1
|
Brandt O, Julkunen L, Saarela RK, Hiltunen K, Mäntylä P. Clinically estimated signs of hyposalivation in older adult residents of long-term care. Gerodontology 2024. [PMID: 39016338 DOI: 10.1111/ger.12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE To assess whether the estimation of clinical signs of hyposalivation is applicable in recognising long-term care facility (LTCF) residents with poor oral health, and which individual characteristics are important in that respect. BACKGROUND A common inconvenience among older adults, dry mouth, particularly hyposalivation, can cause many complications, such as greater susceptibility to root caries and oral infections, and it can lead to further deterioration of oral health. However, very little is known about the association of clinically assessed signs of hyposalivation with the oral health status of LTCF residents. METHODS The study sample comprised 362 individuals (dentate n = 266, edentate n = 96) aged 65 or older. The examinations included a questionnaire and clinical oral examination. Participants were categorised into three groups based on clinically assessed oral dryness: normal salivation (n = 83, 22.9%), lower salivation (n = 182, 50.3%) and dry mouth (n = 97, 26.8%). The association between signs of dry mouth with aspects to oral health was evaluated and further tested with logistic regression analysis. RESULTS The signs of oral dryness were observed among females, those with dementia, and those with longer stays in the current facility. Root caries (odds ratio, OR 1.3) and diagnosis of periodontitis (OR 4.1), together with several individual periodontal parameters, as well as having less than ten occluding pairs of natural teeth (OR 3.5) were associated with dry mouth. Edentate participants showed an increased likelihood of having dry mouth with advancing age, and lesions on the lips were associated with dry mouth with OR 3.0. CONCLUSION Clinical estimation of signs of oral dryness can be a useful adjunct in evaluating the oral health status of dentate LTCF residents. Poor oral health was a frequent finding, especially among dentate LTCF residents with signs of dry mouth.
Collapse
Affiliation(s)
- Otto Brandt
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Lina Julkunen
- Oral and Maxillofacial Diseases Outpatient Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Riitta Kt Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| |
Collapse
|
2
|
Bakker MH, de Smit MJ, Valentijn A, Visser A. Oral health assessment in institutionalized elderly: a scoping review. BMC Oral Health 2024; 24:272. [PMID: 38402181 PMCID: PMC10893687 DOI: 10.1186/s12903-024-04025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.
Collapse
Affiliation(s)
- M H Bakker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
| | - M J de Smit
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Valentijn
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- Department of Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
3
|
Kimble R, Papacosta AO, Lennon LT, Whincup PH, Weyant RJ, Mathers JC, Wannamethee SG, Ramsay SE. The Relationships of Dentition, Use of Dental Prothesis and Oral Health Problems with Frailty, Disability and Diet Quality: Results from Population-Based Studies of Older Adults from the UK and USA. J Nutr Health Aging 2023; 27:663-672. [PMID: 37702340 DOI: 10.1007/s12603-023-1951-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/16/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES This study examined the relationships of dental status, use and types of dental prothesis and oral health problems, individually and combined, with diet quality, frailty and disability in two population-based studies of older adults. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Men form the British Regional Heart Study (BRHS) (aged 85±4 years in 2018; n=1013) and Men and Women from the Health, Aging, and Body Composition (HABC) Study (aged 75±3 years in 1998-99; n=1975). MEASUREMENTS Physical and dental examinations and questionnaires were collected with data available for dental status, oral problems related to eating, diet quality, Fried frailty phenotype, disability based on mobility limitations, and activities of daily living (ADL). The associations of dental status and oral health problems, individually and combined, with risk of frailty and disability were quantified. The relationship with diet quality was also assessed. RESULTS In the BRHS, but not HABC Study, impaired natural dentition without the use of dentures was associated with frailty independently. This relationship was only established in the same group in those with oral problems (OR=3.24; 95% CI: 1.30-8.03). In the HABC Study, functional dentition with oral health problems was associated with greater risk of frailty (OR=2.21; 95% CI: 1.18-4.15). In both studies those who wore a full or partial denture in one or more jaw who reported oral problems were more likely to have disability. There was no association with diet quality in these groups. CONCLUSION Older adults with impaired dentition even who use dentures who experience self-report oral problems related to eating may be at increased risk of frailty and disability. Further research is needed to establish whether improving oral problems could potentially reduce the occurrence of frailty and disability.
Collapse
Affiliation(s)
- R Kimble
- Dr. Rachel Kimble, Institute of Health and Society, University of the West of Scotland, Technology Ave, Blantyre, Glasgow G72 0LH, United Kingdom, E-mail:
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Impact of an Oral Hygiene Intervention in People with and without Dementia on Oral Health Parameters-Results from the Oral Health, Bite Force, and Dementia (OrBiD) Pilot Study. J Clin Med 2022; 11:jcm11051356. [PMID: 35268447 PMCID: PMC8911423 DOI: 10.3390/jcm11051356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/20/2022] Open
Abstract
This study aimed to assess the influence of an oral hygiene intervention on oral health, depending on the degree of dementia. A clinical evaluation of oral health parameters (index of decayed, missing, and filled teeth (DMFT-index), periodontal screening index (PSI), oral hygiene index (OHI), and bleeding on probing (BOP)) was performed in 120 subjects assigned to five groups, based on the mini mental state examination (MMSE) at baseline and after 12 months. Each MMSE group (no dementia (noDem, MMSE 28–30), mild cognitive impairment (mCI, MMSE 25–27), mild dementia (mDem, MMSE 18–24), moderate dementia (modDem, MMSE 10–17), and severe dementia (sDem, MMSE ≤ 9)) was split into control (no intervention) and experimental groups (intervention on oral hygiene: increased frequency, daily usage of high-fluoride toothpaste). In total, 99 out of 120 subjects were included in the analysis. The dropout rate was high in subjects with modDem and sDem due to death. In subjects with noDem, mCI, and mDem, no changes in the DMFT were found, but improvements in the OHI, BOP, and PSI were observed. Subjects with modDem or sDem demonstrated a deterioration in DMFT; however, in these patients, OHI improved in all control and experimental groups, BOP improved in the experimental group only, and PSI did not improve at all. The scope of improving oral health parameters by increasing the recall frequency and by continuously using high fluoride toothpaste is at its limits in people with severe dementia. Multidimensional approaches should be sought to improve the oral health of vulnerable older patients.
