Oral health-related quality of life and associated factors among older people in short-term care

Assessing oral health-related quality of life among older people in home-based care - survey results of the InSEMaP study in Germany

BACKGROUND

Older people receiving home-based care (HBC) often face barriers to access preventive oral health care (OHC) and dental treatments. Leading to deterioration of their oral healthcare. It is further deteriorated by factors such as increasing burden of systemic diseases, medicinal side effects, limited mobility, financial constraints and lack of professional OHC at home. Older people also struggle to maintain necessary daily oral hygiene, leading to malnutrition, weight loss, and a risk of a further health degradation. This cross-sectional survey aimed to investigate the oral health-related quality of life (OHRQoL) and their associated factors in HBC recipients.

METHODS

5,280 older people (≥ 60 years) living in Hamburg, who were in need of care and insured with statutory health insurance DAK-Gesundheit received the questionnaire, which included the German version of the Oral Health Impact Profile (OHIP G-14) and, the EQ-5D health-related quality of life (HRQoL) measure as well as further questions regarding the extent of informal social support, subjective oral health status, oral health behaviour, subjective cognitive status, and socio-demographic variables.

RESULTS

The participants (n = 1,622) had a median age of 83.2 years, with 72.0% of the sample being female. Nearly two thirds of the sample reported that their independence or abilities were significantly impaired (care level 2). Regarding oral health impacts, 40.0% of the participants reported experiencing at least one of the fourteen possible prevalent impacts of the OHIP-G14 fairly often or very often. A multivariate regression model on the severity of oral health impacts revealed, that a better HRQoL, a positive perception of one's own dental status, fewer visits to dental practices, and no need for support in OHC were associated with better OHRQoL. Conversely, respondents with a negative perception of their oral health status, more frequent visits to a dental practice, a need for support in OHC, and subjective memory impairment showed poorer OHRQoL.

CONCLUSIONS

The results highlight the risk for poor oral health among older people in HBC. We conclude that there is an urgent need to prioritise oral health, especially as poor oral health can further compromise the systemic wellbeing of these already care dependent population.

Interdental cleaning and periodontal status among older Koreans: Findings from KNHANES VII

OBJECTIVE

To assess the association between the usage of interdental cleaning and periodontal status among older people in Korea.

BACKGROUND

In order to maintain oral health in older people, it is very important to use interdental cleaning devices. However, there is a lack of research on periodontal status and interdental cleaning device use in older people.

METHODS

This study used data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016-2018). A total of 3426 older people adults aged 65 years or older were selected from 16 489 participants. Data on sociodemographic status (sex, age, level of education, income, residential area), personal health practice (subjective health status, smoking, physical activity, hypertension, and diabetes mellitus), oral health practice (subjective oral health status, tooth brushing frequency, dental visits, and chewing problem), the number of teeth and periodontitis were collected. Periodontitis was defined as having a World Health Organisation community periodontal index (CPI) code greater than or equal to three, and severe periodontitis was defined as a CPI code 4. Participants having a CPI code of 3 or 4 were considered to have periodontal disease in this study. Logistic regression analysis investigated the association between interdental cleaning devices usage and periodontitis controlling the confounding factors.

RESULTS

Those who do not use dental floss had a higher rate of periodontal disease (AOR = 1.47, 95% confidence interval [CI]: 1.05 to 2.1). However, there were no significant differences by interdental brush use. In those with 20 or more teeth, non-users of dental floss had a higher risk of periodontitis in all models. Conversely, in those with fewer than 20 teeth, no significant differences were observed.

CONCLUSIONS

Older people with mostly intact dentitions have better periodontal health if they clean between their teeth.

Oral frailty: a concept analysis

BACKGROUND

Oral frailty has become a worldwide problem among older adults. Although researchers have conducted various studies on oral frailty, its definition remains controversial.

PURPOSE

To clarify the concept of oral frailty.

METHODS

Online databases PubMed, Web of Science, CINAHL, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database were searched from inception to September 20, 2023. The reference lists of relevant studies were searched manually. Eligible articles, theses, and books were analyzed using Walker & Avant's concept analysis model.

RESULTS

The attributes of oral frailty were abnormal oral structure and/or decline in multi-faceted oral function and coexisting decline in physical, cognitive and social functions. Its antecedents were aging, social frailty, and severe periodontitis, whereas its consequences were decline in physical health and mental health, social withdrawal, lower quality of life and systemic frailty.

CONCLUSION

Oral frailty could result in worse conditions among older adults physically, psychologically and socially. Tools based on the concept analysis need to be developed to comprehensively assess oral frailty.

Research hotspots and trends of oral health in older adults from 2013 to 2023: A bibliometric and visual analysis

Background

Oral health problems seriously affect the quality of life of older adults. It is of great significance to investigate the statuses of oral health in older adults. The study aimed to analyze the current status, hotspots and frontiers of global oral health research in older adults through bibliometrics to provide references and guidance for future research in this field.

