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Asante EO, Eldholm RS, Kolberg M, Skjellegrind HK, Selbæk G, Mai XM, Chen Y, Sun YQ. The Association Between Cognitive Function and Oral Health in Home Dwellers and Nursing Home Residents: The HUNT Study. Community Dent Oral Epidemiol 2024. [PMID: 39400410 DOI: 10.1111/cdoe.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 09/25/2024] [Indexed: 10/15/2024]
Abstract
OBJECTIVES To evaluate the relationships of cognitive function and care dependency with oral health in a Norwegian older adult population. METHODS This cross-sectional study included 2623 participants aged 70 and older from the fourth wave of the Trøndelag health study (HUNT4 70+) and the city of Trondheim (Trondheim 70+). Neurocognitive disorders (NCDs) were diagnosed by clinical experts according to the DSM-5 framework. Care dependency referred to nursing home residency. Oral health was assessed by using the Revised Oral Assessment Guide-Jönköping (ROAG-J). Individuals were considered as 'having oral problem' if the score was two or three in at least one of the nine ROAG-J items. Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS The prevalence of having oral problems was 19% higher in participants with NCDs than those with normal cognitive function after adjusting for potential confounders (PR 1.19, 95% CI: 1.09-1.29). Further analysis showed a higher prevalence of having oral problems for home dwellers with NCDs (PR 1.23, 95% CI: 1.13-1.33) and nursing home residents (PR 1.32, 95% CI: 1.20-1.45) compared to home dwellers with normal cognitive function. CONCLUSIONS NCDs were associated with an increased prevalence of oral problems in this Norwegian older adult population. The study suggests the need for increasing oral care for home dwellers with NCDs and nursing home residents.
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Affiliation(s)
- Ernest Obeng Asante
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Geriatrics, Clinic of Medicine, St. Olavs Hospital, Trondheim, Norway
| | - Marit Kolberg
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
| | - Håvard Kjesbu Skjellegrind
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Yi-Qian Sun
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim, Norway
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Chuang JCP, Pradhan A, Walsh LJ, Lopez Silva CP. Singapore dentists' attitudes toward dental care provision for older adults with disabilities. Gerodontology 2024; 41:59-67. [PMID: 36924433 DOI: 10.1111/ger.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES This study aimed to assess dentists' attitudes toward providing dental care for older adults with disabilities in Singapore and the factors influencing their willingness to provide care. BACKGROUND Dentists face a rapidly ageing patient demographic. Practitioner unwillingness to circumvent the attending challenges of care provision prevents older adults from accessing the dental care necessary for better oral and systemic health. Previous studies have reported on dentists' attitudes toward caring for older adults with disabilities; however, these are mostly limited to dependent older adults and exclude frail, community-dwelling older persons. METHODS A cross-sectional study was conducted in 2020 using a self-administered questionnaire. Quantitative data analysis was presented in the form of descriptive statistics, followed by bivariate analyses. RESULTS There were 193 respondents, a response rate of under 9%. Dentists were less willing, confident and involved in the care of older adults with disabilities as the individual's severity of impairments increased. Less than half of respondents were willing to treat individuals with severe disabilities in cooperation (23.3%), swallowing (30.6%), mobility (33.7%) and communication (45.1%). Dentists with training in geriatric dentistry were more willing to provide care. However, younger dentists, general dental practitioners, private practitioners and public sector dentists had specific restraining and driving forces, which further modulated their willingness to provide care. CONCLUSIONS The current areas of training needs among Singapore dentists are in severe impairments of swallowing, communication, cooperation and mobility. Further geriatric dentistry training may effectively increase dentists' willingness to provide care; however, additional specific targeted interventions are also needed.
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Affiliation(s)
- Janice Cheah Ping Chuang
- Tan Tock Seng Hospital, Singapore, Singapore
- The University of Queensland Oral Health Centre, Herston, Queensland, Australia
| | - Archana Pradhan
- The University of Queensland Oral Health Centre, Herston, Queensland, Australia
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Bakker MH, de Smit MJ, Valentijn A, Visser A. Oral health assessment in institutionalized elderly: a scoping review. BMC Oral Health 2024; 24:272. [PMID: 38402181 PMCID: PMC10893687 DOI: 10.1186/s12903-024-04025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.
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Affiliation(s)
- M H Bakker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
| | - M J de Smit
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Valentijn
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- Department of Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Nouri FN, Afshar MK, Afshar MK, Hooshmand H, Nia RG. Exploring the knowledge, attitudes, and performance of dentists in providing care to elderly patients. BMC Oral Health 2024; 24:62. [PMID: 38195514 PMCID: PMC10777511 DOI: 10.1186/s12903-023-03832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Supportive care and dental treatment for older adults are crucial in addressing the global emergency of population aging, requiring specialized healthcare services and knowledge-based practices. METHODS This cross-sectional content analysis study was conducted on 150 general dentists in Kerman in 2021. The participants were selected using cluster sampling. The data were collected using a questionnaire with four sections assessing the participants' demographic characteristics, knowledge, attitudes, and performance. The data were analyzed with SPSS-26 software using the t-test, ANOVA, and linear regression analysis. RESULTS The dentists' mean age was 36.10 ± 7.60 years. The mean knowledge score of the participants was 5.29 ± 1.49 (out of 9). The mean attitude score was 59.42 ± 11.6 (out of 85), and the mean performance score was 24.13 ± 4.96 (out of a maximum of 35). The data showed a positive relationship between the dentists' knowledge, attitudes, and performance. However, the participants' gender had no significant correlation with their knowledge, attitudes, or performance. It was also shown that 50% of dentists had adequate experience treating elderly patients with complex medical problems. CONCLUSIONS The participants had an adequate level of knowledge and performance and a positive attitude toward dental care for older adults. Health officials and administrators need to organize and hold effective training and refresher courses on geriatric dentistry to promote dentists' knowledge and performance. TRIAL REGISTRATION Ethics code IR.KMU.REC.1401.007.
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Affiliation(s)
- Fateme Najmi Nouri
- Department of Community Dentistry, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrnaz Karimi Afshar
- Department of Prosthodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Karimi Afshar
- Department of Orthodontics, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Rahil Ghorbani Nia
- Health Care Management, Noncommunicable Diseases Research Center, Noncommunicable Diseases Research Center, Bam University of Medical Sciences & Health Services, Shahid Rajaie Blvd, Bam, Iran.
