1
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Davies R, Doshi M. Prevention of oral diseases for the older person (Part 1). Br Dent J 2024; 236:35-41. [PMID: 38225311 DOI: 10.1038/s41415-023-6610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Older adults often experience poorer levels of oral health than younger adults, especially if they have become dependent on a third party to support their daily oral care routine. However, the deterioration of oral health does not need to be a part of the ageing process. Most oral diseases are largely preventable with the daily removal of dental plaque that forms on teeth and dentures, using a fluoride toothpaste, eating a healthy diet and reducing any tobacco consumption. The dental team have a duty of care to ensure that older people receive evidence-based oral health preventative advice tailored to the individual, taking into account individual risk factors that can increase with age. This can include the clinical application of topical fluoride and minimally invasive dentistry. Older people at an increased risk of poor oral health include those with cognitive conditions, physical impairments and certain medical conditions. Care home residents face particular barriers to attaining a satisfactory standard of oral care which are discussed herein. Good oral health preventative routines must be established early after the diagnosis of progressive chronic conditions and will help to prevent the need for dental intervention later in life when treatment can be more difficult to tolerate. Inclusion of oral health prevention within health policy and legislation is necessary to improve the oral health for older people living in all health and care settings.
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Affiliation(s)
| | - Mili Doshi
- Dental and Maxillofacial, Surrey and Sussex Healthcare NHS Trust, Surrey, United Kingdom.
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2
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Huang S, Liu Y, Li M, Liu Z, Zhao F, Li J, Lu H, Zhou H. Oral health knowledge, attitudes, and practices and oral health-related quality of life among stroke inpatients: a cross-sectional study. BMC Oral Health 2022; 22:410. [PMID: 36123656 PMCID: PMC9484166 DOI: 10.1186/s12903-022-02446-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stroke patients have poor oral hygiene, experience oral dysfunction due to disease factors, and have impaired oral health-related quality of life (OHRQoL). This study aimed to determine the oral health knowledge, attitudes, and practices of stroke inpatients, assess the OHRQoL of these patients, and identify their correlates. METHODS In this cross-sectional study, 281 stroke inpatients aged between 22 and 88 years (57.94 ± 10.94) were conveniently selected from three hospitals in Guangzhou, China. OHRQoL was measured among these stroke patients using a Chinese version of the Oral Health Impact Profile-14 (OHIP-14). SPSS 26.0 was used for statistical analysis. Mean scores, standard deviations, and frequency distributions were obtained. The Mann-Whitney U test, Kruskal‒Wallis H test, Spearman's correlation, and multiple linear regression were used in the analysis. RESULTS The mean score of the patients' OHRQoL was 8.37 ± 6.67, with the highest score in the pain or discomfort of the mouth dimension (3.11 ± 2.13) and pain being the most common negative effect (13.5%). In multiple linear regression analysis, significant differences were found between patients only in age (P = 0.008), toothache (P < 0.001), self-rated oral health (P < 0.001), time since last dentist visit (P = 0.037) and reason for not having visited a dentist in the past year (P < 0.001). CONCLUSION The OHRQoL of patients hospitalised with stroke was moderate, and oral conditions still need to be improved. Increasing age, toothache, a longer time since the last dental visit and the reason for not visiting a dentist in the past year had a negative effect on OHRQoL, and better self-rated oral health had a positive effect. Therefore, in clinical work, greater attention should be given to elderly stroke patients, patients with poor oral status and poor oral health behaviours, timely assessment of patients' swallowing function, nutritional function, and self-care ability, and early and targeted oral health interventions and guidance.
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Affiliation(s)
- Simin Huang
- Department of Nursing, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Yangyang Liu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Muling Li
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhihong Liu
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Fang Zhao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jinjun Li
- Department of Nursing, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Huiqi Lu
- Department of Nursing, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, China.,School of Nursing, Southern Medical University, Guangzhou, China
| | - Hongzhen Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, China. .,School of Nursing, Southern Medical University, Guangzhou, China.