Collapse
|
5
|
Effects of a Caregiver Training Program on Oral Hygiene of Alzheimer's Patients in Institutional Care. J Am Med Dir Assoc 2021; 22:1429-1434.e1. [PMID: 33571464 DOI: 10.1016/j.jamda.2020.12.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/22/2020] [Accepted: 12/31/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To investigate the effects of a caregiver training program on the oral hygiene of caregivers and patients with Alzheimer's disease (AD) and to identify program components and parameters for accurate assessment of outcomes. DESIGN Single-blinded prospective cohort study. SETTING AND PARTICIPANTS Patients with AD and caregivers in nursing homes in the Greater Zhengzhou Area, China. METHODS Initially 168 AD patient/caregiver pairs were recruited and randomly assigned to control, limited training, and comprehensive training groups. The mini-mental state examination, global deterioration scale, and Katz activities of daily living scale were conducted for patients with AD. Information on participants' oral hygiene habits and general oral health was collected. The modified Quigley-Hein Plaque Index (PI) and Gingival Index (GI) were used to assess oral hygiene and gingival health. Intervention included (1) an educational video showing the role of dental plaque and the modified Bass technique; and (2) caregivers practicing toothbrushing on themselves and patients with AD under professional guidance. Changes in oral hygiene and correlations between patient PI/GI and caregiver PI/GI were analyzed. RESULTS After 6 weeks, complete data for 146 AD patient/caregiver pairs were collected. Before enrollment, most patients with AD had very poor oral hygiene. Compared with controls and limited training, only comprehensive training was able to achieve steady reduction in PI and GI scores in patients with AD, which still fell short of desirable levels (PI: 2.46 ± 0.52, GI: 1.24 ± 0.24, week 6). PI and GI scores in caregivers saw steady improvement only through comprehensive training (PI: 1.41 ± 0.38, GI: 0.88 ± 0.19, week 6). Number of training sessions had the greatest influence on both patient PI and GI scores. CONCLUSIONS AND IMPLICATIONS Comprehensive caregiver training on toothbrushing skills is effective in improving the oral hygiene of caregivers and patients with AD in nursing homes. Additional evidence is needed to establish the optimal program structure.
Collapse
|
6
|
Simões ALS, Oliva Filho A, Hebling E. Signs for Early Detection of Dysphagia in Older Adults with Severe Alzheimer's Disease. J Nutr Health Aging 2020; 24:659-664. [PMID: 32510120 DOI: 10.1007/s12603-020-1382-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of this study was to detect signs of dysphagia in older adults with and without Alzheimer's disease (AD). STUDY DESIGN A cross-sectional study. SETTING AND PARTICIPANTS A total of 280 institutionalized older adults (with AD = 145; without AD = 135), aged > 70 years, with oral feeding, both sexes were examined. MEASUREMENTS Modified water-swallowing test determined the dysphagia. Independent variables were dependency level (modified Barthel Index), oral health and function status (residual teeth, occlusal contacts, passive lip sealing, tongue function, rinsing and gargling ability), nutritional status (Body Mass Index, Mini Nutritional Assessment), and diet-related assessments (appetite, storing or stuffing food in the mouth). Statistical analysis was carried out by Fisher´s Exact and chi-square tests. The analyzes of associations with the dysphagia outcome were performed by simple and multiple logistic regression models. RESULTS Severity of AD was significantly associated with dysphagia. The signs associated with dysphagia were decreased nutritional status, absence of appetite, and storing food in the mouth. CONCLUSION These signs can be useful tools for early diagnosis of dysphagia in AD older adults.
Collapse
Affiliation(s)
- A L S Simões
- Prof. Dr. Eduardo Hebling, PO Box 52, 13414-903, Piracicaba-SP, Brazil, Tel./Fax: +55 19 2106-5209; e-mail:
| | | | | |
Collapse
|
7
|
Manchery N, Subbiah G, Nagappan N, Premnath P. Are oral health education for carers effective in the oral hygiene management of elderly with dementia? A systematic review. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.276232] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
ALFotawi R, Alzahrani S, Alhefdhi R, Altamimi A, Alfadhel A, Alshareef A, Aldawsari B, Sonbol S, Alsubaie F, Alwahibi A, Al-Sinaidi A. The relation between teeth loss and cognitive decline among Saudi population in the city of Riyadh: A pilot study. Saudi Dent J 2019; 32:232-241. [PMID: 32647470 PMCID: PMC7336006 DOI: 10.1016/j.sdentj.2019.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 01/12/2023] Open
Abstract
Background Teeth are necessary for sensory input to the brain during the chewing process, but how the decrease in this sensory input, due to loss of teeth, may cause weak memory and lead to cognitive decline is not well understood. This pilot public survey aiming to assess the correlation between the number of missing teeth, periodontal disease, and cognitive skill in the city of Riyadh. Material& Methods A multicenter cross-sectional survey, targeting geriatric population aged ≥60 years, was performed in Riyadh City, Saudi Arabia. The Montreal Cognitive Assessment (MoCA) was conducted to all participants to assess their cognitive function. Assessment of oral health status was carried out, including the number of present dentation and their periodontal status. Community periodontal-index (CPI) was used to assess the periodontal condition. The primary variables were number of missing teeth, periodontal disease and MoCA test scores. Chi-square test and Pearson’s correlation coefficients were computed and the significant P- value was set at <0.05. Results Of 95 participants, overall, 57 (60%) and 38 (40%) were male and female, respectively, with a mean age of 65.67 ± 6.32 years. Females showed more significant cognitive decline than males (P < 0.001). Cognitive decline was significantly high in participants with low educational level 19 (95%), unemployment 41 (79%), and lower income people 26 (79%), while being cognitive intact was significantly higher in highly educated 13 (87%), retired 21 (62%), and higher income people 28 (74%) at (P < 0.001). An advanced age and greater number of missing teeth are associated with lower MoCA test scores. No statistical significant correlation with regard to periodontal disease and MoCA test scores. Conclusion Based on the preliminary data, positive correlation was confirmed when the number of missing teeth and cognitive skill were assessed. Therefore, larger, multi-center regional surveys are needed to investigate further this relationship.
Collapse
Affiliation(s)
- Randa ALFotawi
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Saudi Arabia
| | - Sarah Alzahrani
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Reem Alhefdhi
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Asma Altamimi
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Alia Alfadhel
- Dept. of Dentistry, Saudi, Ministry of Health, AlBaha Region, Saudi Arabia
| | - Ahmed Alshareef
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Bader Aldawsari
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Saleh Sonbol
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Faisal Alsubaie
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Abdulrahman Alwahibi
- Psychiatry Dept. King Saud University Medical city, collage of Medicine, King Saud University, Riyadh, Saudia Arabia
| | - Aljoharah Al-Sinaidi
- Department of Periodontics and Community Dentistry, Dept of Periodontology Dental Faculty, King Saud University Riyadh, Saudi Arabia
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Klotz AL, Hassel AJ, Schröder J, Rammelsberg P, Zenthöfer A. Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study. Aging Clin Exp Res 2018; 30:581-588. [PMID: 28856592 DOI: 10.1007/s40520-017-0811-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
Abstract
AIM The objective of this controlled clinical study was to evaluate the association between oral health and 1-year mortality among nursing home residents with or without oral health intervention. METHODS This research was part of a multidisciplinary intervention study (EVI-P) performed in 14 nursing homes in Germany. Two-hundred and nineteen nursing home residents were included in the study and assigned to an intervention group, for which dental health education was offered and ultrasonic baths were used for denture cleaning (n = 144), or to a control group (n = 75). Before the intervention, each participant was examined, and dental status, plaque control record (PCR), Denture Hygiene Index, and results from the Revised Oral Assessment Guide were recorded. Amount of care needed and dementia were also assessed, by use of the Barthel Index and the Mini Mental State Examination, respectively. Participant mortality was determined after 12 months, and bivariate analysis and logistic regression models were used to evaluate possible factors affecting mortality. RESULTS Bivariate analysis detected a direct association between greater mortality and being in the control group (p = .038). Participants with higher PCR were also more likely to die during the study period (p = .049). For dentate participants, the protective effect of being in the intervention group was confirmed by multivariate analysis in which covariates such as age and gender were considered. CONCLUSION Oral hygiene and oral health seem to affect the risk of mortality of nursing home residents. Dental intervention programs seem to reduce the risk of 1-year mortality among nursing home residents having remaining natural teeth. Further studies, with larger sample sizes and evaluation of the causes of death, are necessary to investigate the reasons for these associations.