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Rostad HM, Burrell LV, Skinner MS, Hellesø R, Sogstad MKR. Quality of Municipal Long-Term Care in Different Models of Care: A Cross-Sectional Study From Norway. Health Serv Insights 2023; 16:11786329231185537. [PMID: 37475731 PMCID: PMC10354822 DOI: 10.1177/11786329231185537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
The quality of care remains a critical concern for health systems around the globe, especially in an era of unprecedented financial challenges and rising demands. Previous research indicates large variation in several indicators of quality in the long-term care setting, highlighting the need for further investigation into the factors contributing to such disparities. As different ways of delivering long-term care services likely affect quality of care, the objectives of our study is to investigate (1) variation in structure, process and outcome quality between municipalities, and (2) to what extent variation in quality is associated with municipal models of care and structural characteristics. The study had a cross-sectional approach and we utilized data on the municipal level from 3 sources: (1) a survey for models of care (2) Statistics Norway for municipal structural characteristics and (3) the National Health Care Quality Indicator System. Descriptive statistics showed that the Norwegian long-term care sector performs better (measured as percentage or probability) on structure (85.53) and outcome (84.86) quality than process (37.85) quality. Hierarchical linear regressions indicated that municipal structural characteristics and model of care had very limited effect on the quality of long-term care. A deeper understanding of variation in service quality may be found at the micro level in healthcare workers' day-to-day practice.
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Affiliation(s)
- Hanne Marie Rostad
- Center for Care Research East, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Lisa Victoria Burrell
- Center for Care Research East, Norwegian University of Science and Technology, Gjøvik, Norway
| | | | - Ragnhild Hellesø
- Center for Care Research East, Norwegian University of Science and Technology, Gjøvik, Norway
- Department of Public Health Science, University of Oslo, Oslo, Norway
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Chen P, Cai H, Bai W, Zhang Q, Su Z, Tang YL, Ungvari GS, Ng CH, Xiang YT. Global prevalence of mild cognitive impairment among older adults living in nursing homes: a meta-analysis and systematic review of epidemiological surveys. Transl Psychiatry 2023; 13:88. [PMID: 36906613 PMCID: PMC10008549 DOI: 10.1038/s41398-023-02361-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 03/13/2023] Open
Abstract
Mild cognitive impairment (MCI) is the early stage of cognitive impairment between the expected cognitive decline of normal aging and the more serious decline of dementia. This meta-analysis and systematic review explored the pooled global prevalence of MCI among older adults living in nursing homes and its relevant factors. The review protocol was registered in INPLASY (INPLASY202250098). PubMed, Web of Science, Embase, PsycINFO, and CINAHL databases were systematically searched from their respective inception dates to 8 January 2022. The inclusion criteria were made based on the PICOS acronym, as follows: Participants (P): Older adults living in nursing homes; Intervention (I): not applicable; Comparison (C): not applicable; Outcome (O): prevalence of MCI or the data can generate the prevalence of MCI according to study-defined criteria; Study design (S): cohort studies (only baseline data were extracted) and cross-sectional studies with accessible data published in a peer-reviewed journal. Studies involving mixed resources, reviews, systematic reviews, meta-analyses, case studies, and commentaries were excluded. Data analyses were performed using Stata Version 15.0. Random effects model was used to synthesize the overall prevalence of MCI. An 8-item instrument for epidemiological studies was used to assess the quality of included studies. A total of 53 articles were included involving 376,039 participants with a mean age ranging from 64.42 to 86.90 years from 17 countries. The pooled prevalence of MCI in older adults in nursing homes was 21.2% (95% CI: 18.7-23.6%). Subgroup and meta-regression analyses revealed that the screening tools used were significantly associated with MCI prevalence. Studies using the Montreal Cognitive Assessment (49.8%) had a higher prevalence of MCI than those using other instruments. No significant publication bias was found. Several limitations warrant attention in this study; for example, significant heterogeneity between studies remained and some factors associated with the prevalence of MCI were not examined due to insufficient data. Adequate screening measures and allocation of resources are needed to address the high global prevalence of MCI among older adults living in nursing homes.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, SAR, China
| | - Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia.,Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China. .,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China.
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Cao Y, Liu C, Lin J, Ng L, Needleman I, Walsh T, Li C. Oral care measures for preventing nursing home-acquired pneumonia. Cochrane Database Syst Rev 2022; 11:CD012416. [PMID: 36383760 PMCID: PMC9668328 DOI: 10.1002/14651858.cd012416.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pneumonia in residents of nursing homes can be termed nursing home-acquired pneumonia (NHAP). NHAP is one of the most common infections identified in nursing home residents and has the highest mortality of any infection in this population. NHAP is associated with poor oral hygiene and may be caused by aspiration of oropharyngeal flora into the lung. Oral care measures to remove or disrupt oral plaque might reduce the risk of NHAP. This is the first update of a review published in 2018. OBJECTIVES To assess effects of oral care measures for preventing nursing home-acquired pneumonia in residents of nursing homes and other long-term care facilities. SEARCH METHODS An information specialist searched CENTRAL, MEDLINE, Embase, one other database and three trials registers up to 12 May 2022. We also used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated the effects of oral care measures (brushing, swabbing, denture cleaning mouthrinse, or combination) in residents of any age in nursing homes and other long-term care facilities. DATA COLLECTION AND ANALYSIS At least two review authors independently assessed search results, extracted data, and assessed risk of bias in the included studies. We contacted study authors for additional information. We pooled data from studies with similar interventions and outcomes. We reported risk ratios (RRs) for dichotomous outcomes, mean differences (MDs) for continuous outcomes, and hazard ratios (HRs) or incidence rate ratio (IRR) for time-to-event outcomes, using random-effects models. MAIN RESULTS We included six RCTs (6244 participants), all of which were at high risk of bias. Three studies were carried out in Japan, two in the USA, and one in France. The studies evaluated one comparison: professional oral care versus usual oral care. We did not include the results from one study (834 participants) because it had been stopped at interim analysis. Consistent results from five studies, with 5018 participants, provided insufficient evidence of a difference between professional oral care and usual (simple, self-administered) oral care in the incidence of pneumonia. Three studies reported HRs, one reported IRRs, and one reported RRs. Due to the variation in study design and follow-up duration, we decided not to pool the data. We downgraded the certainty of the evidence for this outcome by two levels to low: one level for study limitations (high risk of performance bias), and one level for imprecision. There was low-certainty evidence from meta-analysis of two individually randomised studies that professional oral care may reduce the risk of pneumonia-associated mortality compared with usual oral care at 24 months' follow-up (RR 0.43, 95% CI 0.25 to 0.76, 454 participants). Another study (2513 participants) reported insufficient evidence of a difference for this outcome at 18 months' follow-up. Three studies measured all-cause mortality and identified insufficient evidence of a difference between professional and usual oral care at 12 to 30 months' follow-up. Only one study (834 participants) measured the adverse effects of the interventions. The study identified no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining. No studies evaluated oral care versus no oral care. AUTHORS' CONCLUSIONS Although low-certainty evidence suggests that professional oral care may reduce mortality compared to usual care when measured at 24 months, the effect of professional oral care on preventing NHAP remains largely unclear. Low-certainty evidence was inconclusive about the effects of this intervention on incidence and number of first episodes of NHAP. Due to differences in study design, effect measures, follow-up duration, and composition of the interventions, we cannot determine the optimal oral care protocol from current evidence. Future trials will require larger samples, robust methods that ensure low risk of bias, and more practicable interventions for nursing home residents.