Methods

Literature on oral health in older adults from 2013 to 2023 was retrieved from the Web of Science Core Collection (WoSCC) database. CiteSpace 6.2.R4 was used for bibliometric and visual analysis, including journal and co-cited journal, country/region, institution, author, co-cited references, and keyword analysis.

Results

A total of 1430 publications related to oral health in older adults were included. The number of publications has gradually increased over the past decade. The most widely published and cited journal was Gerodontology. The most prominent contribution came from the United States of America, and the University of London and Hirohiko Hirano were the most prolific institution and author, respectively. The current research hotspots were summarized as oral hygiene interventions, oral health-related quality of life and oral health issues in older adults. Cohort studies of oral health, the relationship between oral health and frailty, and the correlation between oral health and nutritional status may be emerging research trends.

Conclusions

This study systematically analyzed the hotspots and frontiers of oral health in older adults and called for increased collaboration among countries, institutions, and authors. In addition, oral hygiene interventions for older adults, oral health-related quality of life, oral health issues, cohort studies of oral health, and the relationship between oral health and frailty or nutritional status may be the focus of future research.

'Why doesn't anyone ask me'? Patients' experiences of receiving, performing and practices of oral care in an acute Orthopaedic Department

AIMS AND OBJECTIVES

Oral care is an integrated part of everyday life. Within nursing, barriers related to providing oral care often lead to unmet caring needs. Poor oral care is associated with a risk of respiratory and cardiovascular complications during hospitalisation. Knowledge on patients' perspectives of maintaining or receiving oral care during admissions are limited. Following the Fundamentals of Care (FOC) framework, this study uses a person-centred approach to explore patients' perceptions and experiences of receiving or performing oral care, including the nursing staff's clinical practices.

METHODOLOGICAL DESIGN AND JUSTIFICATION

A focussed ethnographic approach was used to explore patients' perspectives and clinical practices during acute admissions in an Orthopaedic Department.

ETHICS ISSUES AND APPROVAL

The local Data Protection Agency and the Ethics Committee approved the study.

RESEARCH METHODS, RESULTS AND CONCLUSIONS

Data were collected in an Orthopaedic ward at a Copenhagen University hospital, Hvidovre, and consisted of 14 days of field observations of clinical practices and 15 patient interviews. Data were analysed inductively using qualitative content analysis. Two themes were identified. The first, 'The purpose of oral care is defined by the eye of the beholder', describes the social implications for the patients and how patients reject the assumption of oral care being a transgressive act. The second, 'The unspoken need', focus on the lack of dialogue, including the limited provision of oral care and how the nursing staff assesses patients' ability to perform oral care (in)dependently without including the patients.

CONCLUSION

Oral care is related to the patient's psychological and physical well-being and affects social appearance. When oral care is provided respectfully, patients do not experience oral care as a transgressive act. Nursing staff's self-assessments of the patients' (in)dependency to perform oral care risk leading to incorrect care. Developing and implementing interventions applicable to the clinical practice is needed.

Effects of oral health-related quality of life on total mortality: a prospective cohort study

BACKGROUND

The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists.

METHODS

In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7-56.7, Q3 = 56.8-59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12-60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model.

RESULTS

We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 - 3.48) for Q1, 1.69 (95% CI, 0.90 - 3.17) for Q2, and 0.65 (95% CI, 0.29 - 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15-2.46) for Q1, 1.53 (95% CI, 1.04-2.27) for Q2, and 1.09 (95% CI, 0.71-1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79).

CONCLUSIONS

A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy.

TRIAL REGISTRATION

Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632-3, 8-21, and E2019-1603).

Oral health-related quality of life among home-dwelling older people with and without domiciliary care

OBJECTIVES

The aim was to compare oral health-related quality of life (OHRQoL) between home-dwelling older people with and without domiciliary care when adjusted for gender, education, use of dental services and removable dental prostheses.

BACKGROUND

OHRQoL of home-dwelling older people with and without domiciliary care is a neglected area of research, with few studies having been conducted.

MATERIALS AND METHODS

A secondary analysis was conducted on the Finnish Health 2011 interview data. Home-dwelling participants (age ≥ 70) with or without domiciliary care were included (n = 758). OHRQoL was measured with the Oral Health Impact Profile questionnaire (OHIP-14) calculating three outcomes: prevalence of at least one impact reported: "occasionally," "fairly often" or "very often" (OFoVo), severity as mean sum score and mean of the seven OHIP-14 dimensions. These were evaluated by use of domiciliary care using logistic and negative binomial regression analyses.

RESULTS

Domiciliary care clients tended to have poorer OHRQoL than non-clients (severity mean 4.33 vs 4.11, P = .057), especially men (6.71 vs 4.15, P = .027), and reported more psychological discomfort than non-clients (mean 1.10 vs 0.82, P = .039). The use of removable dental prostheses was the strongest predictor (OR 2.84, P < .001) of poor OHRQoL.

