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Idris S, Aghanwa S, O'Halloran J, Durey A, Slack-Smith L. Homebound oral care for older adults: A qualitative study of professional carers' perspectives in Perth, Western Australia. Gerodontology 2024; 41:94-100. [PMID: 37454389 DOI: 10.1111/ger.12704] [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: 06/21/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To examine professional support workers and case managers' (professional carers) perspectives of what promoted or compromised oral health care in homebound adults aged over 65 years in Perth, Western Australia and identify professional carers' need for support in this context. BACKGROUND Accessing dental services can be difficult to navigate and unaffordable for homebound older adults. Paid carers often play a substantial role in facilitating access to services yet there is limited qualitative evidence of the perspectives of these stakeholders. METHODS Given limited evidence in this area, this simple qualitative study was informed by constructivist grounded theory. Participants comprised 15 professional carers of homebound older adults. Transcripts were analysed to identify participant perceptions of key barriers and enablers to providing oral health care. RESULTS Barriers to clients accessing dental care included participants' uncertainty around navigating the dental system, low priority of oral health care, affordability and confusion around who was responsible to provide oral care. Enablers included participants supporting clients' autonomy around oral care, better integration of oral care into primary health care and education and opportunity for training for professional carers. CONCLUSION Ensuring oral health is part of primary health plans, clarifying roles and responsibilities around delivering oral health care to homebound older adults and training carers were key findings. Inter-sectoral collaboration between the dental and aged care sectors can benefit dental practitioners and professional carers in shared learning and has likely flow-on effects for homebound older adults.
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Affiliation(s)
- Safaa Idris
- UWA Dental School, University of Western Australia, Perth, WA, Australia
| | - Somto Aghanwa
- UWA Dental School, University of Western Australia, Perth, WA, Australia
| | | | - Angela Durey
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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Zhang M, Mi N, Ying Z, Lin X, Jin Y. Advances in the prevention and treatment of Alzheimer's disease based on oral bacteria. Front Psychiatry 2023; 14:1291455. [PMID: 38156323 PMCID: PMC10754487 DOI: 10.3389/fpsyt.2023.1291455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023] Open
Abstract
With the global population undergoing demographic shift towards aging, the prevalence of Alzheimer's disease (AD), a prominent neurodegenerative disorder that primarily afflicts individuals aged 65 and above, has increased across various geographical regions. This phenomenon is accompanied by a concomitant decline in immune functionality and oral hygiene capacity among the elderly, precipitating compromised oral functionality and an augmented burden of dental plaque. Accordingly, oral afflictions, including dental caries and periodontal disease, manifest with frequency among the geriatric population worldwide. Recent scientific investigations have unveiled the potential role of oral bacteria in instigating both local and systemic chronic inflammation, thereby delineating a putative nexus between oral health and the genesis and progression of AD. They further proposed the oral microbiome as a potentially modifiable risk factor in AD development, although the precise pathological mechanisms and degree of association have yet to be fully elucidated. This review summarizes current research on the relationship between oral bacteria and AD, describing the epidemiological and pathological mechanisms that may potentially link them. The purpose is to enrich early diagnostic approaches by incorporating emerging biomarkers, offering novel insights for clinicians in the early detection of AD. Additionally, it explores the potential of vaccination strategies and guidance for clinical pharmacotherapy. It proposes the development of maintenance measures specifically targeting oral health in older adults and advocates for guiding elderly patients in adopting healthy lifestyle habits, ultimately aiming to indirectly mitigate the progression of AD while promoting oral health in the elderly.
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Affiliation(s)
| | | | | | | | - Ying Jin
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang, China
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3
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Salmi R, Närhi T, Suominen A, Suominen AL, Lahti S. Oral health-related quality of life among home-dwelling older people with and without domiciliary care. Gerodontology 2023; 40:340-347. [PMID: 36178113 DOI: 10.1111/ger.12659] [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: 10/08/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
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.
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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
- City of Turku, 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
- Centre for Population Health, University of Turku and Turku University Hospital, Turku, Finland
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Tian F, Li J, Wu B, Xiao R, Liu J, Yu J, Liu L, Zhu R. Differences in the oral health status in hospitalised stroke patients according to swallowing function: A cross-sectional study. J Clin Nurs 2023; 32:1140-1147. [PMID: 35253288 DOI: 10.1111/jocn.16254] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/29/2021] [Accepted: 01/24/2022] [Indexed: 01/25/2023]
Abstract
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.
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Affiliation(s)
- Fang Tian
- Guizhou University of Traditional Chinese Medicine, School of Nursing, Guiyang City, China.,Guizhou Provincial People's Hospital, Guiyang City, China
| | - Juan Li
- Guizhou Provincial People's Hospital, Guiyang City, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Rong Xiao
- University of Maryland School of Nursing (Shady Grove Campus), Rockville, Maryland, USA
| | - Jiru Liu
- Guizhou University of Traditional Chinese Medicine, School of Nursing, Guiyang City, China
| | - Jie Yu
- Guizhou University of Traditional Chinese Medicine, School of Nursing, Guiyang City, China
| | - Lin Liu
- Guizhou Provincial People's Hospital, Guiyang City, China
| | - Rong Zhu
- Guizhou Provincial People's Hospital, Guiyang City, China
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5
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Morales C, Henríquez F, Muñoz S. Structural validity and reliability of the "Oral Health Assessment Tool" applied by speech-language therapists in a population of older Chilean people. BMC Oral Health 2023; 23:24. [PMID: 36650484 DOI: 10.1186/s12903-023-02725-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A good state of oral health allows people to communicate and eat. This topic is relevant in older people given its close relationship with their general health. At present, health challenges are directed at detecting and preventing oral disorders and are seen to exclusively by dentists, because the existing instruments can only be applied by them. However, speech-language therapists undergo similar training, which would allow them to collaborate in these processes. In this context, the Oral Health Assessment Tool (OHAT) is a detection instrument with good psychometric properties that is currently available for non-dental use. The objective of this study is the translation into Chilean Spanish of the OHAT and a structural validation of that version for application by these professionals. MATERIALS AND METHODS A mixed qualitative-quantitative study was carried out. The OHAT instrument was adapted to Chilean Spanish and subsequently subject to structural validity and evaluation of internal consistency reliability, as well as a valuation of its reproducibility in 286 older people (166 female, 120 male) from different health contexts. RESULTS The cultural adaptation of the instrument proved to be semantically consistent with the original instrument. Its application was considered to be speedy and simple in the pre-test. The confirmatory factor analysis evidenced the unidimensionality of the OHAT. In addition, the instrument shows good internal consistency and test-retest reliability. CONCLUSIONS The OHAT instrument was considered to possess adequate structural validity and test-retest reliability properties. Its usefulness in the context of oral health disorders of this population in Chile is discussed.