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Affiliation(s)
- Yubin Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jie Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Anaesthesiology and Intensive Care Unit, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Linda Ng
- School of Nursing and Midwifery, The University of Queensland, South Brisbane, Australia
| | - Ian Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | - Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Chunjie Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Alqarni MA, Mattoo K, Dhingra S, Baba SM, Al Sanabani F, Al Makramani BMA, Akkam HM. Sensitizing Family Caregivers to Influence Treatment Compliance among Elderly Neglected Patients-A 2-Year Longitudinal Study Outcome in Completely Edentulous Patients. Healthcare (Basel) 2021; 9:healthcare9050533. [PMID: 34063316 PMCID: PMC8147452 DOI: 10.3390/healthcare9050533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers have reported a certain segment of geriatric patients that are suffering from abuse/neglect, which in turn has been associated with anxiety, depression, and helplessness in the individual. Family caregivers (blood relations), being the most common perpetrators of elder abuse and neglect (EAN), have also been shown to respond to sensitization if the type of EAN and the interventions are appropriate. This study was aimed to comparatively analyze the influence of intervention (psychotherapeutic sensitization of FCG) upon long-term (24 months) treatment maintenance and satisfaction in elderly neglected patients. One hundred and fifty patients (aged 41–80 years) suffering from elder neglect (EN) (self-confession) and their respective FCGs, fulfilling the study criteria, participated in this longitudinal 2-year study. The patients were randomly distributed (simple random, convenient) in two equal groups (75 each), namely Group (GP) A (control) and GP B (test). A standardized, complete denture treatment was initiated for all the participants. Both the FCGs and the patients of GP B were sensitized (psychotherapeutic education) for EN, while there was no such intervention in GP A. The influence of such intervention was measured for denture maintenance [denture plaque index (DPI) scores] and treatment satisfaction (10-point visual analog scale). Absolute/relative frequencies and means were major calculations during data analysis. Differences between the groups for any treatment compliance parameter was done through the unpaired t-test, while Karl Pearson’s test determined the level of relationship between variables (p-value < 0.05). Decrease in mean DPI scores (suggesting improvement) was seen among patients in GP A from 1 month (m = 2.92) to 24 months (m = 2.77). A negligible increase in DPI scores was observed among patients of GP B from 1 month (m = 1.38) to 24 months (m = 1.44). Differences in mean values between the two groups were statistically significant at 24-month intervals, while the relationship between the variables was nonsignificant. FCG sensitization through psychotherapeutic education shows a long-term positive influence on the treatment compliance (maintenance and satisfaction). Identifying the existence of EAN among geriatric patients, followed by psychotherapeutic education of FCGs is recommended for routine medical and dental long-duration treatment procedures.
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Affiliation(s)
- Mohammed A. Alqarni
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (M.A.A.); (S.M.B.)
| | - Khurshid Mattoo
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (F.A.S.); (B.M.A.A.M.); (H.M.A.)
- Correspondence: ; Tel.: +966-595-086-078
| | - Surbhi Dhingra
- Department of Oral Maxillofacial Prosthetics, Subharti Dental College, Swami Vivekananda Subharti Univeristy, Meerut 250001, India;
| | - Suheel Manzoor Baba
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (M.A.A.); (S.M.B.)
| | - Fuad Al Sanabani
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (F.A.S.); (B.M.A.A.M.); (H.M.A.)
| | - Bandar M. A. Al Makramani
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (F.A.S.); (B.M.A.A.M.); (H.M.A.)
| | - Hadeel Mohammed Akkam
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (F.A.S.); (B.M.A.A.M.); (H.M.A.)
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First Data in the Process of Validating a Tool to Evaluate Knowledge, Attitude, and Practice of Healthcare Providers in Oral Care of Institutionalized Elderly Residents: Content Validity, Reliability and Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084145. [PMID: 33919908 PMCID: PMC8070937 DOI: 10.3390/ijerph18084145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022]
Abstract
Background: Oral health of elderly people is a global concern. Poor oral health in institutionalized elderly people has been attributed to poor knowledge, attitude, and practice (KAP) of healthcare providers. However, no validated KAP tool is available yet. Objective: To develop and validate a tool to measure knowledge, attitude, and practice of healthcare providers in oral care of institutionalized elderly people. Methods: The development and validation of the tool was based on literature reviews, comments from professional experts, and statistical analytic methods. Content validity in the instrument psychometric property and its relevance with reliability are essential. Content validity ratio and content validity index were performed. Then, a pilot study was conducted in 20 institutionalized healthcare providers for testing applicability, feasibility, and reliability. Results: A total of 43 items were developed in three domains, knowledge (19 items), attitude (13 items), and practice (11 items). Content validity analysis revealed the KAP tool with high values of the I-CVI (score 1.00) and S-CVI (S-CVI/UA result 1.00). The test-retest reliability with Cronbach’s alphas of knowledge, attitude, practice, and overall KAP were 0.67, 0.93, 0.92, and 0.94, respectively. Conclusions: The developed and validated tool is appropriate to measure KAP of healthcare providers in oral care of institutionalized elderly people. It can be used to measure KAP of institutionalized healthcare providers in order to develop appropriate strategies to improve KAP of healthcare providers.
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Usuga-Vacca M, Marin-Zuluaga DJ, Castellanos JE, Martignon S. Association between root/coronal caries and individual factors in institutionalised elderly using ICDAS severity and activity. BMC Oral Health 2021; 21:146. [PMID: 33752655 PMCID: PMC7986499 DOI: 10.1186/s12903-021-01520-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background Caries in the elderly has been associated with dependence, oral-health status and -care practices. This cross-sectional study aimed to investigate the association between root/coronal caries and individual factors among institutionalised elderly people in Bogotá, Colombia, using the International Caries Detection and Assessment System severity and activity criteria (ICDAS).