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3
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Schmalz G, Li S, Ziebolz D. Oral Health-Related Quality of Life in Patients after Stroke-A Systematic Review. J Clin Med 2022; 11:1415. [PMID: 35268507 PMCID: PMC8911029 DOI: 10.3390/jcm11051415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Aim of this systematic review was to assess oral health-related quality of life (OHRQoL) of patients after stroke. METHODS The systematic literature search was performed on December 2021 based on PubMed, Medline, Web of Science, and Scopus, with the search terms: "oral health-related quality of life" AND stroke OR apoplexy OR ischemic stroke OR apoplectic insult. Articles exclusively examining patients after stroke and reporting a well-documented and valid OHRQoL measurement were included. RESULTS Out of 68 findings, 8 studies were included. The number of patients ranged between 31 and 549 individuals, mean age between 55.7 and 73.9 years, and 49-72% of individuals were male. Two studies included a healthy control group. Oral health parameters were rarely reported across studies. Five studies reported on the Oral Health Impact Profile (OHIP) 14 for OHRQoL, showing means between 2.87 and 33.0 in sum score. Three studies applied Geriatric Oral Assessment Index (GOHAI), with sum scores between 45.6 and 55.0. Only one study found worse OHRQoL in stroke patients compared to healthy controls. Two studies reported on an association between OHRQoL and general quality of life. Three studies found OHRQoL to be associated with different oral health parameters. Only one study found OHRQoL to be associated with stroke-related parameters. CONCLUSIONS Patients after stroke show a reduced OHRQoL. Medical staff and caregivers should support oral hygiene and dental visits, to foster patients' oral health and OHRQoL.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou 510280, China;
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
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4
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Bangee M, Martinez-Garduno CM, Brady MC, Cadilhac DA, Dale S, Hurley MA, McInnes E, Middleton S, Patel T, Watkins CL, Lightbody E. Oral care practices in stroke: findings from the UK and Australia. BMC Nurs 2021; 20:169. [PMID: 34526030 PMCID: PMC8442320 DOI: 10.1186/s12912-021-00642-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/27/2021] [Indexed: 11/29/2022] Open
Abstract
Aims To examine current practice, perceptions of healthcare professionals and factors affecting provision for oral care post-stroke in the UK and Australia. Background Poor oral care has negative health consequences for people post-stroke. Little is known about oral care practice in hospital for people post-stroke and factors affecting provision in different countries. Design A cross-sectional survey. Methods Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing inpatient acute or rehabilitation care post-stroke. The survey was conducted between April and November 2019. Non-respondents were contacted up to five times. Results Completed questionnaires were received from 150/174 (86%) hospitals in the UK, and 120/162 (74%) in Australia. A total of 52% of UK hospitals and 30% of Australian hospitals reported having a general oral care protocol, with 53% of UK and only 13% of Australian hospitals reporting using oral care assessment tools. Of those using oral care assessment tools, 50% of UK and 38% of Australian hospitals used local hospital-specific tools. Oral care assessments were undertaken on admission in 73% of UK and 57% of Australian hospitals. Staff had received oral care training in the last year in 55% of UK and 30% of Australian hospitals. Inadequate training and education on oral care for pre-registration nurses were reported by 63% of UK and 53% of Australian respondents. Conclusion Unacceptable variability exists in oral care practices in hospital stroke care settings. Oral care could be improved by increasing training, performing individual assessments on admission, and using standardised assessment tools and protocols to guide high quality care. The study highlights the need for incorporating staff training and the use of oral care standardised assessments and protocols in stroke care in order to improve patient outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00642-y.
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Affiliation(s)
- Munirah Bangee
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Cintia Mayel Martinez-Garduno
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Dominique A Cadilhac
- School of Clinical Sciences at Monash Health, Monash University, VIC, Melbourne, Australia
| | - Simeon Dale
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Margaret A Hurley
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Elizabeth McInnes
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Sandy Middleton
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Tahera Patel
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Caroline L Watkins
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Elizabeth Lightbody
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK.
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Nakayama E, Tohara H, Sato M, Abe K, Kimura M, Watanabe M, Iida M, Ueda K. Relationship between oral intake level and oral health assessment tool scores in the convalescent ward. J Oral Sci 2020; 63:79-82. [PMID: 33281145 DOI: 10.2334/josnusd.20-0414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE To examine the relationship between oral intake function and oral health status in convalescent inpatients. METHODS Subjects were 222 patients admitted to a convalescent hospital between 1 January and 30 June 2018. Investigation items were age, sex, causative disease, body mass index, functional oral intake scale (FOIS), functional independence measure, occlusal contact, assistance with oral cleaning, and oral health assessment tool (OHAT) scores. Multiple regression analysis was performed with FOIS as the dependent variable, and investigation items were related to FOIS as independent variables. RESULTS Results of multiple regression analysis for all patients suggested that saliva and denture scores were significantly associated with FOIS. However, analysis excluding non-oral feeding patients did not show a significant association between FOIS and OHAT scores. CONCLUSION The results of this study suggest that oral health status is associated with oral intake function. In addition, the oral health status of inpatients may be strongly related to whether or not they are eating orally. Therefore, it is necessary to take good care of oral health in non-oral feeding patients in the convalescent ward.