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Affiliation(s)
- Camilo Morales
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de La Salud, Universidad Católica de Temuco, Manuel Montt No. 056, Campus San Francisco, edificio B, Temuco, Chile.
| | - Felipe Henríquez
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de La Salud, Universidad Católica de Temuco, Manuel Montt No. 056, Campus San Francisco, edificio B, Temuco, Chile
| | - Sergio Muñoz
- Departamento de Salud Pública, Facultad de Medicina-CIGES, Universidad de Frontera, Temuco, Chile
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Henni SH, Skudutyte-Rysstad R, Ansteinsson V, Hellesø R, Hovden EAS. Oral health and oral health-related quality of life among older adults receiving home health care services: A scoping review. Gerodontology 2022; 40:161-171. [PMID: 35943193 DOI: 10.1111/ger.12649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/25/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To map the literature on subjective and objective oral health indicators and oral health-related quality of life (OHRQoL) in older adults receiving home health care services (HHCS). BACKGROUND The proportion of older adults in need of HHCS will increase in the coming years. Previous studies indicate that frail and dependent older adults are at increased risk for oral diseases, due to challenges with daily oral hygiene and regular access to dental services. MATERIALS AND METHODS Four databases were searched in November 2020 for relevant literature. Search terms included a comprehensive list of terms for adults 65 years or older receiving HHCS, clinical and subjective oral health indicators, and OHRQoL. The literature was reviewed based on inclusion and exclusion criteria. RESULTS Of the 3114 sources identified, 18 were included. Data on oral diseases and symptoms among older adults receiving HHCS were limited and heterogeneous. Overall, older adults often lacked some of their natural teeth and often had removable dentures that needed repair. In addition, plaque, caries, xerostomia, and chewing and swallowing problems were common among the population group. Data on OHRQoL were scarce and indicated a positive association with a higher number of present teeth, while decayed teeth, root remnants, and dry mouth had substantial negative impacts on the daily activities of older adults receiving HHCS. CONCLUSION This scoping review show that older adults above 65 years receiving HHCS generally have poor oral health status and that there is a knowledge gap regarding their OHRQoL.
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Affiliation(s)
- Silje Havrevold Henni
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Rasa Skudutyte-Rysstad
- Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway.,Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Vibeke Ansteinsson
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
| | - Ragnhild Hellesø
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Wilk A, LaSpina L, Boyd LD, Vineyard J. Perceived Oral Health Literacy, Behaviors, and Oral Health Care among Caregivers to the Homebound Population. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/10848223211008435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p < .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score ( M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score ( M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.
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Effectiveness of a Dental Intervention to Improve Oral Health among Home Care Recipients: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179339. [PMID: 34501925 PMCID: PMC8430536 DOI: 10.3390/ijerph18179339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 01/18/2023]
Abstract
We quantified the effectiveness of an oral health intervention among home care recipients. Seven German insurance funds invited home care recipients to participate in a two-arm randomized controlled trial. At t0, the treatment group (TG) received an intervention comprising an oral health assessment, dental treatment recommendations and oral health education. The control group (CG) received usual care. At t1, blinded observers assessed objective (Oral Health Assessment Tool (OHAT)) and subjective (Oral Health Impact Profile (OHIP)) oral health and the objective periodontal situation (Periodontal Screening Index (PSI)). Of 9656 invited individuals, 527 (5.5%) participated. In the TG, 164 of 259 (63.3%) participants received the intervention and 112 (43.2%) received an outcome assessment. In the CG, 137 of 268 (51.1%) participants received an outcome assessment. The OHAT mean score (2.83 vs. 3.31, p = 0.0665) and the OHIP mean score (8.92 vs. 7.99, p = 0.1884) did not differ significantly. The prevalence of any periodontal problems (77.1% vs. 92.0%, p = 0.0027) was significantly lower in the TG than in the CG, but the prevalence of periodontitis was not (35.4% vs. 44.6%, p = 0.1764). Future studies should investigate whether other recruitment strategies and a more comprehensive intervention might be more successful in improving oral health among home care recipients.
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Older people's experiences of oral health and assisted daily oral care in short-term facilities. BMC Geriatr 2021; 21:388. [PMID: 34176481 PMCID: PMC8237451 DOI: 10.1186/s12877-021-02281-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background Older people’s oral health has improved, and many retain their natural teeth throughout their life. However, their daily oral care can be more difficult because of compromised general health and the reduced capacity for self-care that often comes with old age. More knowledge is needed about how older people view their oral health and oral care. The aim of this study was to describe how older people in short-term care experience their oral health and daily oral care. Method A descriptive, qualitative study was performed through interviews with 14 older people (74–95 years) recruited from short-term care units in two Swedish regions. Data were analysed using inductive content analysis. Results The findings are described in one main category, three categories and nine sub-categories. The main category was Adapting to a changed oral condition while striving to retain independence. The first category, Wanting to manage daily oral care independently, contained three subcategories: Having always brushed my teeth without help, Being satisfied with my mouth and teeth, and Having to accept help if necessary. The second category, Acceptance of changes in oral condition, had three subcategories: Difficulty in chewing and swallowing, Difficulty with tooth brushing, and Not considering a dentist visit to be worth the cost. The third category, Barriers to receiving assistance from staff, had three subcategories: Staff lacking the time to help, Not wanting to be a burden, and Lack of confidence in staff’s knowledge. Conclusions The participants were generally satisfied with their oral health despite an expressed need for dental treatment. Daily oral care was something they wanted to manage themselves, and they had a strong desire to stay independent for as long as possible. Closer collaboration between dental and health care staff is necessary in order to implement clinical practice guidelines for oral health care and increase nursing staff’s attention towards older peoples’ oral health. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02281-z.
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Edman K, Holmlund A, Norderyd O. 'Caries disease among an elderly population-A 10-year longitudinal study'. Int J Dent Hyg 2021; 19:166-175. [PMID: 33523601 DOI: 10.1111/idh.12490] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 12/03/2020] [Accepted: 01/26/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the prevalence of dental caries and to identify risk factors for dental caries in an elderly population between 2008 and 2018. METHODS This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions 10 years apart to 273 individuals who were 65 and 75 years of age in 2008. The variables included were prevalence of dental caries as well as socioeconomic and socio-behavioural factors. RESULTS The number of teeth decreased in both age groups by a mean of 2 over the 10-year study period, but the prevalence of dental caries remained stable. Approximately, a quarter of the participants had caries lesions. Toothbrushing once a day or less was the factor most strongly correlated with dental caries lesions (OR: 3.82, 95% CI: 1.68-8.66, p = 0.001), followed by need for homecare (OR: 3.50, 95% CI: 1.55-7.93, p = 0.003) and interproximal cleaning less than once a day (OR: 2.65, 95% CI: 1.36-5.19, p = 0.004). CONCLUSIONS This longitudinal study revealed no increase in the prevalence of dental caries lesions, indicating that good oral health can be preserved among elderly people. The highest risk for dental caries lesions was among participants with inadequate oral hygiene routines (toothbrushing once a day or less and seldom using interproximal devices) and in need of help in daily living, emphasizing the importance of oral hygiene and collaboration between dental services and community-based health care.