Methods A total of 226 institutionalised elderly were clinically examined for root and coronal caries in 40 institutions. Caries risk was assessed with Cariogram, and demographics, oral health knowledge and practices, oral health-related quality of life and denture-use habits using a questionnaire. Results Participants (mean age: 80.1 ± 9.3 years; 63.7% female) presented a mean number of 10.8 ± 7.3 teeth and 19.4 ± 18.8 exposed root surfaces. Prevalence of Coronal-ICDAS caries experience (C-ICDAS DF) was of 100% and of 54.4% for C-ICDAS D; mean number of C-ICDAS DFS was 16.76 ± 27.36, with 50.9% of subjects having ≥ one active C-ICDAS DS. Prevalence of Root Caries Index was of 49.1% and of R-ICDAS DF of 46%; mean number of R-ICDAS DFS was 2.03 ± 2.78, with 40.3% of subjects having ≥ one active R-ICDAS DS. Most individuals had a systemic condition (94.2%) and required oral-hygiene assistance (58%). Logistic regression analyses showed significant associations (p < 0.05): for coronal active caries when having over six teeth (OR: 2.7), and for root caries, when having coronal caries (OR: 2.41), being a man (OR: 1.95), and having over 14 teeth (OR: 0.30). Those presenting with > eight exposed root surfaces were 4.04 more likely to have root caries and 2.4 times more likely to have active root caries. Conclusion In the institutionalised elderly population in Bogotá significant associations were found, both for the presence as for the activity status of root and coronal caries, with individual clinical factors including coronal caries, exposed root surfaces and number of teeth. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01520-4.
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Affiliation(s)
- Margarita Usuga-Vacca
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Dairo Javier Marin-Zuluaga
- Research Group in Gerodontology, School of Dentistry, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.
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Bianco A, Mazzea S, Fortunato L, Giudice A, Papadopoli R, Nobile CGA, Pavia M. Oral Health Status and the Impact on Oral Health-Related Quality of Life among the Institutionalized Elderly Population: A Cross-Sectional Study in an Area of Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042175. [PMID: 33672197 PMCID: PMC7926719 DOI: 10.3390/ijerph18042175] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
Background: The objectives of this study were to describe the oral health status in the institutionalized geriatric population in an area of southern Italy and to identify the impact of oral health on the Oral Health Related Quality of Life (OHRQoL). Methods: Data were collected from individuals aged ≥60 years in randomly selected Calabrian long-term care facilities. The dental health status was assessed recording the decayed, missing, or filled dental elements due to the carious lesions (DMFT) index, the presence of visible dental plaque, and the gingival condition. The influence of the dental health status on the self-perceived value of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Results: Among the 344 elderly individuals included, 18.4% reported frequent tooth-brushing, and only 39.9% reported the need of dental care. The DMFT index was 26.4. Less than a third of the participants had a GOHAI score of ≤50 which is suggestive of highly compromised OHRQoL. The GOHAI score was significantly better for elderly individuals with no self-perceived need of dental care and with a lower DMFT index. Conclusions: The burden of oral conditions among residents in long-term care facilities was considerable, with a high prevalence of missing teeth and dentures. Strategies targeting care providers are needed.
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Affiliation(s)
- Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
| | - Silvia Mazzea
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
| | - Leonzio Fortunato
- Department of Health Sciences, School of Dentistry, University of Catanzaro “Magna Græcia”, Via T. Campanella, 88100 Catanzaro, Italy; (L.F.); (A.G.)
| | - Amerigo Giudice
- Department of Health Sciences, School of Dentistry, University of Catanzaro “Magna Græcia”, Via T. Campanella, 88100 Catanzaro, Italy; (L.F.); (A.G.)
| | - Rosa Papadopoli
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
| | | | - Maria Pavia
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5, 80138 Naples, Italy
- Correspondence: ; Tel./Fax: +39-81-5667716
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12
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van de Rijt LJM, Feast AR, Vickerstaff V, Sampson EL, Lobbezoo F. Oral function and its association with nutrition and quality of life in nursing home residents with and without dementia: A cross-sectional study. Gerodontology 2021; 38:404-413. [PMID: 33521997 PMCID: PMC9291735 DOI: 10.1111/ger.12535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 12/23/2020] [Accepted: 01/08/2021] [Indexed: 12/11/2022]
Abstract
Background Oral health problems increase with age, and are common in nursing home residents, especially in those with dementia. These problems can lead to tooth loss, diminished oral function and malnutrition. Objectives To compare oral function, nutritional status and quality of life (QoL) between residents with and without dementia, and to examine associations between these variables. Methods Cross‐sectional study conducted in four UK nursing homes. Residents aged 65 + with and without dementia were included. Information was collected on demographics, dental status, quality of swallowing and chewing, xerostomia and orofacial pain. During oral examination, information was collected on number of teeth and occlusal units (OU), and functional categories (eg, OU combined with dentures). Multiple linear regression was used for statistical analysis. Results Of 84 residents with and 27 without dementia participated. Residents with dementia had significantly fewer teeth (Dementia median (IQR) = 14 (6‐21), vs No dementia 22 (12.75‐24.25); P = .021), fewer OU (Dementia median (IQR) = 0 (0‐3), vs No dementia 4 (0‐7); P = .001) and poorer functional categories (Z = −3.283; P = .001), and nutritional status was significantly poorer than those without (Dementia Mean (SD) = 8.3 (2.7), vs No dementia 10.4 (2.0); P = .002). In the regression model, quality of chewing (Coef (95% CI) = −1.27 (−2.22, −0.31); P = .010) was significantly correlated with nutritional status. Conclusion Oral function and nutritional status of residents with dementia was poorer than those without. Almost half of all residents had insufficient oral function, which was negatively associated with QoL and nutritional status.
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Affiliation(s)
- Liza J M van de Rijt
- Department of Orofacial Pain and Dysfunction, Faculty of Dentistry, 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
| | - 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
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Faculty of Dentistry, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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13
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Bellander L, Andersson P, Nordvall D, Hägglin C. Oral health among older adults in nursing homes: A survey in a national quality register, the Senior Alert. Nurs Open 2021; 8:1262-1274. [PMID: 33400398 PMCID: PMC8046056 DOI: 10.1002/nop2.743] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/29/2020] [Accepted: 11/16/2020] [Indexed: 11/09/2022] Open
Abstract
Aim To investigate the extent to which the Revised Oral Assessment Guide–Jönköping (ROAG‐J) is used by nursing staff routinely in nursing homes in Sweden and to describe oral health status of the residents. Design An observational, retrospective register‐based study. Methods Data from different validated health assessments instruments, including ROAG‐J, for the period 2011–2016 were obtained from the Web‐based national quality register Senior Alert. The basis for the analyses was 190,016 assessments. Results About half of all residents had underwent at least one annual ROAG‐J assessment (2014–2016). During the period 2011–2016, 42% of the residents (n = 92,827) were registered to have oral health problems. Significantly more oral health problems were found for men and for those with younger age, poorer physical condition, neurophysiological problems, underweight, impaired mobility and many medications. In conclusion, poorer oral health was found for more care‐dependent individuals, which shows a need of preventive actions.