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Affiliation(s)
- Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry.,Shin-yachiyo Hospital
| | - Haruka Tohara
- Shin-yachiyo Hospital.,Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Mitsuyasu Sato
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Kimiko Abe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Masanori Kimura
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Mao Watanabe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Masato Iida
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Koichiro Ueda
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
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6
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Lawal IU, Ibrahim R, Ramphoma KJ. Oral hygiene in stroke survivors undergoing rehabilitation: does upper extremity motor function matters? Top Stroke Rehabil 2020; 28:531-536. [PMID: 33164693 DOI: 10.1080/10749357.2020.1845013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Traditionally, stroke rehabilitation outcomes are based on indicators of physical function, such measures may underrate the all-inclusive impact of stroke such as oral health.Objectives: To investigate the relationship between upper extremity motor function and oral hygiene status as well as the impact of stroke on Oral Health-Related Quality of Life (OHRQoL).Methods: Sixty stroke survivors were included in this cross-sectional survey. Spasticity and motor function/mobility of the affected upper extremity were assessed using the Modified Ashworth Scale and Action Research Arm Test, respectively. Oral hygiene was assessed using the Simplified Oral Hygiene Index and oral health impact was assessed using the 14-item Oral Health Impact Profile. Pearson's moment correlation coefficient was used to determine the relationship between oral hygiene and upper extremity motor function variables.Results: There were significant relationships between the oral hygiene index and Shoulder muscles spasticity (r = 0.374, p = .01), wrist muscles spasticity (r = 0.352, p = .01), as well as basic mobility (r = 0.423, p = .01). An estimated 8% (n = 5) of study participants have their QoL strongly impacted by their oral health.Conclusions: Upper extremity motor function variables such as spasticity and basic mobility matters in determining oral hygiene status after stroke. Stroke has little impact on oral health-related quality of life.
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Affiliation(s)
- I U Lawal
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
| | - R Ibrahim
- National Assembly Clinic Abuja, Department of Medical Services, Physiotherapy Unit, Abuja, Nigeria
| | - K J Ramphoma
- Department of Community Dentistry, School of Oral Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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7
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Gurgel-Juarez N, Egan M, Wiseman M, Finestone H, Flowers HL. Technology for maintaining oral care after stroke: considerations for patient-centered practice. Disabil Rehabil Assist Technol 2020; 17:916-926. [PMID: 32988252 DOI: 10.1080/17483107.2020.1822450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Activities of daily living including oral care may be challenging after stroke. Some stroke survivors are not able to complete oral care independently and need assistance from healthcare professionals and care partners. Poor oral hygiene may impact stroke recovery and rehabilitation possibly incurring issues such as aspiration pneumonia, malnutrition, and social isolation. The objective of this paper is to outline practical ways to apply oral care technology in daily use for stroke survivors. MATERIALS AND METHODS We reviewed the literature on i) stroke-related impairments impacting oral care, ii) oral hygiene dental devices, and iii) technology for oral care education. RESULTS Oral care activities involve integrated skills in the areas of motivation, energy, planning, body movement and sensation, and mental acuity and health. Post-stroke impairments such as fatigue, hemiparesis, and mental impairments may impact oral care activities. Technology may help survivors and caregivers overcome some barriers. Three types of technologies are available for facilitating post-stroke oral care: i) non-powered tools and adaptations; ii) powered oral care tools, and; iii) electronic aids to guide oral care activities. Particular choices should maximise patient safety and autonomy while ensuring accessibility and comfort during oral care tasks. CONCLUSION The available device and technologies may help substantially with the accommodations needed for post-stroke oral care, improving the oral health of stroke survivors. Good oral health confers benefit to overall health and well-being and could enhance recovery and rehabilitation outcomes. Nonetheless, more research is necessary to demonstrate the feasibility and effectiveness of technology in stroke contexts.IMPLICATIONS FOR REHABILITATIONOral care may be challenging after stroke due to patient fatigue, hemiparesis, cognitive impairments, and other impaired body functions.Poor oral hygiene may impact stroke recovery and rehabilitation due to risk of aspiration pneumonia, malnutrition, and social isolation.Powered oral care tools, non-powered tools, and adaptations to non-powered tools are some of the technology available to help overcome post-stroke barriers for oral care.Computer programs and online resources for education and guidance for oral care activities may help improve recommendation uptake and compliance.