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Affiliation(s)
- Kristina Edman
- Oral and Maxillofacial Surgery, Department of Surgical Sciences, Medical Faculty, Uppsala University, Uppsala, Sweden.,Center for Public Dental Services, Region Dalarna County, Falun, Sweden.,Center for Clinical Research, Uppsala University/Region Dalarna, Falun, Sweden
| | - Anders Holmlund
- Public Dental Services, Region Gävleborg County, Gävle, Sweden.,Center for Clinical Research, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Ola Norderyd
- Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden.,Centre for Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden
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Home care recipients have poorer oral health than nursing home residents: Results from two German studies. J Dent 2021; 107:103607. [PMID: 33607197 DOI: 10.1016/j.jdent.2021.103607] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To describe and compare the objective and subjective oral health of older nursing home residents and home care recipients, and to investigate whether oral health is associated with sociodemographic characteristics and the long-term care (LTC) setting. METHODS In two German studies, the oral health of 246 nursing home residents and 90 home care recipients aged ≥60 years was assessed objectively using the Oral Health Assessment Tool (OHAT) and subjectively using the Oral Health Impact Profile (OHIP). OHAT and OHIP scores were compared between both settings. Multivariable logistic regressions were applied to investigate whether oral health is associated with sex, age group, LTC grade, and LTC setting. RESULTS OHAT and OHIP mean scores in the home care setting were higher compared to the nursing home setting (OHAT: 3.13 vs. 1.28, p < .0001; OHIP: 7.81 vs. 2.15, p < .0001). The adjusted odds ratios for poor objective and subjective oral health for home care recipients vs. nursing home residents were 6.71 (95 % confidence interval 3.29-13.69) and 4.92 (2.77-8.76). No significant associations with sociodemographic characteristics were found. CONCLUSIONS Oral health was poor in both settings, but home care recipients were more likely to have poor oral health than nursing home residents. Interventions to improve oral health are needed in the nursing home setting and, even more importantly, in the home care setting. CLINICAL SIGNIFICANCE Oral health among older people in need of LTC is poor and should be improved. From a health policy perspective, home care recipients may need more attention.
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12
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Bellander L, Andersson P, Nordvall D, Hägglin C. Oral health among older adults in nursing homes: A survey in a national quality register, the Senior Alert. Nurs Open 2021; 8:1262-1274. [PMID: 33400398 PMCID: PMC8046056 DOI: 10.1002/nop2.743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/29/2020] [Accepted: 11/16/2020] [Indexed: 11/09/2022] Open
Abstract
Aim To investigate the extent to which the Revised Oral Assessment Guide–Jönköping (ROAG‐J) is used by nursing staff routinely in nursing homes in Sweden and to describe oral health status of the residents. Design An observational, retrospective register‐based study. Methods Data from different validated health assessments instruments, including ROAG‐J, for the period 2011–2016 were obtained from the Web‐based national quality register Senior Alert. The basis for the analyses was 190,016 assessments. Results About half of all residents had underwent at least one annual ROAG‐J assessment (2014–2016). During the period 2011–2016, 42% of the residents (n = 92,827) were registered to have oral health problems. Significantly more oral health problems were found for men and for those with younger age, poorer physical condition, neurophysiological problems, underweight, impaired mobility and many medications. In conclusion, poorer oral health was found for more care‐dependent individuals, which shows a need of preventive actions.
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Affiliation(s)
- Lisa Bellander
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Centre for Gerodontology, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Pia Andersson
- Department of Oral Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Dennis Nordvall
- Jönköping County Council Qulturum, Center for Development, Jönköping, Sweden
| | - Catharina Hägglin
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Centre for Gerodontology, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
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Nakamura J, Kitagaki K, Ueda Y, Nishio E, Shibatsuji T, Uchihashi Y, Adachi R, Ono R. Impact of polypharmacy on oral health status in elderly patients admitted to the recovery and rehabilitation ward. Geriatr Gerontol Int 2020; 21:66-70. [PMID: 33280240 DOI: 10.1111/ggi.14104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022]
Abstract
AIM The oral health status of elderly adults has implications for general health problems. Polypharmacy for elderly adults is associated with an increased risk of potentially inappropriate medicines and many adverse drug events; however, no report has shown that polypharmacy itself is associated with complex oral problems. This study aimed to determine the association between polypharmacy and oral health status in patients admitted to the recovery and rehabilitation ward. METHODS This cross-sectional study included 471 patients (age: 81.9 ± 7.7 years, women: n = 346). Oral health status was measured using the Oral Health Assessment Tool and poor oral health status was defined as a score of ≥3. Cases of patients taking six or more medications were defined as polypharmacy. Logistic regression analysis was performed to examine the relationship between polypharmacy and oral health status. Age, sex, body mass index, number of comorbidities, cognitive and motor functions, and potentially inappropriate medicines were set as confounding factors. RESULTS Using the Oral Health Assessment Tool, 51.0% (n = 240) of patients scored ≥3. The prevalence of patients with polypharmacy was 56.9% (n = 268). Polypharmacy was significantly associated with poor oral health status (odds ratio = 1.65, 95% confidence interval = 1.14-2.39, P = 0.007; adjusted odds ratio = 1.65, 95% confidence interval = 1.12-2.43, P = 0.011). CONCLUSIONS This study showed that polypharmacy was associated with poor oral health status. Focusing on the number of medications may be helpful in detecting oral problems. Geriatr Gerontol Int 2021; 21: 66-70.