Collapse
Affiliation(s)
- Anna-Luisa Klotz
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Alexander Jochen Hassel
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Johannes Schröder
- Institute of Gerontology, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany
- Section of Geriatric Psychiatry, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
11
|
van de Rijt LJM, Weijenberg RAF, Feast AR, Vickerstaff V, Lobbezoo F, Sampson EL. Oral health and orofacial pain in people with dementia admitted to acute hospital wards: observational cohort study. BMC Geriatr 2018; 18:121. [PMID: 29792172 PMCID: PMC5966900 DOI: 10.1186/s12877-018-0810-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/07/2018] [Indexed: 11/14/2022] Open
Abstract
Background Orofacial pain in people with dementia is difficult to detect, and often under-treated. Our aim was to investigate the prevalence of orofacial pain in people with dementia in acute hospitals in the UK. Secondary aims were to examine oral health status and explore associations between orofacial pain and oral health factors. Methods This cross-sectional observational study was carried out in two UK hospitals. Using the Orofacial Pain Scale in Non-Verbal Individuals (OPS-NVI) to identify orofacial pain, 101 participants with dementia, admitted to acute medical wards, were observed for at least 3 min during rest and chewing. Verbal participants were then asked about presence of orofacial pain, using self-report pain scales. Finally, a brief oral assessment was performed. Results Orofacial pain, assessed with the OPS-NVI, was present in 11.9% (95% C.I. 5.9, 18.8) of participants at rest and 21.9% (95% C.I. 14.6, 31.3) whilst chewing. Participants who were no longer able to self-report pain were significantly more likely to experience orofacial pain. Oral health in both dentate and edentate participants was poor. Brush frequency, indication of chewing quality, consistency of the food, presence of extra-oral abnormalities, person who performed mouth care, and oral hygiene in dentate participants were significant predictors for the presence of orofacial pain. Conclusion Improving oral care in acute hospital patients with dementia, particularly those who cannot self-report pain, may significantly reduce pain and suffering in this population. Electronic supplementary material The online version of this article (10.1186/s12877-018-0810-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Liza J M van de Rijt
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Roxane A F Weijenberg
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alexandra R Feast
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.,The Research Department of Primary Care and Population Health, University College London, London, UK
| | - Frank Lobbezoo
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.,Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
| |
Collapse
|
12
|
Salmi R, Tolvanen M, Suhonen R, Lahti S, Närhi T. Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients. Scand J Caring Sci 2018; 32:1342-1347. [PMID: 29693266 DOI: 10.1111/scs.12579] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/20/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. OBJECTIVES The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. MATERIAL AND METHODS The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi-squared test. RESULTS Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. CONCLUSIONS There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly.
Collapse
Affiliation(s)
- Riikka Salmi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Departement of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, City of Turku, Welfare Division, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, Turku, Finland.,Clinic of Oral Diseases, Turku University Central Hospital, Turku, Finland
| |
Collapse
|
13
|
Kaushik V, Smith ST, Mikobi E, Raji MA. Acetylcholinesterase Inhibitors: Beneficial Effects on Comorbidities in Patients With Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2018; 33:73-85. [PMID: 28974110 PMCID: PMC10852526 DOI: 10.1177/1533317517734352] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Elderly patients with Alzheimer's disease (AD) and other dementias are at high risk of polypharmacy and excessive polypharmacy for common coexisting medical conditions. Polypharmacy increases the risk of drug-drug and drug-disease interactions in these patients who may not be able to communicate early symptoms of adverse drug events. Three acetylcholinesterase inhibitors (ACHEIs) have been approved for AD: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). They are also used off-label for other causes of dementia such as Lewy body and vascular dementia. We here report evidence from the literature that ACHEI treatment, prescribed for cognitive impairment, can reduce the load of medications in patients with AD by also addressing cardiovascular, gastrointestinal, and other comorbidities. Using one drug to address multiple symptoms can reduce costs and improve medication compliance.
Collapse
Affiliation(s)
- Vinod Kaushik
- Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA
| | - Sarah Toombs Smith
- Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA
| | - Emmanuel Mikobi
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA
- School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA
| | - Mukaila A. Raji
- Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
14
|
Emanuel R, Sorensen A. A study of oral health prevention behaviours for patients with early stage dementia. Br Dent J 2018; 224:38-42. [DOI: 10.1038/sj.bdj.2018.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 11/09/2022]
|
15
|
Foley NC, Affoo RH, Siqueira WL, Martin RE. A Systematic Review Examining the Oral Health Status of Persons with Dementia. JDR Clin Trans Res 2017; 2:330-342. [PMID: 30931751 DOI: 10.1177/2380084417714789] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
While the oral health of persons with dementia has been shown to be poor, no systematic reviews have been published that examined the topic in depth, including participants with dementia representing the full spectrum of disease severity, and evaluating a broad scope of oral health assessments. The aim of this study was to conduct a current literature review to fill this gap in knowledge. A systematic search of 5 databases (CINAHL, PubMed, EMBASE, Scopus, and ISI Web of Science) was conducted to identify all relevant studies published up to May 2016. There were no exclusions related to study type, severity of dementia, dentate status, or living arrangements. Results were reported descriptively and summarized. Meta-analyses were performed where possible and reported as mean difference (MD) or standardized mean difference (SMD), with a 95% confidence interval (CI). Twenty-eight studies were identified. Assessments were conducted of tooth status, active dental caries, hygiene (plaque/calculus) of natural and artificial teeth, periodontal diseases, denture status (retention, stability, denture-related mucosal lesions), and oral health-related quality of life. Across all evaluations, persons with dementia generally had scores/results suggestive of poor oral health. In meta-analyses, compared with persons without dementia, those with dementia had a significantly fewer number of teeth (MD, -1.52; 95% CI, -0.2.52 to -0.52; P = 0.003; n = 13 studies), more carious teeth (SMD, 0.29; 95% CI, 0.03 to 0.48; P = 0.028; n = 9), significantly worse oral hygiene evaluated using a broad range of assessment tools (SMD, 0.88; 95% CI, 0.57 to 1.19, P < 0.0001; n = 7), and significantly poorer periodontal health (SMD, 0.38; 95% CI, 0.06 to 0.70; P = 0.02; n = 6 studies). The oral health status of persons with mild to severe forms of dementia, who were living in both the community and residential care facilities, was found to be poor across a broad range of dental assessments. Knowledge Transfer Statement: The results of this study define the scope of oral issues and quantify the degree of impairment in individuals with dementia, evaluated using a variety of oral health measures. The results revealed that poor oral health is associated with dementia.