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Affiliation(s)
| | - Mary Egan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada.,Research Institute Safest, Bruyère Research Institute, Ottawa, Canada
| | | | - Hillel Finestone
- Department of Physical Medicine and Rehabilitation, Élisabeth Bruyère Hospital, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Heather L Flowers
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada.,Research Institute Safest, Bruyère Research Institute, Ottawa, Canada.,Department of Clinical Epidemiology, The Ottawa Hospital Research Institute, Ottawa, Canada.,Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Ottawa, Canada
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8
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Gurgel-Juarez N, Perrier MF, Hoffmann T, Lannin N, Jolliffe L, Lee R, Brosseau L, Flowers H. Guideline Recommendations for Oral Care After Acquired Brain Injury: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e17249. [PMID: 32609090 PMCID: PMC7367530 DOI: 10.2196/17249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/18/2020] [Accepted: 04/07/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Oral care is important to prevent buccal and systemic infections after an acquired brain injury (ABI). Despite recent advancements in the development of ABI clinical practice guidelines, recommendations for specific clinical processes and actions to attain adequate oral care often lack information. OBJECTIVE This systematic review will (1) identify relevant ABI clinical practice guidelines and (2) appraise the oral care recommendations existing in the selected guidelines. METHODS A search strategy was developed based on a recent systematic review of clinical practice guidelines for ABI. The protocol includes a search of MEDLINE, EMBASE, and DynaMed Plus databases, as well as organizational and best-practice websites and reference lists of accepted guidelines. Search terms will include medical subject headings and user-defined terms. Guideline appraisal will involve the Appraisal of Guidelines for Research and Evaluation II ratings, followed by a descriptive synopsis for oral care recommendations according to the National Health and Medical Research Council evidence levels. RESULTS This project started in April 2019, when we developed the search strategy. The preliminary search of databases and websites yielded 863 and 787 citations, respectively, for a total of 1650 citations. Data collection will start in August 2020 and we expect to begin disseminating the results in May 2021. CONCLUSIONS Nursing staff may not have detailed recommendations on how to provide oral care for neurologically impaired patients. The findings of this review will explore the evidence for oral care in existing guidelines and improve outcomes for patients with ABI. We expect to provide adequate orientations to clinicians, inform policy and guidelines for best practices, and contribute to future directions for research in the ABI realm. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/17249.
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Affiliation(s)
- Nalia Gurgel-Juarez
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Marie-France Perrier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Tammy Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Natasha Lannin
- Occupational Therapy Department, Alfred Health Hospital, Melbourne, Australia.,School of Allied Health, Faculty of Science, Health and Engineering, La Trobe University, Melbourne, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Laura Jolliffe
- Occupational Therapy Department, Alfred Health Hospital, Melbourne, Australia.,School of Allied Health, Faculty of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Rachel Lee
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lucie Brosseau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Heather Flowers
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Institut du Savoir Montfort, Ottawa, ON, Canada.,Toronto General Hospital, University Health Network, Toronto, ON, Canada
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9
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Koistinen S, Olai L, Ståhlnacke K, Fält A, Ehrenberg A. Oral health-related quality of life and associated factors among older people in short-term care. Int J Dent Hyg 2020; 18:163-172. [PMID: 31782889 PMCID: PMC7217038 DOI: 10.1111/idh.12424] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 11/12/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES It is well known that oral health status is associated with oral health-related quality of life (OHRQoL) in the general population. The aim of this study was to describe and analyse OHRQoL among older people in short-term care and its associated factors. MATERIALS AND METHODS This cross-sectional study included 391 older people in 36 short-term care units. Data were collected via clinical oral assessments, questions about self-perceived oral and general health, Katz Index of Activities of Daily Living (Katz-ADL) and the Revised Oral Assessment Guide (ROAG). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Multivariate logistic regression models were applied in the analysis. RESULTS Poor OHRQoL was reported by 34% of the older people. Associated factors were swallowing problems according to ROAG; quite poor/poor self-perceived physical, psychological and oral health; and being a woman. CONCLUSIONS There is an association between OHRQoL and older people's self-perceived health according to the OHIP-14. This indicates the importance of early detection of oral health problems in frail older people and to assess both oral health and swallowing problems among older people in short-term care.