CONCLUSION

Domiciliary care clients tended to report poorer OHRQoL, especially with regard to psychological discomfort dimension than non-clients. Thus, support of oral hygiene and regular utilisation of oral health services should be part of domiciliary care among older people to enhance OHRQoL.

Trends in dental care utilisation among the elderly using longitudinal data from 14 European countries: A multilevel analysis

BACKGROUND

The use of dental care among older people is low compared to other forms of health care, with significant health consequences. However, the evidence on the extent to which countries' welfare systems and socio-economic factors influence the uptake of dental care by older people is limited. This study aimed to describe trends of dental care utilisation, and to compare use of dental care with other types of healthcare services among the elderly, considering different socio-economic factors and welfare systems in European countries.

METHODS

Multilevel logistic regression analysis was performed using longitudinal data from four waves (between Wave 5 and 8) of the Survey of Health, Ageing and Retirement in Europe database, with a follow-up period of 7 years. The study sample included 20,803 respondents aged 50 years or older from 14 European countries.

RESULTS

The annual dental care attendance was the highest in Scandinavian countries (85.7%), however, improving trends of dental attendance was recognized in Southern and Bismarckian countries (p<0.001). The difference in use of dental care services between socio-economic groups was expanding over time regarding low- and high-income level and residential area. A more marked difference was observed between social groups in dental care utilisation compared to other forms of care. Income level and unemployed status had significant effect on forgoing dental care due to cost and unavailability.

CONCLUSION

The observed differences between socioeconomic groups may highlight the health consequences of the different organization and financing of dental care. The elderly population could benefit from adopting policies aiming to reduce the financial barriers to dental care usage, especially in Southern and Eastern European countries.

Research status, hotspots and trends on oral care research in the elderly published from 2002 to 2022: A bibliometric analysis - A review article

AIMS

The aim of this study was to analyse the status, hotspots and trends of research on oral care for the elderly in mainland China in the past 20 years through bibliometrics, which aims to provide new ideas and targets for future clinical work and research.

DESIGN

Bibliometric analysis.

METHODS

Relevant literature was retrieved from China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, Web of Science and PubMed. NoteExpress, Co-Occurrence and CiteSpace were used to analyse bibliometric features in terms of year of publication, journal of publication, authors, institution and keywords.

RESULTS

A total of 716 related articles were obtained. The number of publications shows an increasing trend over time, only 2017-2021; 309 papers were published, accounting for 43.2% of the total number of publications. A total of 238 articles were published in Science Citation Index journals or Chinese core journals, accounting for 33.2% of the total number of articles. The study of oral health-related quality of life in the elderly is a hot research topic. There is a lack of research on the elderly living in elderly care facilities.

Differences in the oral health status in hospitalised stroke patients according to swallowing function: A cross-sectional study

BACKGROUND

Dysphagia is one of the common complications caused by stroke, leading to poor oral health. Oral health is often neglected after stroke by clinical care providers and the patients. Identifying the status of oral health in hospitalised stroke patients with swallowing disorders will facilitate the attention of clinical care providers.

AIM

To investigate the differences in the oral health status between hospitalised post-stroke patients with dysphagia and non-dysphagia.

DESIGN

A cross-sectional study.

METHODS

A purposive sampling method was used to recruit participants. Participants included hospitalised post-stroke patients with dysphagia and without dysphagia. Stroke patients were recruited from the Department of Neurology, Guizhou Provincial People's Hospital in China. A total of 120 stroke patients completed the survey. The data collected included their demographics, the scores on the Oral Health Assessment Tool (OHAT), Geriatric Oral Health Assessment Index (GOHAI), and the Eating Assessment Tool-10 (EAT-10). The study was compliant with the STROBE checklist.

RESULTS

The average age of the dysphagia group was 67 (64~76) vs the participants without dysphagia group 67 (65~76), (p = .610). The mean standard deviation (SD) OHAT score of participants with dysphagia was 5.28 (2.33) compared to participants without dysphagia 8.89 (3.07), (p < .05). This result indicates post-stroke dysphagia (PSD) patients had worse oral health than stroke patients without dysphagia. Binary logistic regression analysis showed that oral health status was the independent influencing factor of swallowing function (p < .01).

CONCLUSION

The participants with dysphagia had worse oral health status compared to those without dysphagia, illustrating the critical importance of improving attention to oral health management in patients with post-stroke swallowing disorders.

RELEVANCE TO CLINICAL PRACTICE

Oral health was often omitted when comparing to other functional impairments resulting from stroke. Health caregivers of post-stroke patients with dysphagia should be aware of the importance of evaluating patient's oral condition and implementing oral care.

Image diagnosis models for the oral assessment of older people using convolutional neural networks: A retrospective observational study

AIMS

The purpose of this study was to construct a model for oral assessment using deep learning image recognition technology and to verify its accuracy.