Collapse
Affiliation(s)
- N C Foley
- 1 Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.,2 Department of Foods & Nutrition, Brescia University College, London, Ontario, Canada
| | - R H Affoo
- 3 Graduate Program of Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
| | - W L Siqueira
- 4 Schulich Dentistry and Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - R E Martin
- 1 Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.,3 Graduate Program of Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada.,4 Schulich Dentistry and Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.,5 School of Communication Sciences & Disorders, Elborn College, The University of Western Ontario, London, Ontario, Canada.,6 Departments of Physiology & Pharmacology, The University of Western Ontario, London, Ontario, Canada.,7 Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
16
|
Rozas NS, Sadowsky JM, Jeter CB. Strategies to improve dental health in elderly patients with cognitive impairment. J Am Dent Assoc 2017; 148:236-245.e3. [DOI: 10.1016/j.adaj.2016.12.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/08/2016] [Accepted: 12/12/2016] [Indexed: 12/18/2022]
|
17
|
Almomani FM, Bani-Issa W. Physical, mental and cognitive disabilities in relation to utilization of dental care services by nursing home residents. SPECIAL CARE IN DENTISTRY 2017; 37:126-133. [PMID: 28140479 DOI: 10.1111/scd.12216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The main purpose of this study was to investigate factors affecting dental care utilization among nursing home residents in Jordan. METHODS A total of 221 subjects with a mean age of 62.4 years (121 males and 100 females) taken from among nursing home residents across Jordan were recruited and composed a convenience sample for this study. The Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB), Disability of Arm, Shoulder, and Hand test (DASH) were administered and oral health status was assessed for all subjects and examined as expected correlates of dental care utilization among nursing home residents. RESULTS The response rate was about 88%. One-third of residents suffered from total edentulism and most of the remaining dentate residents exhibited periodontal disease (90%). Of the dentate sample, 90% of residents had bleeding upon probing, 85% were diagnosed with tooth mobility, 88% had presence of dental calculus, and 30% were diagnosed with root caries. Of the denture wearers, 59.1 % reported having soreness with their dentures and 32% of denture wearers reported having poor quality dentures. MMSE score, suffering from tooth sensitivity and having diabetes mellitus were identified to be indicators for utilization of dental care services among the study population. CONCLUSION Regular oral care, assessments, and rehabilitation services are considered to be limited for nursing home residents in Jordan. Based upon these findings, future interventions should address oral health among nursing home residents in Jordan.
Collapse
Affiliation(s)
- Fidaa M Almomani
- Associate Professor, Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Wegdan Bani-Issa
- Associate Professor, Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
18
|
Ziebolz D, Werner C, Schmalz G, Nitschke I, Haak R, Mausberg RF, Chenot JF. Oral Health and nutritional status in nursing home residents-results of an explorative cross-sectional pilot study. BMC Geriatr 2017; 17:39. [PMID: 28143415 PMCID: PMC5282867 DOI: 10.1186/s12877-017-0429-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/21/2017] [Indexed: 01/06/2023] Open
Abstract
Background This study was performed to assess oral and nutritional status of nursing home residents in a region of Lower Saxony, Germany. The aim was to show potential associations between oral status (dentate or edentulous), further anamnestic factors (dementia, age, smoking) and the risk for malnutrition in this population. Methods In this observational cross-sectional pilot study of residents from four nursing homes Mini Nutritional Assessment (MNA), Body-Mass-Index (BMI), dental status (DMF-T) and periodontal situation (PSR®/PSI) were recorded. Associations of recorded factors with oral health and nutritional status were examined in univariate and multivariate analysis. Results Eighty-seven residents participated in the study (mean age: 84.1 years; female: 72%, demented: 47%). Average BMI was 26.2 kg/m2; according MNA 52% were at risk for malnutrition. 48% of the residents were edentulous, and the average DMF-T of dentulous was 25.0 (3.7) (D-T: 2.0 [3.1], M-T: 15.0 [8.3], F-T: 8.0 [7.4]); PSR®/PSI 3 and 4 (need for periodontal treatment) showed 79% of residents. In univariate analysis dementia (OR 2.5 CI95 1.1–5.6) but not being edentulous (OR 2.0 CI95 0.8–5.8) were associated with being at risk for malnutrition. Dementia remained associated in multivariate analysis adjusting for age and sex, (OR 3.1 CI95 1.2–8.2) and additionally being edentulous (OR 2.8 CI95 1.1–7.3) became associated significantly. Furthermore, nursing home residents with dementia had more remaining teeth (OR 2.5 CI95 1.1–5.9). Conclusion Dementia was a stronger predictor for risk of malnutrition in nursing home residents than being edentulous. Further studies to elucidate the possible role of oral health as cofactor for malnutrition in dementia are needed.
Collapse
Affiliation(s)
- Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany.
| | | | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Ina Nitschke
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany.,Clinic of Geriatric and Special Care Dentistry, Center of Dentistry, University of Zurich, Zurich, Switzerland
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Rainer F Mausberg
- Deptartment of Preventive Dentistry, Periodontology and Cariology, University University Medical Center, Goettingen, Germany
| | - Jean-François Chenot
- Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
19
|
Zenthöfer A, Cabrera T, Rammelsberg P, Hassel AJ. Improving oral health of institutionalized older people with diagnosed dementia. Aging Ment Health 2016; 20:303-8. [PMID: 25677603 DOI: 10.1080/13607863.2015.1008986] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Previous research has revealed poor oral hygiene and health among older people suffering from dementia. To evaluate the oral health and denture hygiene of older people with and without dementia, six months after carer have followed a dental education programme. METHOD Ninety-three older people living in four long-term care homes in south-western Germany were included in this longitudinal cohort study. All participants were allocated into two groups on basis of the medical dementia diagnosis extracted from the medical records in the care documentation: suffering from dementia (n = 33) or not (n = 60). For each participant plaque control record, gingival bleeding index (GBI), community periodontal index of treatment needs (CPITN), and denture hygiene index (DHI) were assessed at baseline and six months after carer have followed a dental education programme, and after use of ultrasonic devices for denture cleaning. Differences between all target variables from baseline to follow-up, and between participants with and without dementia, were evaluated by bivariate and multivariate testing. RESULTS In bivariate testing, participants with dementia had a significantly lower DHI (p < 0.001), a lower GBI (p < 0.05), and a lower CPITN (p < 0.01) at follow-up. In participants without dementia, only for DHI (p < 0.001) a significant improvement was observed. In multivariate analyses, the significant association could not be reproduced (p > 0.05). CONCLUSIONS Use of ultrasonic baths can be a successful means for improving denture hygiene among older people in long-term care with and without dementia. Education for carer in order to improve oral hygiene, however, seems to be of minor significance and to be more effective for people with dementia.
Collapse
Affiliation(s)
- Andreas Zenthöfer
- a Department of Prosthodontics, Dental School , University of Heidelberg , Heidelberg , Germany
| | - Tomas Cabrera
- a Department of Prosthodontics, Dental School , University of Heidelberg , Heidelberg , Germany
| | - Peter Rammelsberg
- a Department of Prosthodontics, Dental School , University of Heidelberg , Heidelberg , Germany
| | - Alexander Jochen Hassel
- a Department of Prosthodontics, Dental School , University of Heidelberg , Heidelberg , Germany
| |
Collapse
|
20
|
Zenthöfer A, Meyer-Kühling I, Hufeland AL, Schröder J, Cabrera T, Baumgart D, Rammelsberg P, Hassel AJ. Carers' education improves oral health of older people suffering from dementia - results of an intervention study. Clin Interv Aging 2016; 11:1755-1762. [PMID: 27942206 PMCID: PMC5137930 DOI: 10.2147/cia.s118330] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Aim The aim of this study was to evaluate the effectiveness of carers’ education on improvements in oral health and denture hygiene of care-dependent and cognitively impaired older people in nursing homes compared to those without intervention. Methods A total of 219 seniors living in 14 nursing homes in southwest Germany (intervention: n=144; control: n=75) were enrolled in this study. For each participant, Plaque Control Record (PCR), Gingival Bleeding Index (GBI), Denture Hygiene Index (DHI) and Community Periodontal Index of Treatment Needs (CPITN) were assessed at baseline and six months following the interventions. In addition, demographic parameters such as age, sex, chronic diseases, permanent medications, level of dependency and cognitive state were recorded. In the intervention homes, education for caregivers was provided and ultrasound baths for denture cleaning were implemented. Changes in the dental target variables PCR, GBI, CPITN and DHI during the six-month study period were compared between subjects in the intervention and the control groups as well as between subjects with and without dementia. Additionally, multivariate models were compiled for each dental index to evaluate possible confounders. Results In the intervention group, PCR and DHI significantly improved during the study period (P<0.001). Oral health and denture hygiene improved likewise in subjects with and without dementia. In the control group, no significant improvements were observed (P>0.05). Conclusion Carers’ education improves oral health of people in nursing homes over a clinically relevant period of time. Implementation of ultrasound baths is a simple and effective measure to improve denture hygiene of both institutionalized elderly people and seniors with dementia and in severe need of care. From a clinical standpoint, it is noteworthy that the respective interventions can be easily implemented in everyday care routine.