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Affiliation(s)
- Susanne Koistinen
- School of Education, Health and Social StudiesDalarna UniversityFalunSweden
| | - Lena Olai
- School of Education, Health and Social StudiesDalarna UniversityFalunSweden
- Department of Public Health and Caring SciencesFamily Medicine and Preventive MedicineUppsala UniversityUppsalaSweden
| | - Katri Ståhlnacke
- School of Medicine and HealthSchool of Health SciencesÖrebro UniversityÖrebroSweden
- Dental Research DepartmentPostgraduate Dental Education CenterÖrebroSweden
| | - Anna Fält
- Clinical Epidemiology and BiostatisticsSchool of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Anna Ehrenberg
- School of Education, Health and Social StudiesDalarna UniversityFalunSweden
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10
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Lyons M, Smith C, Boaden E, Brady MC, Brocklehurst P, Dickinson H, Hamdy S, Higham S, Langhorne P, Lightbody C, McCracken G, Medina-Lara A, Sproson L, Walls A, Watkins DC. Oral care after stroke: Where are we now? Eur Stroke J 2018; 3:347-354. [PMID: 31236482 DOI: 10.1177/2396987318775206] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 04/12/2018] [Indexed: 01/25/2023] Open
Abstract
Purpose There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia - a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice. Methods A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities.Findings: Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care. Discussion Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae. Conclusion Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke. Clinically relevant, feasible, cost-effective, evidence-based oral care interventions to improve patient outcomes in stroke care are urgently needed.
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Affiliation(s)
- Mary Lyons
- Faculty of Health and Wellbeing, University of Central Lancashire, UK.,Department of International Public Health, Liverpool School of Tropical Medicine, UK
| | - Craig Smith
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, UK.,Department of Neurosciences, Salford Royal NHS Foundation Trust, UK
| | - Elizabeth Boaden
- Faculty of Health and Wellbeing, University of Central Lancashire, UK
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, UK
| | - Paul Brocklehurst
- North Wales Organisation for Randomised Trials in Health, Bangor Institute of Health and Medical Research and Salford Royal NHS Foundation Trust, UK
| | - Hazel Dickinson
- Faculty of Health and Wellbeing, University of Central Lancashire, UK
| | - Shaheen Hamdy
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Susan Higham
- Institute of Psychology, Health and Society, University of Liverpool, UK
| | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | | | - Giles McCracken
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, UK
| | | | - Lise Sproson
- National Institute for Health Research Devices for Dignity Healthcare Technology Cooperative, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Angus Walls
- Edinburgh Dental Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | - Dame Caroline Watkins
- Faculty of Health and Wellbeing, University of Central Lancashire, UK.,Faculty of Health Sciences, Australian Catholic University, Australia
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11
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Kim HT, Park JB, Lee WC, Kim YJ, Lee Y. Differences in the oral health status and oral hygiene practices according to the extent of post-stroke sequelae. J Oral Rehabil 2018; 45:476-484. [PMID: 29663483 DOI: 10.1111/joor.12634] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 11/28/2022]
Abstract
Oral health and hygiene are crucial parameters in stroke patients. However, few studies have evaluated the oral health status and oral hygiene practices according to the level of function in stroke patients. The aim of this study was to evaluate the oral health status and oral hygiene practices according to ambulation and personal hygiene levels in patients with stroke. Data from the fifth (2010-2012) and sixth (2013-2015) editions of the Korea National Health and Nutrition Examination Survey (KNHANES) for 6 years were combined. A total of 700 stroke patients were enrolled in our study. Subjective oral health was significantly poorer in patients who experienced a moderate problem with walking (adjusted OR [AOR], 1.68; 95% CI, 1.21-2.33) and bed-bound patients (AOR, 2.92; 95% CI, 1.01-8.44) than in patients who could walk without difficulty. Patients who were unable to bathe or dress independently exhibited a significantly higher risk of dental caries than did those who could perform the same activities unassisted. The probability of brushing teeth ≥2 times daily was 69% lower in bed-bound patients (AOR, 0.31; 95% CI, 0.11-0.87) than in patients who could walk without difficulty and 76% lower in patients who were unable to bathe or dress independently (AOR, 0.24; 95% CI, 0.09-0.62) than in those who could perform the same activities without difficulty. There were differences in oral health status and oral hygiene practices, according to ambulation level and functional independence, in the stroke patient group. These results indicate the need for oral care for stroke patients who exhibit ambulatory and functional limitations.