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Affiliation(s)
- Junya Nakamura
- Department of Dentistry and Oral Surgery, Tokiwa Hospital, Hyogo, Japan.,Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Kazufumi Kitagaki
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Yuya Ueda
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Eri Nishio
- Department of Dentistry and Oral Surgery, Tokiwa Hospital, Hyogo, Japan
| | | | | | - Ryohei Adachi
- Department of Dentistry and Oral Surgery, Tokiwa Hospital, Hyogo, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
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14
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Tuuliainen E, Nihtilä A, Komulainen K, Nykänen I, Hartikainen S, Tiihonen M, Suominen AL. The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients. Scand J Caring Sci 2019; 34:938-947. [DOI: 10.1111/scs.12801] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 11/13/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Eveliina Tuuliainen
- Public Health Center Oral Health Care ServicesKuopio Finland
- Institute of Dentistry University of Eastern Finland Kuopio Finland
| | - Annamari Nihtilä
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Chief Dentist, Social and Health Services Espoo Finland
| | - Kaija Komulainen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition 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 Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
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15
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Reisine S, Schensul JJ, Li J, Grady J, Ha T, Lalla R. Gingivitis and plaque scores among residents of low-income senior housing. Gerodontology 2019; 37:2-10. [PMID: 31774201 DOI: 10.1111/ger.12451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/01/2019] [Accepted: 10/26/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this paper is to present Gingival Index (GI) and Plaque Scores (PS) of older and disabled adults living in low-income senior housing and their association with sociodemographic, health status and oral health behaviours. METHODS Participants were recruited from six low-income senior housing residences in Connecticut. Primary outcome measures were Gingival Index (GI) and Plaque Scores (PS). Surveys assessed sociodemographic characteristic, beliefs and behaviours. Logistic regression analysis was used to model the binary outcomes of probability of unfavourable GI status (>=0.34) and unfavourable PS (>=74%) against variables including demographic characteristics, oral hygiene behaviours and health status. RESULTS 331 participants volunteered for the study. Mean baseline GI was 0.38 (SD: 0.3), and mean PS was 71.7% (SD: 18%). Logistic regression showed that males were more likely to have higher GI and plaque scores than females. Those with less formal education were more likely to have worse GI scores and high PS compared to those with college educations. Those with lower incomes and those who rated their oral health poor/fair were more likely to have higher PS. CONCLUSION Participants had remarkably good gingival health regardless of relatively high PS. Males and less educated individuals should receive special attention when implementing oral hygiene interventions because of their relatively poor oral hygiene status.
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Affiliation(s)
- Susan Reisine
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, Farmington, Connecticut
| | | | - Jianghong Li
- Institute for Community Research, Hartford, Connecticut
| | - James Grady
- Department of Community Medicine, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Toan Ha
- Department of Community Medicine, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Rajish Lalla
- Division of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, Connecticut
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16
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Grönbeck Lindén I, Andersson P, Dahlin-Ivanoff S, Gahnberg L, Hägglin C. Development of an instrument to assess oral hygiene ability in older adults: The oral hygiene ability instrument. Gerodontology 2019; 37:19-27. [PMID: 31588600 DOI: 10.1111/ger.12437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 08/09/2019] [Accepted: 08/29/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To describe the development process of an instrument to assess the ability to manage daily oral hygiene and the cause of impaired oral hygiene. The instrument is initially aimed for use by the dental team in the ageing population. BACKGROUND Oral hygiene is an important component of oral health. Inability to manage oral hygiene combined with other risk factors often results in poor oral health and impaired quality of life. METHODS A guideline for instrument development was used during the construction of the instrument. The method included three phases: I. planning: the purpose and target group of the instrument were determined, and a literature review and qualitative focus-group study were conducted; II. construction: objectives were formulated, and a pool of items was built; and III. evaluation and validation, which included two pilot studies, interviews, item analyses and revision of the instrument. RESULTS The planning and construction phases resulted in an instrument with 47 items comprising three parts: (a) interview, (b) clinical examination and (c) observation of activities of daily living (oral hygiene). After two pilot studies, the instrument was found to have good content validity. Analyses of qualitative and quantitative data resulted in a reduction in the number of items to 33. CONCLUSION OHAI can be a valuable tool as a preventive method to identify older adults at risk of impaired oral health. However, the instrument needs further evaluation before wider use.
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Affiliation(s)
- Ingela Grönbeck Lindén
- Department of Gerodontology, Public Dental Service, Region Västra Götaland, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Pia Andersson
- Department of Oral Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Synneve Dahlin-Ivanoff
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lars Gahnberg
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Hägglin
- Department of Gerodontology, Public Dental Service, Region Västra Götaland, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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17
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Koistinen S, Olai L, Ståhlnacke K, Fält A, Ehrenberg A. Oral health and oral care in short-term care: prevalence, related factors and coherence between older peoples' and professionals' assessments. Scand J Caring Sci 2019; 33:712-722. [PMID: 30859599 PMCID: PMC7328680 DOI: 10.1111/scs.12667] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 12/19/2022]
Abstract
Background Oral health is important for well‐being and overall health. Older peoples′ oral health is well described in the residential care context, but remains understudied in short‐term care. Objective The aim of this study was to describe oral health, daily oral care and related factors among older people in short‐term care and to compare self‐perceived oral health with professional assessment. Materials and methods This cross‐sectional study included 391 older people in 36 short‐term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self‐perceived oral health. Self‐care ability was assessed with Katz Index of Activities of Daily Living (Katz‐ADL). Results Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self‐care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self‐perceived oral health. Conclusion Professionals’ assessments of oral health differed considerably from the older peoples′ own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self‐care (ADL). This study indicates that in order to improve older peoples′ oral health and oral care we need to provide person‐centred oral care and to develop a close collaboration between nursing and dental staff.