Collapse
Affiliation(s)
| | - Inga Meyer-Kühling
- Institute of Gerontology, University of Heidelberg; Section of Geriatric Psychiatry, Center of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | | | - Johannes Schröder
- Institute of Gerontology, University of Heidelberg; Section of Geriatric Psychiatry, Center of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Tomas Cabrera
- Department of Prosthetic Dentistry, University of Heidelberg
| | | | | | | |
Collapse
|
21
|
Delwel S, Binnekade TT, Perez RSGM, Hertogh CMPM, Scherder EJA, Lobbezoo F. Oral health and orofacial pain in older people with dementia: a systematic review with focus on dental hard tissues. Clin Oral Investig 2016; 21:17-32. [PMID: 27631597 PMCID: PMC5203832 DOI: 10.1007/s00784-016-1934-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/03/2016] [Indexed: 01/04/2023]
Abstract
Objective The aim of this review was to provide a systematic overview including a quality assessment of studies about oral health and orofacial pain in older people with dementia, compared to older people without dementia. Methods A systematic literature search was performed in PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. The quality assessment of the included articles was performed using the Newcastle-Ottawa Scale (NOS). Results The search yielded 527 articles, of which 37 were included for the quality assessment and quantitative overview. The median NOS score of the included studies was 5, and the mean was 4.9 (SD 2.2). The heterogeneity between the studies was considered too large to perform a meta-analysis. An equivalent prevalence of orofacial pain, number of teeth present, decayed missing filled teeth index, edentulousness percentage, and denture use was found for both groups. However, the presence of caries and retained roots was higher in older people with dementia than in those without. Conclusions Older people with dementia have worse oral health, with more retained roots and coronal and root caries, when compared to older people without dementia. Little research focused on orofacial pain in older people with dementia. Clinical relevance The current state of oral health in older people with dementia could be improved with oral care education of caretakers and regular professional dental care.
Collapse
Affiliation(s)
- Suzanne Delwel
- Faculty of Behavioral and Movement Sciences, Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands. .,Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
| | - Tarik T Binnekade
- Faculty of Behavioral and Movement Sciences, Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Roberto S G M Perez
- Department of Anesthesiology, EMGO+ Institute for Health and Care Research, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Faculty of Medicine, Department of Elderly Care Medicine, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Erik J A Scherder
- Faculty of Behavioral and Movement Sciences, Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Faculty of Dentistry, Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
22
|
Zellmer M, Gahnberg L, Ramberg P. Prevalence of halitosis in elderly living in nursing homes. Int J Dent Hyg 2016; 14:295-300. [PMID: 27476817 DOI: 10.1111/idh.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Halitosis is a concern for many people, but has sparsely been studied in elderly living in nursing homes. The aim of this investigation was to study the prevalence of halitosis in this particular group and factors that could be associated with this condition. METHOD AND MATERIALS One hundred and twenty-four residents at three different nursing homes were included in the study. The level of halitosis was assessed using an organoleptic method based on a 6-graded scale. Oral status, including registrations of plaque, gingivitis and assessment of hyposalivation, was performed by two investigators who both examined all patients. Medical history, that is medication, neurological conditions, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD)/asthma, dementia and mental illness, was obtained from the patient files. Registrations of the use of oral hygiene aids, ADL (Activity of Daily Life) and the frequency of contact with dental services were included in the clinical examination. RESULTS Halitosis occurred in over 50% of residents living in nursing homes and was found to be associated with the presence of hyposalivation, periodontal disease, calculus, fixed prosthodontics and dementia. CONCLUSION Halitosis was a common finding in the elderly living in Swedish nursing homes.
Collapse
Affiliation(s)
- M Zellmer
- Public Dental Health Service, Departments of Hospital Dentistry, Mölndal Hospital and Mun-H-Center, Gothenburg, Västra Götaland Region, Sweden
| | - L Gahnberg
- Department of Behavioural and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - P Ramberg
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
23
|
Kobayashi N, Soga Y, Maekawa K, Kanda Y, Kobayashi E, Inoue H, Kanao A, Himuro Y, Fujiwara Y. Prevalence of oral health-related conditions that could trigger accidents for patients with moderate-to-severe dementia. Gerodontology 2016; 34:129-134. [PMID: 27207609 DOI: 10.1111/ger.12235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study was performed to determine the prevalence of oral health conditions unnoticed by doctors and ward staff that may increase risk of incidents and/or accidents in hospitalised patients with moderate-severe dementia. BACKGROUND DATA DISCUSSING THE PRESENT STATUS OF THE FIELD Dementia patients may not recognise risks in the mouth, such as tooth mobility or ill-fitting dental prostheses and/or dentures. In addition to the risk of choking, injury by sharp edges of collapsed teeth or prosthodontics could pose risks. However, many previous publications were limited to case reports or series. MATERIALS AND METHODS Ninety-two consecutive hospitalised dementia patients (M: 52, F: 40, median age: 82.5 years, range: 62-99 years, from 2011 to 2014), referred for dentistry for dysphagia rehabilitation, were enrolled in this study. Participants referred for dental treatment with dental problems detected by ward staff were excluded. All participants had a Global Clinical Dementia Rating Score >2. Their dental records were evaluated retrospectively for issues that may cause incidents and/or accidents. RESULTS Problems in the mouth, for example tooth stumps, dental caries, and ill-fitting dentures, were detected in 51.1% of participants (47/92). Furthermore, 23.9% (22/92) showed risk factors that could lead to incidents and/or accidents, for example falling out of teeth and/or prosthodontics or injury by sharp edges of teeth and/or prosthodontics. CONCLUSIONS Hospitalised moderate-severe dementia patients had a high prevalence of oral health conditions unnoticed by doctors and ward staff that may increase risk of incidents and/or accidents.