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Affiliation(s)
- H T Kim
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - J B Park
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - W C Lee
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Y J Kim
- Department of Dental Hygiene, Graduate School, Yonsei University, Seoul, Korea.,Department of Health Administration, Graduate School, Yonsei University, Wonju, Korea
| | - Y Lee
- Department of Rehabilitation Medicine, Konyang University College of Medicine, Daejeon, Korea
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Schimmel M, Ono T, Lam OLT, Müller F. Oro-facial impairment in stroke patients. J Oral Rehabil 2017; 44:313-326. [PMID: 28128465 DOI: 10.1111/joor.12486] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 01/10/2023]
Abstract
Stroke is considered one of the leading causes of death and acquired disability with a peak prevalence over the age of 80 years. Stroke may cause debilitating neurological deficiencies that frequently result in sensory deficits, motor impairment, muscular atrophy, cognitive deficits and psychosocial impairment. Oro-facial impairment may occur due to the frequent involvement of the cranial nerves' cortical representation areas, central nervous system pathways or motoneuron pools. The aim of this narrative, non-systematic review was to discuss the implications of stroke on oro-facial functions and oral health-related quality of life (OHRQoL). Stroke patients demonstrate an impaired masticatory performance, possibly due to reduced tongue forces and disturbed oral sensitivity. Furthermore, facial asymmetry is common, but mostly discrete and lip restraining forces are reduced. Bite force is not different between the ipsi- and contra-lesional side. In contrast, the contra-lesional handgrip strength and tongue-palate contact during swallowing are significantly impaired. OHRQoL is significantly reduced mainly because of the functional impairment. It can be concluded that impaired chewing efficiency, dysphagia, facial asymmetry, reduced lip force and OHRQoL are quantifiable symptoms of oro-facial impairment following a stroke. In the absence of functional rehabilitation, these symptoms seem not to improve. Furthermore, stroke affects the upper limb and the masseter muscle differently, both, at a functional and a morphological level. The rehabilitation of stroke survivors should, therefore, also seek to improve the strength and co-ordination of the oro-facial musculature. This would in turn help improve OHRQoL and the masticatory function, subsequently preventing weight loss and malnutrition.
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Affiliation(s)
- M Schimmel
- Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - T Ono
- Division of Comprehensive Prosthodontics, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - O L T Lam
- Department of Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - F Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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Kothari M, Pillai RS, Kothari SF, Spin-Neto R, Kumar A, Nielsen JF. Oral health status in patients with acquired brain injury: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:205-219.e7. [PMID: 27989711 DOI: 10.1016/j.oooo.2016.10.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/16/2016] [Accepted: 10/31/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To undertake a systematic review of the current knowledge and future perspectives regarding the status of various oral health factors, including social and behavioral aspects, in patients with acquired brain injury (ABI). STUDY DESIGN A structured search strategy was applied to PubMed, Embase, and Scopus electronic databases until January 2016 to identify studies presenting assessments of the oral health status of patients afflicted with any kind of ABI. The search strategy was restricted to English-language publications that enrolled patients aged more than 18 years. Studies on the association of oral health conditions and brain injury were excluded. No study was excluded based on its qualitative analysis. RESULTS A total of 27 studies were reviewed. Stroke was the most commonly studied ABI. Stroke patients had a higher number of missing teeth, poorer plaque and gingival index scores, and higher colonization of Candida albicans in saliva, all of which were significantly reduced after intervention. Oral health-related quality of life was poorer in patients compared to the general population. CONCLUSION Stroke was the most predominant brain injury condition studied in the literature, with few publications focusing on other forms of brain injury. Overall, oral health has been noted to be poor in patients with ABI, but oral hygiene and oral health-related quality of life have been found to improve when oral hygiene interventions are provided to patients.