BACKGROUND

The effects of oral care on older people are significant, and the Oral Assessment Guide has been used internationally as an effective oral assessment tool in clinical practice. However, additional training, education, development of user manuals and continuous support from a dental hygienist are needed to improve the inter-rater reliability of the Oral Assessment Guide.

DESIGN

A retrospective observational study.

METHODS

A total of 3,201 oral images of 114 older people aged >65 years were collected from five dental-related facilities. These images were divided into six categories (lips, tongue, saliva, mucosa, gingiva, and teeth or dentures) that were evaluated by images, out of the total eight items that comprise components of the Oral Assessment Guide. Each item was classified into a rating of 1, 2 or 3. A convolutional neural network, which is a deep learning method used for image recognition, was used to construct the image recognition model. The study methods comply with the STROBE checklist.

RESULTS

We constructed models with a classification accuracy of 98.8% for lips, 94.3% for tongue, 92.8% for saliva, 78.6% for mucous membranes, 93.0% for gingiva and 93.6% for teeth or dentures.

CONCLUSIONS

Highly accurate diagnostic imaging models using convolutional neural networks were constructed for six items of the Oral Assessment Guide and validated. In particular, for the five items of lips, tongue, saliva, gingiva, and teeth or dentures, models with a high accuracy of over 90% were obtained.

RELEVANCE TO CLINICAL PRACTICE

The model built in this study has the potential to contribute to obtain reproducibility and reliability of the ratings, to shorten the time for assessment, to collaborate with dental professionals and to be used as an educational tool.

Ethnic Differences in Socioeconomic and Health Determinants Related to Self-Rated Health Status: A Study on Community-Dwelling Israeli Jews and Arabs in Old Age

Self-rated health (SRH) is widely used as a proxy for general health status. In old age, SRH has been found to be a strong predictor of morbidity, physical functioning, recovery from illness, use of health services, and mortality. This study was designed to examine differences in socioeconomic and health determinants related to self-rated health status among community-dwelling Jews and Arabs aged 65+ years. Cross-sectional data from 2011 on such Jews and Arabs were extracted from reprehensive National Surveys. The association between socioeconomic and health factors with poor SRH was estimated using three hierarchical logistic regression models. The majority of the respondents were Jews (86%), with a mean age of 73.1 (±6.3) years. The study revealed that older Arabs are disadvantaged according to almost every socioeconomic and health indicator compared to Jews. Poor SRH was significantly associated with age (OR = 1.03, p = 0.002), ethnicity (Jews OR = 2.62, p < 0.001), unemployment/retirement (OR = 2.03, p < 0.001), low income (OR = 3.03, p < 0.001), low education (OR = 1.37, p = 0.013), absence of physical activity (OR = 2.17, p < 0.001), dentures (OR = 1.40, p = 0.002), and prevalence of one or more chronic diseases (OR = 4.06, p < 0.001). The findings therefore indicated that these factors need to be detected and focused on by health professionals in order to improve the population's general health status.

Association of Number of Teeth with ADL/IADL in Korean Middle-Aged and Older Adults: An Analysis of the 7th Korean Longitudinal Study of Aging

We determined the association between the number of natural and implant teeth with activities of daily living (ADL) and instrumental ADL (IADL) levels in middle-aged and older adults aged ≥ 55 years. We included 6,925 participants, who underwent a computer-assisted personal interview in the 7th Korean Longitudinal Study of Aging. After controlling for general characteristics, the associations between the number of natural and implant teeth with ADL and IADL levels were examined using multiple regression analysis. The participants had 21.2 natural teeth and 1.08 implant teeth on average. The ADL and IADL levels were 0.61 and 1.56, 0.40 and 1.16, and 1.10 and 0.31 in participants with ≤ 9, 10-19, and ≥ 20 teeth, respectively. There was no significant association between ADL and the number of natural and implant teeth (p > 0.05). However, a one-unit increase in IADL score was associated with a reduced number of natural (β = -0.031, p < 0.001) and implant (β = -0.194, p = 0.006) teeth. Difficulties regarding IADL were associated with fewer natural and implant teeth, suggesting that maintaining and managing the number of teeth is critical to promoting the health of middle-aged and older adults.

The Effect of Counseling on the Pregnant Women's Stress of Covid-19: A Clinical Trial Study

