospective study was conducted at a Japanese clinic specializing in dental care for older adults. The functional status, nutritional status, oral assessment, details of the dental treatment, and outcomes after 6 months of older adults receiving DDC were surveyed. The Oral Health Assessment Tool (OHAT) was used for oral assessment. Cox proportional hazards analysis was used to analyze the factors at the first visit that were associated with treatment continuation. A total of 72 participants (mean age, 85.8 ± 6.9) were included. Twenty-three participants (31.9%) could not continue treatment after 6 months. The most frequently performed procedures were oral care and dysphagia rehabilitation, followed by prosthetic treatment, then tooth extraction. The percentage of participants with teeth that required extraction after 6 months and the total OHAT score decreased significantly. The Barthel Index, Mini Nutritional Assessment Short-Form, and rinsing ability were significantly associated with treatment continuation. Furthermore, instrumental activities of daily living (ADL) and the OHAT "tongue" sub-item were correlated with treatment continuation. In conclusion, DDC improved the oral health status of older adults after 6 months. Factors that impeded treatment continuation were decreased ADL, decreased nutritional status, difficulty in rinsing, and changes in the tongue such as tongue coating.
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Affiliation(s)
- Kumi Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan.
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan.
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Takashi Tohara
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Hiroyasu Furuya
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Yoko Ichikawa
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Yuka Komagata
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Arato Mizukoshi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
| | - Maiko Ozeki
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
| | - Fumiyo Tamura
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
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Tanaka K, Tominaga T, Kikutani T, Sakuda T, Tomida H, Tanaka Y, Mizukoshi A, Ichikawa Y, Ozeki M, Takahashi N, Tamura F. Oral status of older adults receiving home medical care: A cross-sectional study. Geriatr Gerontol Int 2024; 24:706-714. [PMID: 38830832 DOI: 10.1111/ggi.14917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/19/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
AIM This study examined the oral status and the presence of teeth requiring treatment among older adults receiving home medical care. METHODS This cross-sectional study was conducted at a Japanese dental clinic specializing in geriatric treatment. We recruited older adults receiving home medical care in the community who had begun to receive domiciliary dental care. The Japanese version of the Oral Health Assessment Tool (OHAT-J), as well as the presence of teeth requiring extraction and the need for assistance in maintaining oral hygiene were used to evaluate the participants' oral health and its association with other items. RESULTS Ninety-three participants (44 male and 49 female, median age: 87.0 years) were surveyed. The median OHAT-J score was 6. The duration since the previous dental visit was 23 months. Sixty-two (73.8%) of 84 participants with ≥1 natural tooth had severe caries or teeth with severe mobility that required extraction. Logistic analysis revealed that requiring assistance in maintaining oral hygiene, mild dementia, severe dementia, and depression were significantly associated with an OHAT score of ≥6. CONCLUSIONS Older adults receiving home medical care had poor oral health, with approximately 70% of them requiring tooth extraction. The need for assistance in maintaining oral hygiene and poor mental status contribute to poor oral health. Geriatr Gerontol Int 2024; 24: 706-714.
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Affiliation(s)
- Kumi Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | | | - Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Taeko Sakuda
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Hiroko Tomida
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Yuko Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Arato Mizukoshi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Yoko Ichikawa
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Maiko Ozeki
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Fumiyo Tamura
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
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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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Yang H, Xiao J, Cui S, Zhang L, Chen L. Oral Health Assessment Tools for Elderly Adults: A Scoping Review. J Multidiscip Healthc 2023; 16:4181-4192. [PMID: 38148947 PMCID: PMC10750773 DOI: 10.2147/jmdh.s442439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose The aim of this study was to synthesize the Oral Health Assessment Tool for elderly adults and determine its psychosocial properties. Methods We conducted a scoping review. The Arkey and O'Malley methodology was employed to conduct scoping reviews involving the exploration of both national and international databases, as well as a manual search of the reference lists of the selected studies. We focused on oral health assessment tools for elderly adults (>60 years). The review report adhered to the standards outlined in the PRISMA-ScR guidelines. The study protocol was officially filed with the Open Science Framework. Results A total of 19 documents were included. The literature search included a time frame ranging from 1995 to 2023 and covered a diverse range of 13 countries. Of the 19 assessment tools examined, it was found that only the Oral Assessment Sheet had multidimensional characteristics, while the remaining tools were unidimensional in nature. The evaluation of oral health assessment tools was conducted across several contexts, including nursing homes, geriatric facilities, communities, and hospitals. A total of eleven studies underwent reliability testing, whereas two studies were alone validated for validity and did not undergo reliability testing. Additionally, seven studies were exclusively validated for reliability and did not undergo validity testing. Conclusion Multidimensional oral health assessment tools for elderly adults that integrate social and psychological aspects need to be developed and validated. It is necessary to develop oral health assessment tools based on hospitalized elderly patients to meet the oral and dental health needs of elderly patients.
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Affiliation(s)
- Heng Yang
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Jiechenming Xiao
- Department of Nursing, Huangyan Hospital, Wenzhou Medical University, Taizhou, Zhejiang, People’s Republic of China
| | - Shaomei Cui
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Liyan Zhang
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Lixia Chen
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
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Maitre Y, Collet S, Denis F, Amador G. The oral care practices and needs of older adults in nursing homes: Assessment of carers and patients. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:77-82. [PMID: 38040648 DOI: 10.3917/spub.hs1.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Good oral health preservation in nursing homes is hampered by the lack of caregivers, who are often inadequately trained, which has an impact on patients’ quality of life. The aim was to assess caregivers’ practices and the objective and perceived oral care needs of patients in nursing homes. A cross-sectional survey was conducted between September 15 and November 24, 2021, in three nursing homes in Mayenne (France). A self-administered questionnaire was used to identify oral care practices and caregivers’ training needs. The care needs and oral health related quality of life of patients were assessed by a single dental surgeon using the OHAT and the GOHAI questionnaire. Assessments were done with 30.8 percent of caregivers, and 40.0 percent and 36.2 percent of patients for OHAT and GOHAI respectively. Oral cavity and prosthesis examinations were systematically carried out by 4.9 percent and 24.4 percent of caregivers respectively. Fifty percent of the nurses had never performed oral care. A need for practical training was expressed by 75.6 percent of the caregivers. The mean GOHAI and OHAT scores were 56.17 ± 5.69 and 6.01 ± 2.42. These scores were significantly correlated (rho=-0.34; p=0.002). Preventive oral care in nursing homes is necessary to maintain residents’ quality of life. Efforts must be made to provide training for caregivers and to simplify oral care procedures for patients.
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Affiliation(s)
- Yoann Maitre
- Collège national des chirurgiens-dentistes universitaires en santé publique, France
- UFR odontologie, université de Nantes
- CHU de Nantes
| | | | - Frédéric Denis
- Collège national des chirurgiens-dentistes universitaires en santé publique, France
- UFR odontologie, université de Tours
- EA 75-05 éducation, éthique, santé, faculté de médecine, université François-Rabelais, Tours
| | - Gilles Amador
- Collège national des chirurgiens-dentistes universitaires en santé publique, France
- UFR odontologie, université de Nantes
- CHU de Nantes
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