Collapse
Affiliation(s)
| | - Yoshihiko Soga
- Department of Dentistry, Mannari Hospital, Okayama, Japan.,Division of Hospital Dentistry, Okayama University Hospital, Okayama, Japan
| | - Kyoko Maekawa
- Department of Dentistry, Mannari Hospital, Okayama, Japan.,Center of Special Needs Dentistry, Okayama University Hospital, Okayama, Japan
| | - Yuko Kanda
- Department of Dentistry, Mannari Hospital, Okayama, Japan.,Center of Special Needs Dentistry, Okayama University Hospital, Okayama, Japan
| | - Eiko Kobayashi
- Department of Dentistry, Mannari Hospital, Okayama, Japan
| | - Hisako Inoue
- Department of Dentistry, Mannari Hospital, Okayama, Japan
| | - Ayana Kanao
- Department of Dentistry, Mannari Hospital, Okayama, Japan
| | - Yumiko Himuro
- Department of Dentistry, Mannari Hospital, Okayama, Japan
| | - Yumi Fujiwara
- Department of Dentistry, Mannari Hospital, Okayama, Japan
| |
Collapse
|
24
|
Morishita S, Watanabe Y, Ohara Y, Edahiro A, Sato E, Suga T, Hirano H. Factors associated with older adults' need for oral hygiene management by dental professionals. Geriatr Gerontol Int 2015; 16:956-62. [DOI: 10.1111/ggi.12585] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2015] [Indexed: 01/07/2023]
Affiliation(s)
- Shiho Morishita
- Department of Oral Diseases Research; National Center for Geriatrics and Gerontology; Aichi Japan
| | - Yutaka Watanabe
- Department of Oral Diseases Research; National Center for Geriatrics and Gerontology; Aichi Japan
| | - Yuki Ohara
- Department of Oral Health Education, Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence of the Elderly; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Emiko Sato
- Department of Oral Medicine and Oral and Maxillofacial Surgery; Tokyo Dental College; Chiba Japan
| | - Takeo Suga
- Department of Geriatric Dentistry; Tsurumi University School of Dental Medicine; Kanagawa Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence of the Elderly; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| |
Collapse
|
25
|
van Kooten J, Delwel S, Binnekade TT, Smalbrugge M, van der Wouden JC, Perez RSGM, Rhebergen D, Zuurmond WWA, Stek ML, Lobbezoo F, Hertogh CMPM, Scherder EJA. Pain in dementia: prevalence and associated factors: protocol of a multidisciplinary study. BMC Geriatr 2015; 15:29. [PMID: 25879681 PMCID: PMC4436741 DOI: 10.1186/s12877-015-0025-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/02/2015] [Indexed: 01/28/2023] Open
Abstract
Background Pain is a common problem in people with dementia, however the exact prevalence of pain in dementia subtypes, e.g. Alzheimer’s Disease (AD), Vascular Dementia (VaD), Frontotemporal Dementia (FTD) and dementia with Lewy Bodies (DLB), is unknown, as is the relation between pain and the different subtypes of dementia. In this study, the prevalence of pain in people with dementia will be investigated per dementia subtype and the relationship between the various subtypes of dementia and the presence of specific types of pain (i.e. musculoskeletal pain, neuropathic pain and orofacial pain) will be examined. Secondly, associations between various types of pain, cognitive functioning, neuropsychiatric symptoms and quality of life in people with dementia will be examined. A third purpose is to study the value of the assessment of autonomic responses in assessing pain in people with dementia. Finally, the effect of feedback to the attending physician on the presence of pain, based on examination by investigators with backgrounds in neuropsychology, geriatric dentistry and elderly care medicine, will be evaluated. Methods/Design A cross-sectional, partially longitudinal observational study in 400 participants with dementia, aged 60 years and older. Participants will be recruited from an outpatient memory clinic and dementia special care units. All participants will be examined by an elderly care medicine trainee, a dentist with experience in geriatric dentistry, and a neuropsychologist. The primary outcome is presence of pain. Secondary outcomes will include oral health, autonomic responses to pain stimulus, vital sensibility and gnostic sensibility, musculoskeletal examination, cognitive functioning, neuropsychiatric symptoms, and quality of life. Discussion This study will help to enhance our knowledge regarding the prevalence of different types of pain in different dementia subtypes i.e. AD, VaD, FTD and DLB. This study also aims to contribute to a better understanding of oral health status in people with dementia, the use of autonomic responses in the assessment of pain in people with dementia and the relationships between pain and cognitive symptoms, neuropsychiatric symptoms and quality of life in people with various dementia subtypes and in different stages of the disease.
Collapse
Affiliation(s)
- Janine van Kooten
- Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Suzanne Delwel
- Department of Clinical Neuropsychology VU University, Amsterdam, The Netherlands. .,Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
| | - Tarik T Binnekade
- Department of Clinical Neuropsychology VU University, Amsterdam, The Netherlands.
| | - Martin Smalbrugge
- Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Johannes C van der Wouden
- Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Roberto S G M Perez
- Department of Anesthesiology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Didi Rhebergen
- GGZ InGeest /Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Wouter W A Zuurmond
- Department of Anesthesiology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Max L Stek
- GGZ InGeest /Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
| | - Cees M P M Hertogh
- Department of General Practice and Elderly Care Medicine and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Erik J A Scherder
- Department of Clinical Neuropsychology VU University, Amsterdam, The Netherlands.
| |
Collapse
|
26
|
Salom M, Hachulla E, Bertolus C, Deschaumes C, Simoneau G, Mouly S. Efficacy and safety of a new oral saliva equivalent in the management of xerostomia: a national, multicenter, randomized study. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:301-9. [DOI: 10.1016/j.oooo.2014.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/17/2014] [Accepted: 12/03/2014] [Indexed: 12/01/2022]
|
27
|
Janssens B, De Visschere L, van der Putten GJ, de Lugt-Lustig K, Schols JM, Vanobbergen J. Effect of an oral healthcare protocol in nursing homes on care staffs' knowledge and attitude towards oral health care: a cluster-randomised controlled trial. Gerodontology 2014; 33:275-86. [DOI: 10.1111/ger.12164] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Barbara Janssens
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Nijmegen The Netherlands
- Community Dentistry and Oral Public Health; Dental School; Ghent University; Ghent Belgium
| | - Luc De Visschere
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Nijmegen The Netherlands
- Community Dentistry and Oral Public Health; Dental School; Ghent University; Ghent Belgium
| | - Gert-Jan van der Putten
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- Birkhoven Zorggoed; Amersfoort The Netherlands
- University of Applied Sciences; Utrecht The Netherlands
- Department of Oral Function and Prosthetic Dentistry; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Kersti de Lugt-Lustig
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- Department of Oral Function and Prosthetic Dentistry; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Naarderheem; Vivium Zorggroep; Huizen The Netherlands
| | - Jos M.G.A. Schols
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- Caphri; Departments of Family Medicine and Health Services Research; Maastricht University; Maastricht The Netherlands
| | - Jacques Vanobbergen
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Nijmegen The Netherlands
- Community Dentistry and Oral Public Health; Dental School; Ghent University; Ghent Belgium
| |
Collapse
|
28
|
Silva M, Hopcraft M, Morgan M. Dental caries in Victorian nursing homes. Aust Dent J 2014; 59:321-8. [PMID: 24819713 DOI: 10.1111/adj.12188] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The poor oral health of nursing home residents is the cause of substantial morbidity and has major implications relating to health care policy. The aim of this study was to measure dental caries experience in Australians living in nursing homes, and investigate associations with resident characteristics. METHODS Clinical dental examinations were conducted on 243 residents from 19 nursing homes in Melbourne. Resident characteristics were obtained from nursing home records and interviews with residents, family and nursing home staff. Two dental examiners assessed coronal and root dental caries using standard ICDAS-II criteria. RESULTS Residents were elderly, medically compromised and functionally impaired. Most required assistance with oral hygiene and professional dental care was rarely utilized. Residents had high rates of coronal and root caries, with a mean 2.8 teeth with untreated coronal caries and 5.0 root surfaces with untreated root caries. Functional impairment and irregular professional dental care were associated with higher rates of untreated tooth decay. There were no significant associations with medical conditions or the number of medications taken. CONCLUSIONS Nursing home residents have high levels of untreated coronal and root caries, particularly those with high needs due to functional impairment but poor access to professional services.