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Affiliation(s)
- Lisa Bellander
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Centre for Gerodontology, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Pia Andersson
- Department of Oral Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Dennis Nordvall
- Jönköping County Council Qulturum, Center for Development, Jönköping, Sweden
| | - Catharina Hägglin
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Centre for Gerodontology, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
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14
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Konstantopoulou K, Kossioni A, Karkazis H, Polyzois G. Implementation and evaluation of an oral health education programme for caregivers in nursing homes. SPECIAL CARE IN DENTISTRY 2021; 41:154-163. [PMID: 33382125 DOI: 10.1111/scd.12558] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim was the design, implementation, and evaluation of an oral health education program for nursing home caregivers. METHODS AND RESULTS Fifty-five formal caregivers working in the three units of a nursing home were allocated to either a control (n = 27) or an intervention group (n = 28). A knowledge and attitudes questionnaire about oral health was developed and completed by the caregivers. Then, an education program about oral heath in older people was applied to the intervention group, and the completion of the questionnaire was repeated by both the intervention and control groups. Two months after the intervention, the questionnaire was completed again by the intervention group. Within groups analyses revealed a statistically significant increase in knowledge and attitudes only in the intervention group after the implementation of the education program (P < .001). Between-group analyses showed that the total knowledge and attitudes score in the intervention group were statistically significantly higher than in the control group (P < .001 and P = .02, respectively). In the intervention group, knowledge and attitudes were maintained in the measurement recorded 2 months later (P = .11 and P = .21, respectively). CONCLUSION The education program was effective in improving the caregivers' knowledge and attitudes toward nursing home residents' oral health and maintaining them 2 months after implementation.
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Affiliation(s)
- Kalliopi Konstantopoulou
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastassia Kossioni
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Hercules Karkazis
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregory Polyzois
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Akifusa S, Liu HY, Huang MS, Funahara M, Izumi M, Harada K, Shono Y. Comparison of attitudes towards persons with dementia, knowledge of dementia and ageism amongst students in Taiwan and Japan: A cross-sectional study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:301-309. [PMID: 31967693 DOI: 10.1111/eje.12498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
INTRODUCTION This study aimed to compare the attitudes towards people with dementia, knowledge of dementia and ageism amongst Taiwanese and Japanese dental hygiene students. MATERIAL AND METHODS A total of 328 students participated in this cross-sectional study. Attitudes, knowledge and ageism were assessed using self-reports. Participants' association with older adults or persons with dementia was also assessed. Primary outcomes included attitude, knowledge and ageism amongst students. Secondary outcomes were the factors related to their desire to work with persons with dementia. RESULTS Data of 175 Taiwanese and 91 Japanese students were analysed. There were significantly more Japanese (69.2%) than Taiwanese (33.2%) students without experience of cohabitation with older adults. More Taiwanese (45.1%) than Japanese students (30.8%) gave a neutral answer regarding their desire to work with persons with dementia. Japanese students scored significantly higher on the attitude and ageism scales than did Taiwanese students; however, the scores of knowledge assessment were approximately the same. Attitude or ageism did not correlate with knowledge amongst students from either country. Logistic regression analysis revealed that the desire to work with persons having dementia was related to ageism and the relationship with these people, irrespective of country. CONCLUSION Although the students had comparable levels of knowledge, there existed significant difference in the attitudes and the degree of ageism between students from Taiwan vs Japan. This finding may prompt improvement of education on dementia, where differences in nationality and lifestyle, including the rate of ageing and family structure, are taken into consideration.
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Affiliation(s)
- Sumio Akifusa
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Kaohsiung, Taiwan
| | - Mao-Suan Huang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Madoka Funahara
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Maya Izumi
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Kazuaki Harada
- Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Yasuo Shono
- Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
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van de Rijt LJ, Feast AR, Vickerstaff V, Lobbezoo F, Sampson EL. Prevalence and associations of orofacial pain and oral health factors in nursing home residents with and without dementia. Age Ageing 2020; 49:418-424. [PMID: 31860004 DOI: 10.1093/ageing/afz169] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/20/2019] [Accepted: 11/25/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES determine and compare the prevalence of orofacial pain in older nursing home residents with and without dementia and explore the association between orofacial pain and health factors. METHODS cross-sectional study conducted in four UK nursing homes. We used the Orofacial-Pain Scale for Non-Verbal Individuals (OPS-NVI) to identify orofacial pain in residents with dementia. Residents who were able to communicate self-reported orofacial pain. A brief oral examination was conducted. Information on demographics, Clinical Dementia Rating, Charlson Comorbidity Index, Cohen Mansfield Agitation Inventory, Barthel Index, 5-level Euroqol 5 Dimension, Oral Health Impact Profile 14, Mini Nutritional Assessment Short Form and medication was collected. Chi-squared tests, independent sample t-tests and Mann-Whitney U-tests were used to compare outcomes between groups. Multivariable logistic regression was used to evaluate predictors of orofacial pain. RESULTS orofacial pain, assessed with the OPS-NVI, was present in 48.8% (95% confidence interval [C.I.] 36.1-50.7) of residents with dementia. Self-reported orofacial pain was present in 37.8% (95% C.I. 20.4-53.7) of residents with dementia and in 14.8% (95% C.I. 0.5-30.4) residents without dementia. Orofacial pain was significantly more prevalent in residents with dementia than those without (OPS-NVI; P = 0.002, self-report; P = 0.04). Having a soft diet, xerostomia, being dentate, and poor oral hygiene in dentate residents were significant predictors of orofacial pain in residents with dementia. CONCLUSION orofacial pain was more prevalent in residents with dementia. Oral health care should be part of routine care for residents, especially for those with dementia, to improve oral health and decrease the risk of developing orofacial pain.
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Affiliation(s)
- Liza Jm van de Rijt
- Faculty of Dentistry, Department of Orofacial pain and Dysfunction, Academic Centre for 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, United Kingdom
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom
- The Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Frank Lobbezoo
- Faculty of Dentistry, Department of Orofacial pain and Dysfunction, Academic Centre for 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, United Kingdom
- Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, United Kingdom
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Yoon MN, Ickert C, Wilson R, Mihailidis A, Rochon E. Oral care practices of long-term care home residents and caregivers: Secondary analysis of observational video recordings. J Clin Nurs 2020; 29:2023-2030. [PMID: 31945246 DOI: 10.1111/jocn.15187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/15/2019] [Accepted: 11/10/2019] [Indexed: 01/01/2023]
Abstract
AIMS AND OBJECTIVES To describe the proportion of toothbrushing task steps, long-term care residents had an opportunity to complete; the duration and quality of toothbrushing by both residents and caregivers; and the feedback caregivers provided. BACKGROUND Poor oral health is widespread among older adults in long-term care homes; however, little is known about their actual oral health practices. DESIGN Secondary analysis of video recordings. METHODS A total of 58 video-recorded sessions were analysed from two long-term care homes in Canada. Eligible residents had at least one natural tooth, required oral care assistance, had Alzheimer's disease and understood English. Eligible caregivers spoke English and had worked for at least 1 year with people with dementia. Toothbrushing success was identified by the resident's participation in, and completion of, nine toothbrushing steps. Total time spent brushing teeth was calculated by summing the duration of time spent brushing teeth. Quality was described by time spent brushing the facial versus the lingual or occlusal surfaces. Caregiver verbal feedback was pulled from transcripts and analysed using content analysis. STROBE guidelines were used in reporting this study. RESULTS The two step residents most frequently completed or attempted were brushing their teeth (77% complete, 7% attempt) and rinsing their mouth (86% complete, 2% attempt). The average time spent brushing teeth was 60.33 s (SD = 35.15). In 66% of observed videos, toothbrushing occurred only on the facial tooth surfaces, with no time spent brushing the lingual or occlusal surfaces. CONCLUSION Caregivers are supporting residents to independently complete toothbrushing; however, the duration and quality of toothbrushing are not sufficient to ensure optimal oral health. RELEVANCE TO CLINICAL PRACTICE Clear, detailed guidelines are required to ensure adequate oral care for long-term care residents. Staff need to be aware that all surfaces should be brushed to ensure proper oral health.