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Affiliation(s)
- Susanne Koistinen
- School of Education, Health and Social Studies, Dalarna University, Dalarna, Sweden.,School of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Lena Olai
- School of Education, Health and Social Studies, Dalarna University, Dalarna, Sweden.,Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Katri Ståhlnacke
- School of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.,Dental Research Department, Postgraduate Dental Education Center, Örebro, Sweden
| | - Anna Fält
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Anna Ehrenberg
- School of Education, Health and Social Studies, Dalarna University, Dalarna, Sweden
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18
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Srinivasan M, Delavy J, Schimmel M, Duong S, Zekry D, Trombert V, Gold G, Müller F. Prevalence of oral hygiene tools amongst hospitalised elders: A cross‐sectional survey. Gerodontology 2019; 36:125-133. [DOI: 10.1111/ger.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Joris Delavy
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Division of Gerodontology University of Bern Bern Switzerland
| | - Stephan Duong
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Dina Zekry
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Veronique Trombert
- Department of Internal Medicine and Rehabilitation (Trois‐Chêne) Geneva University Hospitals Geneva Switzerland
| | - Gabriel Gold
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
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19
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Trinks A, Hägglin C, Nordvall D, Rothenberg E, Wijk H. The impact of a national quality register in the analysis of risks and adverse events among older adults in nursing homes and hospital wards—a Swedish Senior Alert survey. ACTA ACUST UNITED AC 2018. [DOI: 10.1186/s40886-018-0077-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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20
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Ástvaldsdóttir Á, Boström AM, Davidson T, Gabre P, Gahnberg L, Sandborgh Englund G, Skott P, Ståhlnacke K, Tranaeus S, Wilhelmsson H, Wårdh I, Östlund P, Nilsson M. Oral health and dental care of older persons-A systematic map of systematic reviews. Gerodontology 2018; 35:290-304. [PMID: 30129220 DOI: 10.1111/ger.12368] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 07/01/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias. BACKGROUND Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing. METHODS A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps. RESULTS We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness. CONCLUSIONS There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
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Affiliation(s)
| | - Anne-Marie Boström
- Division of nursing, Department of Neurobiology, Care Sciences and Society, Karolinska institutet, Huddinge, Sweden.,Theme Aging, Karolinska University Hospital, Huddinge, Sweden.,Department of nursing, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Thomas Davidson
- Division of health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Pia Gabre
- Department of Preventive Dentistry, Public Dental Health, Uppsala County Council, Uppsala, Sweden.,Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Gahnberg
- Department of Preventive Dentistry, Public Dental Service, Region Västra Götaland, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunilla Sandborgh Englund
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Pia Skott
- Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Katri Ståhlnacke
- Public Dental Services, Region Örebro County, Sweden.,Faculty of Health and Medicine, Örebro University, Örebro, Sweden
| | - Sofia Tranaeus
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Inger Wårdh
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Pernilla Östlund
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Mikael Nilsson
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
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21
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Pham TAV, Nguyen TQ. Dental and periodontal problems of elderly people in Vietnamese nursing homes. Gerodontology 2018; 35:192-199. [PMID: 29856083 DOI: 10.1111/ger.12338] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the oral health status and treatment needs of elderly residents in Vietnamese nursing homes. METHODS This study was conducted among 360 men and 431 women with a mean age of 72.9 ± 9.1 years in three nursing homes in Ho Chi Minh City. Demographic information on education, duration of stay, chronic diseases, tooth brushing and tobacco use were obtained from medical records and a questionnaire. The oral health of participants was clinically assessed by a dental examiner using WHO criteria. Oral health status included estimates of coronal and root caries, periodontal disease, denture status and dental treatment needs. RESULTS Nearly all (90.1%) of the participants had natural teeth. The mean numbers of teeth with coronal or root decay were 5.8 ± 4.0 and 6.0 ± 4.2, respectively, and almost everyone required at least one restoration for coronal or root caries. Most of the participants with natural teeth had bleeding gingiva on probing, 26.2% had deep periodontal pockets, 96.5% needed oral hygiene improvement plus scaling and 20.3% required complex periodontal treatment. None of the edentulous participants had dentures, and 86.6% required new or repaired dentures. CONCLUSION The prevalence of untreated oral diseases is very high and the need for dental care extensive among the residents of government-administered long-term care facilities in Ho Chi Minh City.
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Affiliation(s)
- Thuy Anh Vu Pham
- Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Tam Quang Nguyen
- Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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22
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Fjeld KG, Eide H, Mowe M, Sandvik L, Willumsen T. A 1-year follow-up of a randomized clinical trial with focus on manual and electric toothbrushes' effect on dental hygiene in nursing homes. Acta Odontol Scand 2018; 76:257-261. [PMID: 29239260 DOI: 10.1080/00016357.2017.1416166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE A 2-month randomized clinical trial (RCT) study comparing electric and manual toothbrushes used by residents in nursing homes showed significant reduction in plaque score for both groups. The aim of this follow up study was to study if the effect sustained in a longer perspective when toothbrushes were used according to resident's own preference. MATERIALS AND METHODS One year after baseline of the RCT-study, 100 participants were re-examined. The simplified oral hygiene index (OHI-S) was used as outcome measure on dental plaque. RESULTS The mean age was 86.6, 78.1% had three or more medical diagnoses and 52.2% had moderate to severe cognitive impairment. The mean number of natural teeth was 18.8. After 1 year, mean plaque scores was significantly reduced within the population, from 1.2 to 0.7 (p < .001). A total of 46 participants preferred to use an electric toothbrush and 54 preferred manual. No significant difference in plaque score was found between electric and manual toothbrushes. CONCLUSION After 1 year, the improvement in dental hygiene from the RCT study sustained for users of both electric and manual toothbrush. Focus upon tooth brushing seems to be efficient and both manual and electric toothbrushes should be available in nursing homes.
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Affiliation(s)
- Katrine Gahre Fjeld
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University College of Southeast-Norway, Drammen, Norway
| | - Morten Mowe
- Medical Clinic, Oslo University Hospital and Inst. Clinical Medicine, University of Oslo, Oslo, Norway
| | - Leiv Sandvik
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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23
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Seleskog B, Lindqvist L, Wårdh I, Engström A, von Bültzingslöwen I. Theoretical and hands-on guidance from dental hygienists promotes good oral health in elderly people living in nursing homes, a pilot study. Int J Dent Hyg 2018; 16:476-483. [DOI: 10.1111/idh.12343] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/30/2022]
Affiliation(s)
- B Seleskog
- Public Dental Health Norrstrand Värmland; Karlstad Sweden
| | - L Lindqvist
- Preventive Dentistry Department; Public Dental Health Värmland; Karlstad Sweden
| | - I Wårdh
- Department of Dental Medicine; Academic Centre of Geriatric Dentistry; Karolinska Institutet; Stockholm Sweden
| | - A Engström
- Preventive Dentistry Department; Public Dental Health Värmland; Karlstad Sweden
| | - I von Bültzingslöwen
- Preventive Dentistry Department; Public Dental Health Värmland and Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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24
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Åstrøm AN, Ekbäck G, Ordell S, Lie SA, Gulcan F. Dental hygienist attendance and its covariates in an ageing Swedish cohort. Eur J Oral Sci 2017; 125:487-494. [PMID: 29083073 DOI: 10.1111/eos.12385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Delegation of tasks between professional groups is important to make health-care services accessible and effective for ageing people. Focussing on a Swedish 1942 birth cohort and guided by Andersen's Behavioral Model, this study assessed dental hygienist attendance from age 50 to age 70 and identified covariates at the population-averaged and person-specific levels. In 1992, a census of 50-yr-old subjects was invited to participate in a questionnaire survey. Of the 6,346 respondents, 3,585 completed follow-ups in 1997, 2002, 2007, and 2012. Multiple logistic regression analysis was conducted using a marginal model and a random intercept model. Cochran's Q test revealed that significantly more respondents confirmed dental hygienist attendance in 2012 than in 1992 (57.2% in 2012 vs. 26.0% in 1992). Population-averaged ORs for dental hygienist attendance across time were 3.5 at age 70 yr compared with age 50 yr (baseline); 2.0 if being a regular rather than an irregular dental attendee; and 0.7 if being of non-native origin compared with native origin. The corresponding person-specific ORs were 8.9, 3.2, and 0.5. Consistent with Andersen's Behavioral Model, predisposing, enabling, and need-related factors were associated with dental hygienist attendance at population-averaged and person-specific levels. This has implications for promoting dental hygienist attendance among ageing people.