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Affiliation(s)
- Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
| | - Rajath Sasidharan Pillai
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Hammel, Denmark
| | - Simple Futarmal Kothari
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Hammel, Denmark
| | - Rubens Spin-Neto
- Section of Oral Radiology, Institute of Odontology and Oral Health, Aarhus University, Denmark
| | - Abhishek Kumar
- Section of Oral Rehabiliation, Department of Dental Medicine, Karolinska Institute, Sweden
| | - Jørgen Feldbæk Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
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14
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Oral health related quality of life and it’s related factors of stroke patients at home in Korea. Arch Gerontol Geriatr 2015; 61:523-8. [DOI: 10.1016/j.archger.2015.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 06/27/2015] [Accepted: 06/29/2015] [Indexed: 11/17/2022]
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Kuo YW, Yen M, Fetzer S, Chiang LC, Shyu YIL, Lee TH, Ma HI. A home-based training programme improves family caregivers’ oral care practices with stroke survivors: a randomized controlled trial. Int J Dent Hyg 2015; 14:82-91. [DOI: 10.1111/idh.12138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2015] [Indexed: 01/30/2023]
Affiliation(s)
- Y-W Kuo
- Department of Nursing; Asia University; Taichung Taiwan
| | - M Yen
- Department of Nursing and Institute of Allied Health Sciences; College of Medicine; National Cheng Kung University; Tainan Taiwan
| | - S Fetzer
- Department of Nursing, College of Health and Human Services; University of New Hampshire; Durham NH USA
| | - L-C Chiang
- School of Nursing; National Defense; Medical Center; Taipei Taiwan
| | - Y-IL Shyu
- School of Nursing and Healthy Aging Research Center; Chang Gung University; Taoyuan Taiwan
| | - T-H Lee
- College of Medicine; Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Neurology; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - H-I Ma
- Department of Occupational and Institute of Allied Health Sciences; College of Medicine; National Cheng Kung University; Tainan Taiwan
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Kwok C, McIntyre A, Janzen S, Mays R, Teasell R. Oral care post stroke: a scoping review. J Oral Rehabil 2014; 42:65-74. [DOI: 10.1111/joor.12229] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- C. Kwok
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - A. McIntyre
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - S. Janzen
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - R. Mays
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - R. Teasell
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry; Western University; London ON Canada
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Dai R, Lam OLT, Lo ECM, Li LSW, Wen Y, McGrath C. Orofacial functional impairments among patients following stroke: a systematic review. Oral Dis 2014; 21:836-49. [PMID: 25041135 DOI: 10.1111/odi.12274] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/11/2014] [Accepted: 06/23/2014] [Indexed: 11/27/2022]
Affiliation(s)
- R Dai
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
| | - O LT Lam
- Department of Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 4/F; Sai Ying Pun Hong Kong China
| | - E CM Lo
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
| | - L SW Li
- Department of Rehabilitation Medicine; Tung Wah Hospital; Sheung Wan Hong Kong China
| | - Y Wen
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
| | - C McGrath
- Department of Public Health; Faculty of Dentistry; The University of Hong Kong; Prince Philip Dental Hospital 3/F; Sai Ying Pun Hong Kong China
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Dai R, Lam OLT, Lo ECM, Li LSW, Wen Y, McGrath C. A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. J Dent 2014; 43:171-80. [PMID: 24960298 DOI: 10.1016/j.jdent.2014.06.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 06/12/2014] [Accepted: 06/14/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective of this study was to review clinical, microbiological, and immunological aspects of oral health, as well as oral health related behaviours among patients following stroke. DATA SOURCES A structured search strategy was applied to three electronic databases to identify relevant papers. STUDY SELECTION The initial search yielded 19,927 papers, 60 potentially relevant studies (Kappa: 0.974) and 23 relevant papers (Kappa: 0.965) in accordance with the inclusion criteria. Outcomes regarding tooth condition, periodontal condition, oral hygiene status, and dental attendance were pooled for seven meta-analyses. Narrative summaries were provided for those outcomes which could not be pooled for meta-analysis. RESULTS The standardized differences in mean values of the parameters (fixed effect, random effect model) for patients with stroke compared to control groups were: number of teeth (-0.325, -0.271), DMFT (0.246, 0.246), oral hygiene status - plaque index (0.305, 0.356) and gingival index (0.716, 0.653), periodontal health status - clinical attachment loss (0.437, 0.490) and probing depth (0.470, 0.579). In addition, a lower chance of dental attendance was observed among patients with stroke (odds ratio: 0.493, 0.480). For those outcomes which could not be pooled for meta-analysis, it was not possible to draw any qualitative conclusion due to the equivocal results of these studies. CONCLUSIONS There is an increasing interest in oral health of patients with stroke. Patients with stroke had a poorer clinical oral health status across a range of parameters (tooth loss, dental caries experience, and periodontal status). Coupled with this, their dental attendance was less frequent. Further studies employing standardized assessments of oral health/oral health behaviour can confirm these oral health disparities. CLINICAL SIGNIFICANCE With comprehensive literature search, this systematic review and meta-analysis indicated a poorer oral health status and less frequent dental attendance behaviour among patients with stroke.
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Affiliation(s)
- Ruoxi Dai
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Otto L T Lam
- Department of Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 4/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Edward C M Lo
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Leonard S W Li
- Department of Rehabilitation Medicine, Tung Wah Hospital, 12 Po Yan Street, Sheung Wan, Hong Kong, China
| | - Yifeng Wen
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Colman McGrath
- Department of Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital 3/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, China.