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Affiliation(s)
- Minn N Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carla Ickert
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Rozanne Wilson
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Alex Mihailidis
- Department of Occupational Science & Occupational Therapy, Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Rochon
- Department of Speech-Language Pathology, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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18
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Mulic A, Tveit AB, Stenhagen KR, Oscarson N, Staxrud F, Jönsson B. The frequency of enamel and dentin caries lesions among elderly Norwegians. Acta Odontol Scand 2020; 78:6-12. [PMID: 31267814 DOI: 10.1080/00016357.2019.1634283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: To describe the distribution of enamel-, dentin-, root- and secondary caries within an elderly population in Northern-Norway.Material and methods: A study population (n = 1 173) was divided into age groups: 65-69 (seniors), 70-74 (young elderly), 75-79 (elderly) and 80-94 (old elderly). Seven examiners registered presence, location and severity of caries lesions on x-rays and intra-oral photos. Severity of approximal, occlusal, secondary and root caries was graded (D1-2: into enamel; D3-5: into dentin, root caries), and decayed missing filled surfaces/teeth (DMFS/DMFT) were calculated. T-test, ANOVA and a Bonferroni correction were used.Results: The seniors had more primary caries (DS1-5) compared to the oldest age groups, while the old elderly had significantly more secondary caries than the other groups (p < .05). Of those ≥65 years 13.8% were affected with root caries, 21% among the oldest. About 48% of the old elderly had one or more surfaces with untreated caries lesions into dentin, while for the other groups the number was 35% (p < 0.05).Conclusion: Individuals seem to maintain good oral health up to at least 80 years of age. Those older than 80 years have more root caries needing more intensified caries-controlling measures and a higher prevalence of untreated dentin lesions often in need of operative treatment.
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Affiliation(s)
- Aida Mulic
- Nordic Institute of Dental Materials, NIOM, Oslo, Norway
| | - Anne B. Tveit
- Public Dental Service Competence Centre of Northern Norway, TkNN, Tromsø, Norway
| | | | - Nils Oscarson
- Public Dental Service Competence Centre of Northern Norway, TkNN, Tromsø, Norway
| | - Frode Staxrud
- Nordic Institute of Dental Materials, NIOM, Oslo, Norway
| | - Birgitta Jönsson
- Public Dental Service Competence Centre of Northern Norway, TkNN, Tromsø, Norway
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Hoben M, Yoon MN, Lu L, Estabrooks CA. If we cannot measure it, we cannot improve it: Understanding measurement problems in routine oral/dental assessments in Canadian nursing homes-Part I. Gerodontology 2019; 37:153-163. [PMID: 31774205 DOI: 10.1111/ger.12449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/26/2019] [Accepted: 10/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items collected by nursing home (NH) care staff to (a) assessments collected by trained research assistants (RAs) and (b) "gold standard" clinical assessments by dental hygienists (DHs). BACKGROUND Routine collection of RAI oral/dental items is mandatory in most Canadian NHs. However, the performance of these items is less than optimal and oral/dental problems are severely under-reported. Accurate assessment is a prerequisite for preventing, detecting and treating oral health problems. Not knowing the reasons for performance problems is a barrier to improving performance of the RAI oral/dental items. MATERIALS AND METHODS We included 103 NH residents from 4 NHs in Edmonton, Alberta, Canada. Using Kappa statistics, we compared the agreement of residents' last (no older than 90 days) RAI assessment with RAI assessments completed by trained RAs and "gold standard" clinical assessments by DHs. We also assessed the inter-rater reliability (IRR) of RA and DH assessments. RESULTS Care staff assessments had poor agreement with RA and DH assessments (Kappa < 0.2 for most items). RAs and DHs identified more oral/dental problems than care staff. However, IRR of RA assessments was low (Kappa < 0.7 for 7/9 items). IRR of DH assessments was acceptable (Kappa > 0.7) for most items. CONCLUSIONS The quality of RAI oral/dental assessments can be improved by better training care staff and ensuring appropriate time to do the assessments. However, remaining problems-even with trained RAs-suggest that rewording some of the items or supplementing them by more robust tools may be required.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Minn N Yoon
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lily Lu
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Wong FMF, Ng YTY, Leung WK. Oral Health and Its Associated Factors Among Older Institutionalized Residents-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214132. [PMID: 31717812 PMCID: PMC6861909 DOI: 10.3390/ijerph16214132] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/16/2022]
Abstract
The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. Objective: The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Methods: Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender, educational level, acquired systemic conditions or dementia/cognitive impairment). Results: Twenty-five surveys (or study series) from 19 countries were included. The level of evidence reported by these studies was generally moderate to strong. The reported oral cleanliness and health of the surveyed institutionalized elderly were poor (>50% of residents had calculus; denture hygiene index > 80%). Gum (approximately 30% of dentate residents had moderate to severe periodontitis), teeth (decayed, missing or filled teeth >20), mucosa (>10% had mucosal lesions) and denture problems (up to 40%) were prevalent and were associated with a poor OHRQoL, especially in females, socially deprived residents or those with mild or above cognitive impairment. Those with a poor OHRQoL might show signs of poor nutrition. Conclusions: This report reviewed evidence-based knowledge on oral health, the OHRQoL and the associated factors among elderly institutional residents. Further research is needed to confirm these observations. For improved oral health, a better OHRQoL and the general well-being of older residents, clinical trials are needed, targeting modifiable factors, such as social inequality, oral healthcare accessibility, and/or nursing home service quality. The relationship between oral health, the OHRQoL and nutrition in this at-risk population also warrants exploration.