Collapse
Affiliation(s)
- M Silva
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria
| | | | | |
Collapse
|
29
|
Sato E, Hirano H, Watanabe Y, Edahiro A, Sato K, Yamane G, Katakura A. Detecting signs of dysphagia in patients with Alzheimer's disease with oral feeding in daily life. Geriatr Gerontol Int 2013; 14:549-55. [DOI: 10.1111/ggi.12131] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Emiko Sato
- Oral Medicine and Oral and Maxillofacial Surgery; Tokyo Dental College; Chiba Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Geriatric Institute of Gerontology; Chiba Japan
| | | | - Ayako Edahiro
- Tokyo Metropolitan Geriatric Institute of Gerontology; Chiba Japan
| | | | | | - Akira Katakura
- Oral Medicine and Oral and Maxillofacial Surgery; Tokyo Dental College; Chiba Japan
| |
Collapse
|
30
|
Kazancioglu HO, Cakir O, Koyuncuoglu G, Ciftci A, Ak G. Oral Findings and Health Status among Turkish Geriatric Patients with or without Dementia (Oral Lesions and Dementia Patients). INT J GERONTOL 2013. [DOI: 10.1016/j.ijge.2012.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
31
|
Ribeiro GR, Costa JLR, Ambrosano GMB, Garcia RCMR. Oral health of the elderly with Alzheimer's disease. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 114:338-43. [PMID: 22862974 DOI: 10.1016/j.oooo.2012.03.028] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 03/12/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to describe the oral health of elderly people diagnosed with Alzheimer's disease (AD). STUDY DESIGN Thirty elderly subjects with AD (mild, moderate, and severe) and 30 without AD (controls) were included in the study. Volunteer-reported oral health data were collected using the General Oral Health Assessment Index (GOHAI). Demographic and oral characteristics were assessed, including the number of natural teeth; number of decayed, missing, and filled teeth (DMTF); oral health index (OHI); removable prosthesis conditions; and oral pathologies. RESULTS GOHAI values were similar for both groups. Compared with the controls, the subjects with AD had a higher age, DMTF, OHI, and number of oral pathologies and a lower educational level and number of natural teeth. CONCLUSIONS Elderly subjects with AD had poorer oral health than those without the disease. Despite the positive self-perception of their oral health, the oral health of subjects with AD tended to decline as their disease progressed.
Collapse
Affiliation(s)
- Giselle Rodrigues Ribeiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | | | | | | |
Collapse
|
32
|
Chen X, Clark JJ, Naorungroj S. Oral health in older adults with dementia living in different environments: a propensity analysis. SPECIAL CARE IN DENTISTRY 2013; 33:239-47. [DOI: 10.1111/scd.12006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Xi Chen
- Department of Dental Ecology; University of North Carolina; Chapel Hill; North Carolina
| | - Jennifer J.J. Clark
- Department of Biostatistics; University of North Carolina, Gillings School of Global Public Health; North Carolina
| | - Supawadee Naorungroj
- Department of Epidemiology; University of North Carolina, Gillings School of Global Public Health; North Carolina
| |
Collapse
|
33
|
Le P, Dempster L, Limeback H, Locker D. Improving residents’ oral health through staff education in nursing homes. SPECIAL CARE IN DENTISTRY 2012; 32:242-50. [DOI: 10.1111/j.1754-4505.2012.00279.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
No more fighting and biting during mouth care: applying the theoretical constructs of threat perception to clinical practice. Res Theory Nurs Pract 2012; 25:163-75. [PMID: 22216691 DOI: 10.1891/1541-6577.25.3.163] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this article is to describe how the neurobiological principles of threat perception and fear response can support clinical approaches to prevent and reduce care-resistant behaviors during mouth care. Nursing home residents who exhibit care-resistant behavior are at risk for poor oral health because daily oral hygiene may not be consistently provided. Poor oral health predisposes these older people to systemic problems such as pneumonia, cerebral vascular accidents, and hyperglycemia. Care-resistant behavior is a fear-evoked response to nurses' unintentionally threatening behavior during mouth care. Nurses can safely and effectively provide mouth care to persons with dementia who resist care by using personalized combinations of 15 threat reduction strategies.
Collapse
|
35
|
Zuluaga DJM, Montoya JAG, Contreras CI, Herrera RR. Association between oral health, cognitive impairment and oral health-related quality of life. Gerodontology 2011; 29:e667-73. [DOI: 10.1111/j.1741-2358.2011.00542.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Philip P, Rogers C, Kruger E, Tennant M. Caries experience of institutionalized elderly and its association with dementia and functional status. Int J Dent Hyg 2011; 10:122-7. [DOI: 10.1111/j.1601-5037.2011.00525.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
37
|
Philip P, Rogers C, Kruger E, Tennant M. Oral hygiene care status of elderly with dementia and in residential aged care facilities. Gerodontology 2011; 29:e306-11. [DOI: 10.1111/j.1741-2358.2011.00472.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
38
|
Chen X, Shuman SK, Hodges JS, Gatewood LC, Xu J. Patterns of tooth loss in older adults with and without dementia: a retrospective study based on a Minnesota cohort. J Am Geriatr Soc 2011; 58:2300-7. [PMID: 21143439 DOI: 10.1111/j.1532-5415.2010.03192.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study tooth loss patterns in older adults with dementia. DESIGN Retrospective longitudinal study. SETTING A community-based geriatric dental clinic in Minnesota. PARTICIPANTS Four hundred ninety-one older adults who presented to the study clinic as new patients during the study period, remained dentate after finishing the initial treatment plan, and returned for care at least once thereafter were retrospectively selected. One hundred nineteen elderly people with International Classification of Diseases, Ninth Revision, codes 290.x, 294.1, or 331.2 or a plain-text diagnosis of dementia, Alzheimer's disease, or chronic brain syndrome in the medical history were considered having dementia. INTERVENTION All existing dental conditions were treated before enrollment. Dental treatment was continually provided for all participants during follow-up. MEASUREMENTS Tooth loss patterns, including time to first tooth loss, number of tooth loss events, and number of teeth lost per patient-year were estimated and compared for participants with and without dementia using Cox, Poisson, and negative-binomial regressions. RESULTS Participants with dementia arrived with an average of 18 and those without dementia with an average of 20 teeth; 27% of remaining teeth in the group with dementia were decayed or retained roots, higher than in the group without dementia (P<.001). Patterns of tooth loss did not significantly differ between the two groups; 11% of participants in both groups had lost teeth by 12 months of follow-up. By 48 months, 31% of participants without dementia and 37% of participants with dementia had lost at least one tooth (P=.50). On average, 15% of participants in both groups lost at least one tooth each year. Mean numbers of teeth lost in 5 years were 1.21 for participants with dementia and 1.01 for participants without dementia (P=.89). CONCLUSION Based on data available in a community-based geriatric dental clinic, dementia was not associated with tooth loss. Although their oral health was poor at arrival, participants with dementia maintained their dentition as well as participants without dementia when dental treatment was provided.