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A systematic review of the effectiveness of oral health promotion activities among patients with cardiovascular disease. Int J Cardiol 2010; 151:261-7. [PMID: 21176980 DOI: 10.1016/j.ijcard.2010.11.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 11/18/2010] [Accepted: 11/29/2010] [Indexed: 01/08/2023]
Abstract
AIMS This study aimed to review the effectiveness of oral health promotion activities conducted among patients with cardiovascular disease. METHODS AND RESULTS Three electronic databases were searched for effective papers using standardized search methods, and key findings of effective studies were summarized. The initial search yielded 3101 papers but only 8 studies met the criteria for this review: 3 were randomized controlled studies, 3 were pre-/post group interventions, 1 was a randomized split-mouth study, and 1 was a quasi-experimental study. Studies retrieved concerned oral health promotion activities in patients with coronary heart disease, hypertension, heart transplantation, and stroke. Interventions comprised periodontal treatment performed by dental personnel, and oral hygiene interventions provided by nursing home care assistants. Outcomes included improvements in periodontal health, and modifications of systemic inflammatory markers. No studies, however, evaluated the effects of oral health promotion interventions on oral microflora. CONCLUSION There are limited studies on the efficacy of oral health promotion activities in patients with cardiovascular disease, particularly stroke patients. Oral health promotion activities appear to produce improvements in periodontal health, and also result in changes to systemic markers of inflammation and endothelial function (at least) in the short term. Whether these effects can ultimately lower the risk of secondary cardiovascular events has not yet been determined.
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A new management approach for dental treatment after a cerebrovascular event: a comparative retrospective study. ACTA ACUST UNITED AC 2010; 110:145-50. [DOI: 10.1016/j.tripleo.2010.03.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 02/15/2010] [Accepted: 03/16/2010] [Indexed: 11/18/2022]
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Tran P, Mannen J. Improving oral healthcare: improving the quality of life for patients after a stroke. SPECIAL CARE IN DENTISTRY 2009; 29:218-21. [PMID: 19740154 DOI: 10.1111/j.1754-4505.2009.00096.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
With the increase in the elderly population, the prevalence of systemic diseases such as strokes and heart attacks will also increase. Persons who have had a stroke will be more susceptible to mistreatment, neglect, abuse, and aspiration pneumonia. The expansion of the elderly population will make the training of professional healthcare workers and other auxiliaries extremely important. Quality of life can be maintained if poor oral health is reduced through better daily oral hygiene practices. Informing others about the known association between oral health and systemic diseases will increase the awareness of the need for good oral hygiene in order to reduce the risk of systemic diseases. Healthcare professionals must also be able to recognize, document, and report to Adult Protective Services suspected abuse such as physical and dental neglect. The networking of healthcare providers with Adult Protective Services and other professional disciplines will provide a collaborative approach to assure successful integration of healthcare protocols for the elderly population.
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Hebling E, Pereira AC. Oral health-related quality of life: a critical appraisalof assessment tools used in elderly people. Gerodontology 2007; 24:151-61. [PMID: 17696892 DOI: 10.1111/j.1741-2358.2007.00178.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to undertake a critical appraisal of oral health-related quality of life (OHRQoL) measurements used for research in the elderly. BACKGROUND A variety of OHRQoL measurements have been developed in the past 20 years as a result of increased concern about the impact of oral conditions on a person's quality of life. There is need for an assessment aimed at prioritising the recommended measurements to be used for different purposes in the elderly. MATERIALS AND METHODS Original English language papers using measurements to assess OHRQoL in the elderly were identified from Web of Science, EMBASE, PubMed, Medline and Lilacs databases. The search included all papers published from 1985 to February 2007. The criteria of assessment were: (i) measurement criteria (number of items and domains, and classification of the results found for each measurement); (ii) quantitative-qualitative criteria (frequency, acceptability, reproducibility, reliability, sensitivity and capability of being reproduced in other language versions). RESULTS In a total of 152 papers selected, 20 measurements were identified. However, only seven fulfilled all the measurement and quantitative-qualitative criteria. CONCLUSION Geriatric Oral Health Assessment Index, Subjective Oral Health Status Indicators, Oral Health Impact Profile-49, Dental Impact on Daily Living, Oral Health Impact Profile-14, Oral Impact on Daily Performances and German Version of the Oral Heath Impact Profile were considered as instruments of choice to assess OHRQoL in the elderly. The other 13 instruments identified require further research aimed at a validation process and the use of a language other than English.
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Affiliation(s)
- Eduardo Hebling
- Department of Community Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, Sao Paulo, Brazil.
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