Objective: Due to the Covid-19 pandemic crisis, which causes stress and threatens health, especially in vulnerable groups including pregnant women, the present study was conducted to determine the effect of individual counseling on the pregnant women's stress of Covid-19. Materials and methods: In this randomized controlled clinical trial, 66 pregnant women in 24 to 28 weeks were randomly divided into two groups of intervention (33 participants) and control (33 participants). At the beginning of the study, both groups completed the questionnaires of demographic information and pandemic related pregnancy test. Then, the intervention was performed in 3 sessions with the interval of one week, in the form of individual counseling by BELIFE method for the experimental group. The control group received only the routine services of the centers. The post-test was performed two weeks after the last consultation session for both groups. Data were analyzed using Stata-13 software. Significance level was considered 0.05. Results: The experimental and control groups were almost homogeneous in terms of quantitative and qualitative demographic variables. Total mean and standard deviation of stress score, before and after the intervention in the experimental group, were 40.27 ± 12.65 and 41.71 ± 1.74, respectively. These numbers in the control group were 33.84 ± 13.08 and 43.84 ± 1.69. Comparing the two groups in terms of stress score which was done after the intervention showed that although the stress score in the experimental group was lower than that in the control group, this difference was not statistically significant (p = 0.39). Conclusion: The results of this study show that although individual counseling for pregnant women was able to reduce the mean scores of stress of Covid-19 in the experimental group, this difference was not statistically significant. Therefore, although the BELIFE individual counseling method for pregnant women, who naturally suffer from pregnancy stress, is an acceptable way to reduce their stress, it is recommended to plan and implement early and more effective interventions for these women because the course of stress is severe in them and has an upward trend during Covid-19 pandemic.

Oral Health and Frailty in Community-Dwelling Older Adults in the Northern Netherlands: A Cross-Sectional Study

The aim of this study was to explore the association between oral health and frailty in community-dwelling Dutch adults aged 55 years and older. Included were 170 participants (n = 95 female [56%]; median age 64 years [IQR: 59−69 years]). Frailty was assessed by the Groningen Frailty Indicator. Oral health was assessed by the Oral Health Impact Profile-14-NL (OHIP-NL14). OHIP-NL14 item scores were analyzed for differences between frail and non-frail participants. Univariate and multivariate logistic regression analyses were performed to assess the association between oral health and presence of frailty. The multivariate analysis included age, gender, and depressive symptoms as co-variables. After adjustment, 1 point increase on the OHIP-NL14 scale was associated with 21% higher odds of being frail (p = 0.000). In addition, significantly more frail participants reported presence of problems on each OHIP-NL14 item, compared to non-frail participants (p < 0.003). Contrast in prevalence of different oral health problems between frail and non-frail was most prominent in ‘younger’ older adults aged 55−64 years. In conclusion: decreased oral health was associated with frailty in older adults aged ≥55 years. Since oral health problems are not included in most frailty assessments, tackling oral health problems may not be sufficiently emphasized in frailty policies.

Design of Optimization Algorithm for Configuration of Amateur Sports Training Equipment in Smart City Community

Community amateur sports training equipment is necessary to ensure the development of national fitness activities. It is found that the design concept of community public sports space in China is not perfect, the structural layout is not reasonable, the stock space is not optimized, and the resource allocation is not balanced. In particular, there is a lack of indoor fitness facilities and sports venues in the community, and the people's “fitness where to go” is still a difficult problem. In the smart city construction, the resource integration and optimization of community amateur sports training facilities have also been further developed. Considering various influencing factors, this paper establishes a location model of community amateur sports training facilities with the least total cost and convenience. Aiming at the practical optimization problem with high complexity, an improved adaptive weight multiobjective particle swarm optimization (PSO) model is proposed. These parameters in the algorithm were adjusted dynamically, which balanced the overall search ability and partial improvement ability of the PSO algorithm and completed the optimal scheduling of community amateur sports training equipment configuration while ensuring the optimal global solution. Experimental results show that the algorithm’s efficiency and searching ability have been further promoted. It also has an excellent performance in solving the complex location problem of community amateur sports training facilities.

Dental Anxiety and Oral-Health-Related Quality of Life among Rural Community-Dwelling Older Adults

Aim: This study aimed to investigate the association between dental anxiety (DA) and oral-health-related quality of life (OHRQoL) among rural community-dwelling older adults. Methods: A cross-sectional descriptive study was conducted among 390 rural community-dwelling older adults attending outpatient clinics of the Damanhur National Medical Institute during the year 2021. Three instruments were used: a demographic and clinical data structured interview schedule, Modified Dental Anxiety Scale (MDAS), and the Oral Health Impact Profile (OHIP-5) questionnaire. All statistical analyses were considered significant at a p-value of ≤0.001. Results: The main results showed that the prevalence of DA among participants was 90.5%, and 66.9% of the studied elderly population were either extremely (phobic) or very anxious. Moreover, a significant association was found between older adults’ DA and their OHRQoL (p ˂ 0.001). Conclusions: It was concluded that DA represents a common problem among rural community-dwelling older adults and is a predictor for poor OHRQoL. Raising community awareness about the importance of oral health and implementing measures to avoid DA through specialized community campaigns is recommended, particularly in rural areas.

A Narrative of Oral Care in Palliative Patients

Painful oral conditions represent a significant problem for most patients with a serious disease and palliative care needs. The main causes of such conditions may be associated with the underlying disease and its treatment, but primarily with adverse side effects of drugs. Oral conditions can lead to worsening of the illness and reduced quality of life. The objective of this narrative is to present an overview of oral care problems of this group, including present clinical practice. The evidence base for procedures and efficient products is weak. There is therefore an obvious need for research within this field.