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Affiliation(s)
- Florence M. F. Wong
- School of Nursing, Tung Wah College, Hong Kong SAR, China
- Correspondence: ; Tel.: +852-3468-6838
| | - Yannies T. Y. Ng
- North District Hospital, Hospital Authority, Hong Kong SAR, China;
| | - W. Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
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Chen X, D'Souza V, Yu L. The oral health status of residents with different cognitive and dental-related functions in three North Carolina assisted living facilities. Gerodontology 2019; 36:142-148. [PMID: 30724388 DOI: 10.1111/ger.12391] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/03/2018] [Accepted: 12/08/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of the study was to describe the oral health status of persons with different cognition and dental-related functions (DRFs). METHODS The present study was a secondary analysis of data collected for a cross-sectional study of residents in three assisted living facilities in North Carolina. The participants were aged 50 years or older, had normal to severely impaired cognition and spoke English. Upon obtaining informed consent, an oral assessment was completed by a trained geriatric dentist. A research team member who was blind to the oral examination outcomes then used the Minimum Data Set Cognition Scale to assess participants' cognition and the dental activities test to evaluate oral self-care and other DRFs. Descriptive statistics were used to describe the demographic, cognitive, functional and oral health status of the study participants. The impacts of cognitive and functional status on oral health measures were examined using simple linear regression models, negative binomial and zero-inflated negative binomial models. RESULTS A total of 91 long-term residents from three long-term care facilities participated in the study. Oral hygiene and gingival health were significantly associated with cognition (P = 0.056 and P = 0.017, respectively) and DRFs (P = 0.013 and P = 0.008, respectively). Residents with poor cognitive and dental-related function also presented with poor oral hygiene and gingival health. CONCLUSION The study results suggest that oral hygiene and gingival health were significantly associated with cognition and DRFs.
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Affiliation(s)
- Xi Chen
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Violet D'Souza
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Lixi Yu
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
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Srinivasan M, Delavy J, Schimmel M, Duong S, Zekry D, Trombert V, Gold G, Müller F. Prevalence of oral hygiene tools amongst hospitalised elders: A cross‐sectional survey. Gerodontology 2019; 36:125-133. [DOI: 10.1111/ger.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Joris Delavy
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Division of Gerodontology University of Bern Bern Switzerland
| | - Stephan Duong
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Dina Zekry
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Veronique Trombert
- Department of Internal Medicine and Rehabilitation (Trois‐Chêne) Geneva University Hospitals Geneva Switzerland
| | - Gabriel Gold
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
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Marín Zuluaga DJ, Gil Montoya JA, Willumsen T. Effectiveness of a training program for the nursing staff on the oral health of institutionalised aged. Randomised trial. ACTA ODONTOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/aoc.v9n1.76124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: it has been suggested that nursing-staff’ should be educated in maintaining the oral health (OH) of institutionalised elder people. Objective: this work aimed for measuring the effectiveness of a 3-hour oral health training-programme (OHTP) provided to nursing-staff by assessing the residents’ OH gains. Materials and methods: this was a one-year longitudinal-controlled-interventional study evaluated via a nursing-staff’ questionnaire and residents’ oral examinations. Managers of 30 nursing homes in Granada, Spain, were contacted and offered three oral examinations for their residents and an OHTP for the nursing-staff; nine of them consequently agreed to participate for all consenting people. 269 residents were examined at baseline and 12 months. After the baseline examination, the nursing homes were randomised into an intervention or control group; the OHTP was then carried out on the intervention group. Results: the residents’ denture hygiene (p=0.03) and wearing of dentures at night (p=0.003) improved significantly in the intervention group; caries prevalence increased in both groups. Conclusions: the OHTP was effective for improving caregivers’ knowledge and OH care routines, but the improvements were not enough to improve residents’ overall OH.
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Pentapati KC, Siddiq H, Yeturu SK. Global and regional estimates of the prevalence of root caries - Systematic review and meta-analysis. Saudi Dent J 2018; 31:3-15. [PMID: 30705564 PMCID: PMC6349959 DOI: 10.1016/j.sdentj.2018.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 01/04/2023] Open
Abstract
Aim To evaluate the pooled prevalence of root caries through a systematic review and meta-analysis. Methods A keyword search was done in Scopus, Pubmed and CINAHL databases using all the synonyms of root caries in the published literature (till January 1st, 2018). The search was supplemented with standard Boolean operators and other keywords like prevalence, epidemiology in the title, abstract and MeSH terms. Data was extracted and exported to Covidence software for screening and removal of duplicates. Results The search revealed a total of 492 documents from Scopus (n = 95), Pubmed (n = 220) and CINAHL (n = 177). Random effects model was used as there was a high degree of heterogeneity was seen among the studies published (I2 = 99.62%). A total of 74 publications were included in the analysis of the pooled prevalence of root caries which yielded a prevalence of 41.5 (36.9–46.1). Conclusion Root caries is a significant problem, and four out of ten adults might be affected.
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Affiliation(s)
- Kalyana Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Hanan Siddiq
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sravan Kumar Yeturu
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Viswavidya Peetham, Kochi, India
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Dentistry and nursing working together to improve oral health care in a long-term care facility. Geriatr Nurs 2018; 40:197-204. [PMID: 30528781 DOI: 10.1016/j.gerinurse.2018.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 01/06/2023]
Abstract
Inadequate oral care in long-term care (LTC) facilities compromises the quality of life of residents. This study assessed oral care knowledge of, and challenges experienced by, nurses and allied nursing staff (ANS) in a LTC facility in Canada. Dentists and nursing staff used the findings to implement strategies for improved care. Using a sequential mixed method design, data on oral care knowledge and practices were collected using self-administered questionnaires (n = 114) and focused groups (n = 39). Data were analyzed using descriptive statistics and thematic analysis. While participants (>80%) felt knowledgeable and confident in providing oral care, they desired improved skills to overcome resistive behavior, communication, and wanted adapted oral care materials. Implemented strategies included skills-acquisition workshop, oral care posters, and oral health champion. Overall, our interprofessional collaboration increased awareness of the need for oral care training, and implemented strategies to help nursing staff overcome barriers in providing care.