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Affiliation(s)
- Anne N Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Gunnar Ekbäck
- Örebro County Council, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Sven Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden
| | - Stein A Lie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Ferda Gulcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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25
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Maramaldi P, Cadet T, Burke S, LeCloux M, White E, Kinnunen TH, Kalenderian E. Administrators' Perceptions of Oral Health Care and Cancer Screening in Long-Term Care Nursing Facilities. J Appl Gerontol 2017; 38:1391-1420. [PMID: 29165003 DOI: 10.1177/0733464817732517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
An estimated 1.7 million adults in the United States more than the age of 65 reside in long-term care nursing facilities (LTCNFs), and only 17% of them receive dental care. More than 83% of LTCNF residents require assistance with oral care. Adequate dental care is a preventative behavior for oral cancer. Adults more than age 65 will account for 60% of oral cancer-related deaths, despite an 80% cure rate for early diagnosis. This study sought to expand knowledge of the perceived benefits, barriers, and ability to perform or provide for oral health care and oral cancer screening as reported by Administrators and Directors of Nursing in LTCNFs. Findings indicate that competing demands for resources make oral health a low priority issue and low knowledge about oral cancer risk among nursing home residents, family members, and staff is a barrier. Potential interventions suggested by participants are discussed.
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26
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Oral Health Status of Older Adults in Sweden Receiving Elder Care: Findings From Nursing Assessments. Nurs Res 2017; 65:215-23. [PMID: 27124257 DOI: 10.1097/nnr.0000000000000158] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Frail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life. OBJECTIVE The aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care. METHODS Data were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care. RESULTS Individuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p < .01); at the subsequent assessment, gender differences in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006) were observed. DISCUSSION Most participants had good oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.
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Derblom C, Hagman-Gustafsson ML, Gabre P. Older people's description of factors that facilitate and impede regular dental care - a qualitative interview study. Int J Dent Hyg 2016; 15:313-320. [PMID: 27868346 DOI: 10.1111/idh.12263] [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: 10/25/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to achieve an understanding of older people's view of the benefits of regular dental care and investigate factors that facilitate and impede regular dental care. METHODS A qualitative research method was used. To gain a deeper understanding of the elderly people's views, individual interviews were conducted. Fifteen respondents, eleven women and four men aged between 65 and 95, participated, all recruited from senior social centres. All interviews were tape-recorded and transcribed verbatim, and the content analysis method was then used. Meaning units were identified and condensed into codes which were labelled and grouped into categories and subcategories. RESULTS Findings were grouped into three categories: experiences of dental care, obstacles and facilitators to dental care and about oral health and responsibility. The elderly had experience of both regular and irregular dental care. Obstacles to visiting dental services included high costs and complicated dental insurance, other practical obstacles, lack of confidence in dentistry and seeing no benefits of dental care at their age. Views of the importance of oral health varied, and some people thought poor teeth were shameful. Some expressed that oral health was your own responsibility, while others thought that oral health was the responsibility of the dental services. CONCLUSIONS Several factors which hamper regular dental care have been identified, and taken together, these obstacles often became unsurmountable. However, individuals taking their own responsibility for their dental status and dental services making certain adaptations, both encourage people to seek regular dental care.
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Affiliation(s)
- C Derblom
- Public Dental Health, Uppsala County Council, Uppsala, Sweden
| | | | - P Gabre
- Public Dental Health, Uppsala County Council, Uppsala, Sweden.,Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Derblom C, Hagman-Gustafsson ML, Gabre P. Dental attendance patterns among older people: a retrospective review of records in public and private dental care in Sweden. Int J Dent Hyg 2016; 15:321-327. [DOI: 10.1111/idh.12265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2016] [Indexed: 11/26/2022]
Affiliation(s)
- C Derblom
- Public Dental Health; Uppsala County Council; Uppsala Sweden
| | | | - P Gabre
- Public Dental Health; Uppsala County Council; Uppsala Sweden
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Olerud E, Hagman-Gustavsson ML, Gabre P. Oral health status in older immigrants in a medium-sized Swedish city. SPECIAL CARE IN DENTISTRY 2016; 36:328-334. [PMID: 27458173 DOI: 10.1111/scd.12195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of the study was to investigate oral health and oral care habits among older immigrants to Sweden from countries outside the Nordic region. METHOD Participants ≥60 years of age from senior social centers for immigrants were invited to attend oral examinations. Data was collected on the number of teeth, dentures, caries, periodontal status, saliva secretion, and plaque scores. Participants also described their general health and oral care habits. RESULTS Fourteen men and 28 women, median age 71.5 years, participated. Seventeen percent were edentulous, women often than men. Three out of four had caries and 63% had gingival bleeding. Two-thirds brushed their teeth twice per day and 60% had visited dental services in the last 2 years. CONCLUSION The group had a high prevalence of oral diseases and discomfort. They used dental services and brushed their teeth less frequently than Swedish populations of the same age.
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Affiliation(s)
- Eva Olerud
- Public Dental Health, Uppsala County Council, Sweden
| | | | - Pia Gabre
- Public Dental Health, Uppsala County Council, Sweden. .,Department of Cariology, Institute of Odontology, The Sahlgrens, ka Academy, University of Gothenburg, Gothenburg, Sweden.
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30
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Åstrøm AN, Gülcan F, Ekbäck G, Ordell S. Long-term healthy lifestyle patterns and tooth loss studied in a Swedish cohort of middle-aged and older people. Int J Dent Hyg 2015; 13:292-300. [PMID: 26294114 DOI: 10.1111/idh.12173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2015] [Indexed: 02/02/2023]
Abstract
UNLABELLED The promotion of a healthy lifestyle has become an issue of public health importance in the context of ageing populations and increasing prevalence of chronic diseases. OBJECTIVE (i) To estimate changes in use of fluoridated tooth paste, use of tooth picks, smoking and alcohol consumption and (ii) to examine whether experience with incident or prevalent tooth loss predict healthy lifestyle transitions from age 50 to 70. METHOD In 1992, 6346 individuals born in 1942 agreed to participate in a prospective cohort study and 3585 completed follow-up questionnaires in 1997, 2002, 2007 and 2012. Statistical analyses were conducted by chi-square statistics, Cochran's Q and logistic regression. RESULTS In total, 15.7% and 74.0% reported incident (tooth loss only in 2012) and prevalent tooth loss (tooth loss in 1992 and 2012). Significant differences occurred between the 1992 and 2012 prevalence of using toothpicks (from 48.3% to 69.1%), smoking (from 26.9% to 10.1%) and alcohol consumption (from 41.5% to 50.5%), 29% and 15.6% increased use of toothpicks and alcohol consumption, whereas 15.5% stopped daily smoking. Increased use of fluoridated tooth paste, smoking cessation and failure to increase use of toothpicks was associated with prevalent tooth loss between age 50 and 70. CONCLUSION This study revealed positive and negative trends in oral health behaviours over a 20-year period in persons aged 50 at baseline. Mixed support was obtained for the assumption that oral health promoting lifestyle transitions follow experience with tooth loss. Older people with tooth loss experience could benefit from targeted counselling aimed at coping with oral diseases.