Investigating the perspectives of older adults in residential aged care on oral health-related quality of life

OBJECTIVE

The objective of the study was to explore how older people living in a residential aged care facility perceived that their oral health influenced their food preferences and attitudes towards food, their social interactions and their self-esteem.

BACKGROUND

Poor oral health can have biological, behavioural and social impacts on quality of life among older adults (aged 65+ years). In terms of biological impacts, oral health impairments may cause older adults to avoid many types of foods. This shift in dietary pattern can lead to malnutrition among older people, undermine general health and negatively impact quality of life (QOL).

MATERIALS AND METHODS

Using a mixed methods approach, quantitative data from the General Oral Health Assessment Index (GOHAI) were explored and supported by data from semi-structured interviews with 10 older adults from a residential aged care facility in Perth, (Australia) to provide insights into their oral health-related quality of life. Thematic analysis of qualitative data was guided by the conceptual framework informed by Locker.

RESULTS

The average GOHAI score was 32.9 ± 3.6, which indicated that participants had an average oral health-related quality of life. Participants coped with oral functional problems by adopting personal strategies and seeking organisational assistance. Some participants appeared to have accepted associated changes to their physical appearance, while others reported significant dissatisfaction and low self-esteem. Perceptions differed on their social interactions at the facility, from being self-conscious about their own oral health problems, to distaste at others' eating behaviours.

CONCLUSIONS

Poor oral health had negative biological, behavioural and social impacts on daily activities and quality of life among some participants. However, changes at the organisation level may help to support participant QOL.

The Influence of Periodontal Disease on Oral Health Quality of Life in Patients with Cardiovascular Disease: A Cross-Sectional Observational Single-Center Study

Background and Objectives: Cardiovascular disease is a leading cause of global death with a rising prevalence and a heavy economic burden. Periodontal disease has been associated with cardiovascular diseases—including incident coronary heart disease, peripheral artery disease and ischemic stroke. The study evaluates the quality of life of patients with cardiovascular and periodontal disease from the point of view of oral health by using the short version of the Oral Health Impact Profile (OHIP-14) questionnaire. Materials and Methods: This study included a total of 221 patients (61.86 ± 15.03 years old) selected from the Emergency Hospital of Sibiu, Romania. The participants self-completed the OHIP-14 questionnaire and they benefited from an oral health examination conducted to assess the presence and the severity of periodontal disease. Results: Out of the 147 patients with cardiovascular disease, 77.5% had periodontal disease (32.6% stage I, 29.2% stage II, and 15.6% stage III and IV). The presence of periodontal disease was associated with a lower oral-health-related quality of life (p < 0.001, ANOVA) and with a higher OHIP-14 score in patients with cardiovascular disease (18.67 ± 8.17, p < 0.001 ANOVA). No significant difference was observed concerning patient sex and background; however, age, body mass index and the lack of an appropriate oral hygiene routine had a strong association with the individual quality of life. The general OHIP-14 score was higher in patients with periodontal disease and associated cardiovascular disease, the presence of both cardiovascular and periodontal disease being associated with a lower quality of life. Conclusions: By increasing the patients’ awareness to oral healthcare measures, better outcomes and improved oral-health-related quality of life could be observed.

Oral health related quality of life in long-term survivors of head and neck cancer compared to a general population from the seventh Tromsø study

Background

Both the incidence and survival rate of head and neck cancer (HNC) is increasing, making quality of life of HNC survivors an important issue.

Methods

In this cross-sectional study we compared the oral health related quality of life (OHRQoL) of long-term HNC survivors to that of a general population cohort from the seventh survey of the Tromsø study with the Oral Impact on Daily Performances questionnaire. Comparisons were done with frequency analyses and cross tabulation. We also assessed OHRQoL’s association to sociodemographic and oral health related variables in both cohorts as well as with cancer related variables in the HNC cohort with regression analyses.

Results

The HNC survivors had four times the risk of reporting problems with daily performances compared with the general population cohort. The ability to eat and enjoy food was most frequently affected in both cohorts. Moderate-poor self-rated dental health and general health as well as high frequency of dental visits were significantly associated with poorer OHRQoL. To have a history of oral or pharyngeal cancer was associated with more problems than having a history of laryngeal cancer.

Conclusions

Our study shows that HNC treatment is associated with a strong and lasting impairment of OHRQoL, highlighting the need to find less toxic, yet effective ways to treat the disease, and to provide easy access to expert dental care at all stages of the disease to minimize morbidity. Given the widespread side effects of cancer treatment, a multidisciplinary approach might be required to improve the OHRQoL of HNC survivors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02140-2.