Collapse
Affiliation(s)
- Xi Chen
- Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, North Carolina 27599, USA.
| | | | | | | | | |
Collapse
|
39
|
Syrjälä AMH, Ylöstalo P, Ruoppi P, Komulainen K, Hartikainen S, Sulkava R, Knuuttila M. Dementia and oral health among subjects aged 75 years or older. Gerodontology 2010; 29:36-42. [DOI: 10.1111/j.1741-2358.2010.00396.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Assessing caries increments in elderly patients with and without dementia: a one-year follow-up study. J Am Dent Assoc 2010; 140:1392-400. [PMID: 19884398 DOI: 10.14219/jada.archive.2009.0076] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted a study to determine one-year coronal and root caries increments in patients newly diagnosed as having Alzheimer disease (AD), other dementia (OD) or no dementia. METHODS The authors recruited patients from two hospital memory clinics in Copenhagen. The oral examination included an assessment of dental status and dental caries. The authors used a structured questionnaire to obtain information regarding demographic, social and functional variables. RESULTS In the baseline study, 106 dentate patients participated. Of these, 77 completed the follow-up study. The participants' mean age was 81.9 years at baseline and 82.5 years at follow-up. At baseline, 87 (82 percent) of 106 participants had dementia and at follow-up, 64 (83 percent) of 77 participants had dementia. The mean number of decayed tooth surfaces was significantly higher at follow-up than at baseline for all participants, and the number was highest for the OD group. The one-year adjusted caries and filling increments (ADJCIs) were high for participants with and without dementia but were highest for participants in the AD and OD groups. Baseline risk factors for developing elevated coronal and root ADJCIs included having caries, having many teeth and being older than 80 years. CONCLUSIONS Elderly people referred to a memory clinic were at an elevated risk of developing high levels of coronal and root-surface caries during the first year after referral, and those with a dementia diagnosis other than AD appeared to be at a particularly high risk of developing multiple carious lesions during the first year after diagnosis. CLINICAL IMPLICATIONS These findings underscore the importance of addressing the oral health needs of elderly people suspected of having experienced cognitive decline.
Collapse
|
41
|
Dougall A, Fiske J. Access to special care dentistry, part 9. Special care dentistry services for older people. Br Dent J 2009; 205:421-34. [PMID: 18953303 DOI: 10.1038/sj.bdj.2008.891] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article looks at three common neurological conditions associated with later years: stroke, Parkinson's disease and dementia. All of them impact on oral health, access to dental services and delivery of dental care, and treatment goals need to be adapted to take into account patients' changing needs, medical status, pattern of recovery or the stage of dementia that they have reached. The article concludes by considering the topic of elder abuse. The dental team may have a role both in identifying abuse and ensuring appropriate action is taken.
Collapse
Affiliation(s)
- A Dougall
- Division One/Special Care Dentistry, Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland
| | | |
Collapse
|
42
|
Jablonski RA, Munro CL, Grap MJ, Schubert CM, Ligon M, Spigelmyer P. Mouth care in nursing homes: knowledge, beliefs, and practices of nursing assistants. Geriatr Nurs 2008; 30:99-107. [PMID: 19345849 DOI: 10.1016/j.gerinurse.2008.06.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 05/25/2008] [Accepted: 06/01/2008] [Indexed: 02/06/2023]
Abstract
UNLABELLED The purpose of this study was to examine the knowledge, beliefs, and practices of nursing assistants (NAs) providing oral hygiene care to frail elders in nursing homes, with the intent of developing an educational program for NAs. METHODS The study occurred in two economically and geographically diverse nursing homes. From a sample size of 202 NAs, 106 returned the 19-item Oral Care Survey. RESULTS The NAs reported satisfactory knowledge regarding the tasks associated with providing mouth care. The NAs believed that tooth loss was a natural consequence of aging. They reported that they provided mouth care less frequently than is optimal but cited challenges such as caring for persons exhibiting care-resistive behaviors, fear of causing pain, and lack of supplies. CONCLUSION Nurses are in a powerful position to support NAs in providing mouth care by ensuring that they have adequate supplies and knowledge to respond to resistive behaviors.
Collapse
Affiliation(s)
- Rita A Jablonski
- School of Nursing, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | | | | | | | | | | |
Collapse
|
43
|
Yu YH, Kuo HK. Association Between Cognitive Function and Periodontal Disease in Older Adults. J Am Geriatr Soc 2008; 56:1693-7. [DOI: 10.1111/j.1532-5415.2008.01847.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Willumsen T, Solemdal K, Wenaasen M, Øgaard B. Stannous fluoride in dentifrice: an effective anti-plaque agent in the elderly? Gerodontology 2007; 24:239-43. [DOI: 10.1111/j.1741-2358.2007.00161.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
45
|
Ellefsen B, Holm-Pedersen P, Morse DE, Schroll M, Andersen BB, Waldemar G. Caries prevalence in older persons with and without dementia. J Am Geriatr Soc 2007; 56:59-67. [PMID: 18028345 DOI: 10.1111/j.1532-5415.2007.01495.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine the prevalence of coronal and root caries in a memory clinic-based population of elderly patients with and without a diagnosis of dementia and to examine the influence of age, sex, social relations, social position, and functional ability. DESIGN Cross-sectional. SETTING Patients referred with possible cognitive dysfunction were recruited from two university hospital dementia clinics. PARTICIPANTS In total, 106 dentate persons participated in the study. Mean age was 82, 69 were women, and 87 had a diagnosis of dementia. MEASUREMENTS Data from interviews and a clinical examination were collected. The diagnosis of dementia was made at the dementia clinics according to the criteria of International Classification of Diseases, Tenth Revision. Active coronal and root caries was assessed using previously defined diagnostic criteria from the National Institute of Dental and Craniofacial Research. RESULTS The mean number of coronal and root surfaces with caries was statistically significantly higher in subjects with a diagnosis of dementia (7.0 vs 2.7, P<.05). Subjects with a diagnosis of Alzheimer's disease had a significantly higher mean number of root surfaces with caries (4.9, P<.05) than subjects with other dementia diagnoses (2.3) and those without dementia (1.7). People with Alzheimer's disease also had significantly more mean total caries than subjects without dementia (7.8 vs 2.7, P<.05). Participants with a Mini-Mental State Examination (MMSE) score less than 24 had significantly more caries than participants with a MMSE-score of 24 or higher (7.6 vs 4.3, P<.05). CONCLUSION Patients with newly diagnosed dementia already had a high level of active dental caries when they were referred to the memory clinic. The high caries prevalence was related to dementia type and severity.
Collapse
Affiliation(s)
- Birita Ellefsen
- Copenhagen Gerontological Oral Health Research Centre, School of Dentistry, University of Copenhagen, Copenhagen, Denmark.
| | | | | | | | | | | |
Collapse
|
46
|
Mouly S, Salom M, Tillet Y, Coudert AC, Oberli F, Preshaw PM, Desjonquères S, Bergmann JF. Management of Xerostomia in Older Patients. Drugs Aging 2007; 24:957-65. [DOI: 10.2165/00002512-200724110-00007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
47
|
|