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Affiliation(s)
- A N Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - F Gülcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - G Ekbäck
- Örebro County Council, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - S Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden
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31
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Jensen O, Moberg Sköld U, Birkhed D, Gabre P. Self-reported changes in using fluoride toothpaste among older adults in Sweden: an intervention study. Acta Odontol Scand 2015; 73:48-56. [PMID: 25183252 DOI: 10.3109/00016357.2014.949847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the possibility of increasing knowledge about the caries-reducing effects of fluoride (F) toothpaste and to increase the use of F toothpaste among older adults through an intervention. MATERIALS AND METHODS 63-67-year-olds in Sweden, who 2 years earlier had answered a questionnaire about their knowledge of F toothpaste, toothbrushing and toothpaste habits and who had shown less favourable habits with regard to toothpaste use, were invited to participate. The 20-min intervention, performed at a Public Dental Clinic, was implemented by a dental hygienist (author OJ) and consisted of individual information and instruction on the use of F toothpaste. The questionnaire was repeated 4 months after the intervention and a population in another city in Sweden served as control. RESULTS In the intervention group, 68 individuals responded and 151 in the control group. Knowledge of the benefits of F toothpaste in the intervention group had improved between the times of the first and second questionnaires, but the same effect was also noted in the control group. After the intervention, a clear improvement concerning the use of F toothpaste was reported: the individuals brushed for a longer time, used more toothpaste and used less water during and after brushing. In the control group, there were no changes of habits between the first and second occasions. CONCLUSION Individually-based interventions performed by a dental hygienist had a positive effect on changing the way older adults used F toothpaste.
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Affiliation(s)
- Olga Jensen
- Public Dental Service, Västra Götaland Region , Stenungsund , Sweden
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Information for physicians and pharmacists about drugs that might cause dry mouth: a study of monographs and published literature. Drugs Aging 2014; 31:55-65. [PMID: 24293180 DOI: 10.1007/s40266-013-0141-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Over three-quarters of the older population take medications that can potentially cause dry mouth. Physicians or pharmacists rarely inform patients about this adverse effect and its potentially severe damage to the teeth, mouth and general health. OBJECTIVES The objectives of this study were to (1) identify warnings in the literature about dry mouth associated with the most frequently prescribed pharmaceutical products in Canada; and (2) consider how this information might be obtained by physicians, pharmacists and patients. METHODS Monographs on the 72 most frequently prescribed medications during 2010 were retrieved from the Compendium of Pharmaceuticals and Specialties (CPS, a standard drug information reference for physicians and pharmacists), the National Library of Medicine's 'DailyMed' database, directly from the manufacturers, and from a systematic search of biomedical journals. RESULTS The CPS provided monographs for 43% of the medications, and requests to manufacturers produced the remaining monographs. Mentions of dry mouth were identified in 61% of the products (43% amongst CPS monographs; an additional 43% amongst manufacturers' monographs; 7% in the DailyMed database and 7% from biomedical journals); five medications had contradictory reports in different monographs. CONCLUSION Nearly two-thirds (61%) of the most commonly prescribed medications can cause dry mouth, yet warnings about this adverse effect and its potentially serious consequences are not readily available to physicians, pharmacists, dentists or patients.
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Fjeld KG, Mowe M, Eide H, Willumsen T. Effect of electric toothbrush on residents' oral hygiene: a randomized clinical trial in nursing homes. Eur J Oral Sci 2014; 122:142-8. [DOI: 10.1111/eos.12113] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2013] [Indexed: 11/26/2022]
Affiliation(s)
| | - Morten Mowe
- Medical Clinic; Institution of Clinical Medicine; Oslo University Hospital; University of Oslo; Oslo Norway
| | - Hilde Eide
- Faculty of Health Sciences; Buskerud University College; Drammen Norway
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Niesten D, van Mourik K, van der Sanden W. The impact of frailty on oral care behavior of older people: a qualitative study. BMC Oral Health 2013; 13:61. [PMID: 24175989 PMCID: PMC3819177 DOI: 10.1186/1472-6831-13-61] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Frailty has been demonstrated to negatively influence dental service-use and oral self-care behavior of older people. The aim of this study was to explore how the type and level of frailty affect the dental service-use and oral self-care behavior of frail older people. METHODS We conducted a qualitative study through 51 open interviews with elders of varying frailty in the East-Netherlands, and used a thematic analysis to code transcripts, discussions and reviews of the attributes and meaning of the themes to the point of consensus among the researchers. RESULTS Three major themes and five sub-themes emerged from our analyses. The major themes indicate that frail elders: A) favor long-established oral hygiene routines to sustain a sense of self-worth; B) discontinue oral hygiene routines when burdened by severe health complaints, in particular chronic pain, low morale and low energy; and C) experience psychological and social barriers to oral health care when institutionalized. The subthemes associated with the discontinuation of oral care suggest that the elders accept more oral pain or discomfort because they: B1) lack belief in the results of dental visits and tooth cleaning; B2) trivialize oral health and oral care in the general context of their impaired health and old age; and B3) consciously use their sparse energy for priorities other than oral healthcare. Institutionalized elderly often discontinue oral care because of C1) disorientation and C2) inconveniencing social supports. CONCLUSION The level and type of frailty influences people's perspectives on oral health and related behaviors. Frail elders associate oral hygiene with self-worth, but readily abandon visits to a dentist unless they feel that a dentist can relieve specific problems. When interpreted according to the Motivational Theory of Life Span Development, discontinuation of oral care by frail elderly could be viewed as a manifestation of adaptive development. Simple measures aimed at recognizing indicators for poor oral care behavior, and providing appropriate information and support, are discussed.
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Affiliation(s)
- Dominique Niesten
- Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, PO Box 9101HB, Nijmegen, The Netherlands.