Oral Health Behaviors and Oral Health-Related Quality of Life Among Dental Patients in China: A Cross-Sectional Study

BACKGROUND AND PURPOSE

Oral health plays an important role in overall health. But little is known about the problems with oral health behaviors and oral health-related quality of life (OHRQoL) among dental patients in China. This study aimed to investigate oral health behaviors and OHRQoL, as well as to examine the effects of oral health behaviors and associated factors on OHRQoL among dental patients.

METHODS

This cross-sectional study was conducted from June 2022 to July 2022 in the Department of Stomatology of the First Mobile General Hospital of Armed Police, Hebei, China. The five-item short form of the Oral Health Impact Profile (OHIP-5) was used to evaluate OHRQoL. Oral health behaviors were assessed by a 16-items oral health behavior questionnaire, and socio-demographic data were collected by a socio-demographic questionnaire. The t-test, one-way ANOVA, and multiple linear regression analysis were used to investigate the associations between the study variables.

RESULTS

186 participants were included in the study. The average age of the participants was 24.62 years (SD = 10.67). The mean OHIP-5 score was 4.31 (SD =3.35). Oral health-related quality of life differed significantly by smoking history, history of alcohol consumption, work status, economic pressure, self-rated oral health status, daily brushing frequency, dental caries condition, and whether they take the initiative to learn about oral health. Multivariate analysis found that the self-rated oral health status and work status were significantly associated with the OHIP scores. The retired people and those with poor self-rated oral health displayed poor OHRQoL.

CONCLUSION

In general, dental patients' oral health needs to be improved, the majority of patients reported practicing poor oral health behaviors, among which the retired population and hose with poor self-rated oral health showed poor OHRQoL. OHRQoL in dental patients is a complex issue associated with social and behavioral factors.

Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults' Oral Health in a Longitudinal Perspective

Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.

Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals

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.

'Differences in self-perceived OHRQoL between fully dentate subjects and edentulous patients depending on their prosthesis type, socio-demographic profile, and clinical features'

OBJECTIVES

This observational cross-sectional study aimed to evaluate and compare the oral health-related quality of life (OHRQoL) and clinical performance between dentate subjects and edentulous patients restored with conventional dentures or implant overdentures.

METHODS

85 edentulous patients were grouped as follows: Group-1 (CD): conventional denture wearers (n= 42), and Group-2 (IO): implant-retained overdenture wearers (n= 43). For the OHRQoL comparisons, a control group of subjects with a healthy natural dentition (Group-3, ND; n= 50) was included. Participants completed three validated questionnaires (OHIP-14sp, OHIP-20sp, and QoLIP-10). Socio-demographic data, prosthesis-related factors, clinical condition of the mouth, and patient subjective evaluations, were gathered. Descriptive and non-parametric probes were run (α= 0.05).

RESULTS

The ND group was the most unsatisfied (OHIP-14sp; p≤ 0.001). The OHIP-20sp attributed significantly worse Psychological disability (p= 0.029) and Handicap (p= 0.027) to CD wearers when compared to IO wearers. The CD group showed the significantly highest need for relining (p= 0.041), and the lowest retention (p= 0.011). The OHIP-14sp disclosed a significantly worse OHRQoL for those volunteers who had a job (p= 0.003), a basic education instead of a secondary one (p= 0.022), and no partner (p= 0.006).

CONCLUSIONS

The overall OHRQoL was comparable for both prosthodontic groups, being modulated by socio-demographic and prosthesis-related features. Nonetheless, CD wearers presented prosthetic complications more frequently.

[Quality of life related to oral health in adults in the city of Macas, Ecuador, 2021]

Objective

To determine the quality of life related to oral health in 18-99-year-old people in the city of Macas-Ecuador 2021.

Materials and methods

This was a descriptive, cross-sectional study following a quantitative approach. A total of 415 people over 18 years of age from Macas-Ecuador were evaluated. The instrument of measure was a OHIP-14 instrument composed of 7 dimensions, each of which had 2 questions. The study variables (sex, age, socioeconomic level, occupation) were analyzed using the Mann-Whitney U statistical test, with p <0.05 being considered as significant.

Results

There was a predominance of 63% of women. The dimension of "psychological distress" had the highest overall impact of all the items answered. Comparison of the OHIP-14 dimensional scores between men and women showed statistically significant differences in functional limitation and handicap with p = 0.012 and p = 0.036, respectively.

Conclusions

There is a relationship between quality of life and oral health among the inhabitants of the city of Macas-Ecuador. The OHIP-14 instrument showed the dimension of "psychological distress" to be the main factor of oral problems.