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Jensen O, Gabre P, Sköld UM, Birkhed D, Povlsen L. ‘I take for granted that patients know’ - oral health professionals' strategies, considerations and methods when teaching patients how to use fluoride toothpaste. Int J Dent Hyg 2013; 12:81-8. [DOI: 10.1111/idh.12041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
- O Jensen
- Public Dental Service; Västra Götaland Region; Stenungsund Sweden
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - P Gabre
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Department of Preventive Dentistry; Public Dental Health; Uppsala County Council; Uppsala Sweden
| | - UM Sköld
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - D Birkhed
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - L Povlsen
- Nordic School of Public Health NHV; Gothenburg Sweden
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Strömberg E, Holmèn A, Hagman-Gustafsson ML, Gabre P, Wårdh I. Oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living. Acta Odontol Scand 2013; 71:771-7. [PMID: 23146109 DOI: 10.3109/00016357.2012.734398] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To describe the oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living. MATERIALS AND METHODS A total of 302 selected persons in three counties in Sweden over 65 years of age and in need of daily support from society participated in the study. Half of the participants had moderate needs of support, defined as supportive care of 15-50 h per month and half had substantial needs of supportive care, i.e. 3-times a day with a night overview. An oral examination was performed and structured questions were asked about general health and living conditions, medication, oral care routines and quality-of-life, using the instrument GOHAI (Geriatric Oral Health Assessment Instrument). RESULTS Cardiovascular disease was common and an average of seven prescription drugs was used. More than half of the participants had dentures. The strongest correlation with GOHAI was the total number of teeth. There was a significant difference between individuals with moderate and substantial needs according to GOHAI, irrespective of gender. More elderly people with substantial needs of support had low GOHAI values. Decayed teeth, DT/T, root remnants and dry mouth were negatively correlated to GOHAI among individuals with substantial needs. CONCLUSIONS This study found that elderly homebound individuals with substantial needs of supportive care had a lower quality-of-life than elderly homebound individuals with moderate needs of supportive care, although both medical and odontological variables were similar in the groups.
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Affiliation(s)
- Ella Strömberg
- Public Dental Health, Gävleborg County Council, Gävle, Sweden.
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Weijenberg RAF, Lobbezoo F, Knol DL, Tomassen J, Scherder EJA. Increased masticatory activity and quality of life in elderly persons with dementia--a longitudinal matched cluster randomized single-blind multicenter intervention study. BMC Neurol 2013; 13:26. [PMID: 23496988 PMCID: PMC3615955 DOI: 10.1186/1471-2377-13-26] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 03/13/2013] [Indexed: 12/14/2022] Open
Abstract
Background Worldwide, millions of people are suffering from dementia and this number is rising. An index of quality of life (QoL) can describe the impact a disease or treatment has on a person’s wellbeing. QoL comprises many variables, including physical health and function, and mental health and function. QoL is related to masticatory ability and physical activity. Animal studies show that disruption of mastication due to loss of teeth or a soft diet leads to memory loss and learning problems. Since these are common complaints in dementia, it is hypothesized that improvement of masticatory function and normalization of diet consistency can increase QoL in elderly persons suffering from dementia. Therefore, the goal of the present study is to examine whether an increase in masticatory activity, achieved by increased food consistency and enhancement of masticatory function through improved oral health care has a positive effect on QoL, including cognition, mood, activities of daily living (ADL), and circadian rhythm in elderly persons with dementia. Methods and design The described study is a prospective longitudinal matched cluster randomized single-blind multicenter study. Participants are elderly persons living in the Netherlands, suffering from dementia and receiving psychogeriatric care. An intervention group will receive improved oral health care and a diet of increased consistency. A control group receives care as usual. Participants will be assessed four times; outcome variables besides QoL are cognition, mood, independence, rest-activity rhythm, blood pressure, and masticatory function. Discussion This research protocol investigates the effect of an intervention executed by daily caregivers. The intervention will increase masticatory activity, which is achieved by three different actions, (providing oral health care, increasing food consistency, or a combination of both). There is a certain amount of variety in the nature of the interventions due to local differences in nursing homes. This might be a scientific weakness in the study design; however, a practical implementation of any findings will be subject to the same factors, making this study design clinically relevant. Trial registration NTR1561
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Al-Haboubi M, Zoitopoulos L, Beighton D, Gallagher J. Oral health patterns of independently living dentate older people: a cross-sectional survey of dental attendees in south-east London. Gerodontology 2013; 31:265-73. [PMID: 23347075 DOI: 10.1111/ger.12033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND The oral health needs of older adults present increasing challenges to dental services. OBJECTIVES To examine the clinical oral health status of dentate older people living in the community and attending dental services. METHODS One hundred and eighty-six dentate adults, aged ≥60 years, underwent clinical examination (DMFS, Plaque and Gingival Indexes), salivary analysis and completed a questionnaire. RESULTS Participants had an average of 21.4 (±6.2) teeth present and 1.2 (±3.0) decayed, 51.0 (±28.8) missing and 32.6 (±20.5) restored surfaces. Individuals living in the most deprived areas had significantly lower numbers of teeth than those in the least deprived areas (19.1 ± 7.5 cf 23.8 ± 4.1; p < 0.001). Whilst there were no significant differences in DMFS score, residents in the most deprived areas had significantly more missing and fewer filled surfaces than those in the least deprived areas (p = 0.001 and p < 0.001, respectively). Participants with ≥21 teeth (64%) had lower plaque scores, fewer decayed root surfaces, higher stimulated saliva flow rates and lower salivary lactobacilli and yeast counts than those with <21 teeth (p < 0.05 for all). CONCLUSIONS The findings highlight differences in clinical oral health by age and deprivation status and underline the importance of saliva and retaining a functional dentition.
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Affiliation(s)
- Mustafa Al-Haboubi
- Unit of Oral Health Services Research and Dental Public Health, King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, London, UK
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Gabre P, Moberg Sköld U, Birkhed D. Simplified methods of topical fluoride administration: effects in individuals with hyposalivation. SPECIAL CARE IN DENTISTRY 2012; 33:111-7. [PMID: 23600981 DOI: 10.1111/scd.12002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Pia Gabre
- Public Dental Health; Uppsala County Council; Uppsala; Sweden
| | - Ulla Moberg Sköld
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
| | - Dowen Birkhed
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
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Olerud E, Hagman-Gustafsson ML, Gabre P. Oral status, oral hygiene, and patient satisfaction in the elderly with dental implants dependent on substantial needs of care for daily living. SPECIAL CARE IN DENTISTRY 2012; 32:49-54. [DOI: 10.1111/j.1754-4505.2012.00236.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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