Physical Activity and Quality of Life of University Students, Their Parents, and Grandparents in Poland-Selected Determinants

Physical activity is one of the factors conditioning human health. Research shows a positive impact of regular physical activity on the quality of human life. The aim of the study was to determine the relationship between the physical activity of university students, their parents, and their grandparents, and the overall quality of their lives in individual domains (physical, mental, social, environmental), as well as the perceived state of health in relation to selected determinants. The research included 1001 participants, including 253 students related to physical culture and health promotion studying at the University of Szczecin (faculties: physical education, tourism and recreation, public health, sports diagnostics), and their 336 parents and 412 grandparents. Purposive sampling was used to outline the determinants of quality of life and family factors in physical activity. The diagnostic survey was carried out based on the standardized WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Statistically significant differences were shown in the studied generations regarding the assessment of quality of life and satisfaction with health in the physical, psychological, social, and environmental domains. The oldest generation gave the lowest assessment of quality of life and was the least satisfied with their health regarding particular domains. Female students were more satisfied with their health compared to grandmothers and grandfathers, whereas male students compared to mothers and fathers. Fathers achieved the highest scores in the psychological and social domains, but, in case of the latter, differences were found between mothers’ and fathers’ assessments. Intergenerational differences were found in quality of life and the assessment of health status. Current participation in broadly understood physical culture was often a result of positive attitudes towards physical education and doing sport in the past, which meant higher scores in the physical domain each time. The study demonstrated that taking up physical activity impacted the quality of life and assessment of health in the past and currently.

Physical ability and comorbidity and oral health among home-dwelling older people in the Finnish population

AIM

To examine how physical ability and comorbidity associate with oral health.

METHODS AND RESULTS

The study population comprised 161 individuals belonging to the Oral Health GeMS study. Outcome variables were the number of teeth with dental caries and deepened periodontal pockets and self-perceived oral health (pain/discomfort in mouth). Physical ability was determined by measuring limitations in daily activities (activities of daily living [ADL] and instrumental activities of daily life [IADL]) and the number of comorbidities with Functional Comorbidity Index (FCI). Poisson's multivariate regression model was used to estimate prevalence rate ratio (PRR) and their 95% confidence intervals (CI). The physical ability or number of comorbidities did not associate consistently with oral diseases, but ADL, IADL and FCI associated all with self-perceived oral discomfort (PRR: 1.74, CI: 1.01-3.03; PRR: 1.20, CI: 1.06-1.35; PRR: 1.20, CI: 1.05-1.36, respectively). Furthermore, IADL associated also with poor self-perceived oral health (PRR: 1.27, CI: 1.03-1.57).

CONCLUSION

Older people with impaired physical ability and comorbidities are more likely to have oral discomfort and have poorer self-perceived oral health.

Oral health is essential for quality of life in older adults: A Swedish National Quality Register Study

OBJECTIVE

To examine the relationship between QoL and oral health from two Swedish national quality registries (NQRs).

BACKGROUND

Oral health plays an important part in general health, which might also affect QoL. No studies have examined the relationships between QoL and oral health in late adulthood based on aggregated data from Swedish NQRs.

MATERIAL AND METHODS

Four NQRs incorporated the EQ-5D, which assesses 5 aspects of QoL: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Items from the Revised Oral Assessment Guide, obtained from the NQR Senior Alert, were used to identify older adults at risk for oral health issues.

RESULTS

A total of 510 individuals had data on all relevant variables. Analyses indicated significantly higher QoL for individuals without risk of oral health problems (M = -0.15 (SD = 1.01)), compared to those with risk (M = -0.75 (SD = 1.52)). Logistic regression analysis showed that lower QoL (OR = 0.69 (0.49, 0.97)), mental status (OR = 0.37 (0.19, 0.71)), lower self-rated health (OR = 0.59 (0.42, 0.85)) and higher age (OR = 1.07 (1.01, 1.13)) were significantly related to risk of oral health problems. Higher BMI (OR = 1.13 (0.99, 1.30)), living alone (OR = 2.37 (0.93, 6.06)) and more years of education (OR = 1.15 (1.01, 1.31)) were associated with higher risk of oral health problems.

CONCLUSIONS

Oral health is a significant component of quality of life in late adulthood. NQRs are of value for healthy ageing research in populations that may be underrepresented in research studies.

Oral health-related quality of life and associated factors among older people in short-term care

Objectives

It is well known that oral health status is associated with oral health‐related quality of life (OHRQoL) in the general population. The aim of this study was to describe and analyse OHRQoL among older people in short‐term care and its associated factors.

Materials and Methods

This cross‐sectional study included 391 older people in 36 short‐term care units. Data were collected via clinical oral assessments, questions about self‐perceived oral and general health, Katz Index of Activities of Daily Living (Katz‐ADL) and the Revised Oral Assessment Guide (ROAG). OHRQoL was measured using the Oral Health Impact Profile (OHIP‐14). Multivariate logistic regression models were applied in the analysis.

Results

Poor OHRQoL was reported by 34% of the older people. Associated factors were swallowing problems according to ROAG; quite poor/poor self‐perceived physical, psychological and oral health; and being a woman.

Conclusions

There is an association between OHRQoL and older people's self‐perceived health according to the OHIP‐14. This indicates the importance of early detection of oral health problems in frail older people and to assess both oral health and swallowing problems among older people in short‐term care.