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Liu C, Cao Y, Lin J, Ng L, Needleman I, Walsh T, Li C. Oral care measures for preventing nursing home-acquired pneumonia. Cochrane Database Syst Rev 2018; 9:CD012416. [PMID: 30264525 PMCID: PMC6513285 DOI: 10.1002/14651858.cd012416.pub2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Pneumonia occurring in residents of long-term care facilities and nursing homes can be termed 'nursing home-acquired pneumonia' (NHAP). NHAP is the leading cause of mortality among residents. NHAP may be caused by aspiration of oropharyngeal flora into the lung, and by failure of the individual's defence mechanisms to eliminate the aspirated bacteria. Oral care measures to remove or disrupt oral plaque might be effective in reducing the risk of NHAP. OBJECTIVES To assess effects of oral care measures for preventing nursing home-acquired pneumonia in residents of nursing homes and other long-term care facilities. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 November 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 10), MEDLINE Ovid (1946 to 15 November 2017), and Embase Ovid (1980 to 15 November 2017) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1937 to 15 November 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We also searched the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, and the Sciencepaper Online to 20 November 2017. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated the effects of oral care measures (brushing, swabbing, denture cleaning mouthrinse, or combination) in residents of any age in nursing homes and other long-term care facilities. DATA COLLECTION AND ANALYSIS At least two review authors independently assessed search results, extracted data, and assessed risk of bias in the included studies. We contacted study authors for additional information. We pooled data from studies with similar interventions and outcomes. We reported risk ratio (RR) for dichotomous outcomes, mean difference (MD) for continuous outcomes, and hazard ratio (HR) for time-to-event outcomes, using random-effects models. MAIN RESULTS We included four RCTs (3905 participants), all of which were at high risk of bias. The studies all evaluated one comparison: professional oral care versus usual oral care. We did not pool the results from one study (N = 834 participants), which was stopped at interim analysis due to lack of a clear difference between groups.We were unable to determine whether professional oral care resulted in a lower incidence rate of NHAP compared with usual oral care over an 18-month period (hazard ratio 0.65, 95% CI 0.29 to 1.46; one study, 2513 participants analysed; low-quality evidence).We were also unable to determine whether professional oral care resulted in a lower number of first episodes of pneumonia compared with usual care over a 24-month period (RR 0.61, 95% CI 0.37 to 1.01; one study, 366 participants analysed; low-quality evidence).There was low-quality evidence from two studies that professional oral care may reduce the risk of pneumonia-associated mortality compared with usual oral care at 24-month follow-up (RR 0.41, 95% CI 0.24 to 0.72, 507 participants analysed).We were uncertain whether or not professional oral care may reduce all-cause mortality compared to usual care, when measured at 24-month follow-up (RR 0.55, 95% CI 0.27 to 1.15; one study, 141 participants analysed; very low-quality evidence).Only one study (834 participants randomised) measured adverse effects of the interventions. The study identified no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining.No studies evaluated oral care versus no oral care. AUTHORS' CONCLUSIONS Although low-quality evidence suggests that professional oral care could reduce mortality due to pneumonia in nursing home residents when compared to usual care, this finding must be considered with caution. Evidence for other outcomes is inconclusive. We found no high-quality evidence to determine which oral care measures are most effective for reducing nursing home-acquired pneumonia. Further trials are needed to draw reliable conclusions.
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Affiliation(s)
- Chang Liu
- West China Hospital of Stomatology, Sichuan UniversityDepartment of Oral and Maxillofacial Surgery, State Key Laboratory of Oral DiseasesNO.14, 3rd Section of Ren Min Nan RoadChengduSichuanChina610041
| | - Yubin Cao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityDepartment of Head and Neck OncologyNo. 14, Section Three, Ren Min Nan RoadChengduSichuanChina610041
| | - Jie Lin
- West China Hospital of Stomatology, Sichuan UniversityDepartment of Oral Anaesthesiology and Intensive Care UnitNo 14, Section 3, South Renmin RoadChengduSichuanChina610041
| | - Linda Ng
- The University of QueenslandSchool of Nursing and MidwiferyMater Campus: JP Kelly BuildingSouth BrisbaneQueenslandAustralia4101
| | - Ian Needleman
- UCL Eastman Dental InstituteUnit of Periodontology and International Centre for Evidence‐Based Oral Health256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Chunjie Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityDepartment of Head and Neck OncologyNo. 14, Section Three, Ren Min Nan RoadChengduSichuanChina610041
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Shin MS, Shin YJ, Karna S, Kim HD. Rehabilitation of lost teeth related to maintenance of cognitive function. Oral Dis 2018; 25:290-299. [PMID: 30129990 DOI: 10.1111/odi.12960] [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] [Received: 05/10/2018] [Revised: 07/05/2018] [Accepted: 07/30/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE As the era of aging comes, cognitive impairment (CI) is increasing. The impact of rehabilitation of lost tooth on CI remains unclear. This study aimed to investigate whether non-rehabilitated lost teeth (NRLT) is associated with CI among Korean elders. METHODS A total of 280 elders comprising of 140 cases and 140 age-sex-matched controls were included in this cross-sectional study. CI was assessed using the Mini-Mental Status Examination (MMSE). NRLT was evaluated using panoramic radiograph and oral examination. NRLT was categorized into low (≤4) and high (≥5). Age, sex, education, drinking, smoking, exercise, obesity, hypertension, subclinical atherosclerosis, glucose, cholesterol, depression, and denture-wearing were considered as confounders. Conditional multivariate logistic regression analysis was applied to assess the adjusted association. RESULTS NRLT was associated with increased CI after controlling for confounders (odds ratio [OR] = 1.06, 95% confidence interval [95% CFI]: 1.00-1.13). However, lost teeth were not associated with CI. Those with high NRLT (≥5) compared to those with low NRLT (≤4) was more likely to have CI by 2.7 times (OR = 2.74, 95% CFI = 1.28-5.86). CONCLUSION Our data showed that NRLT was independently associated with CI. Hence, rehabilitation of the lost teeth could be important for the maintenance of cognitive function.
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Affiliation(s)
- Myung-Seop Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoo Jin Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,BK21 PLUS Life Science, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sandeep Karna
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,BK21 PLUS Life Science, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Marchini L, Recker E, Hartshorn J, Cowen H, Lynch D, Drake D, Blanchette DR, Dawson DV, Kanellis M, Caplan D. Iowa nursing facility oral hygiene (INFOH) intervention: A clinical and microbiological pilot randomized trial. SPECIAL CARE IN DENTISTRY 2018; 38:345-355. [PMID: 30194737 DOI: 10.1111/scd.12327] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/12/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE/AIM The aim of this pilot study was to evaluate feasibility and gather initial data for a definitive study to test the clinical and microbiological effectiveness of a nursing facility (NF) customized oral hygiene protocol, intended to be delivered by dental hygienists and NF personnel. MATERIALS AND METHODS A convenience sample of 8 Eastern Iowa NFs was recruited, and each NF was assigned to one of three intervention groups: (1) control (current oral hygiene practice), (2) educational program only, and (3) educational program plus 1% chlorhexidine varnish monthly application. Demographic information, systemic health data, patient centered data, oral health data, and microbiology samples were collected at baseline and after 6 months. RESULTS Recruitment response rates were 21% for NFs and 23% for residents. A total of 81 residents were examined at baseline and of those, 49 were examined at 6 months (39.5% attrition). There were no statistically or clinically significant differences among the intervention groups at 6 months for any of the recorded clinical or microbiological outcomes. CONCLUSIONS Recruitment and retention posed a significant challenge to this trial, even with a relatively short observation period. Results from this pilot study did not encourage further investigation of this customized oral hygiene protocol.
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Affiliation(s)
- Leonardo Marchini
- Assistant Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Erica Recker
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Jennifer Hartshorn
- Clinical Assistant Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Howard Cowen
- Clinical Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - David Lynch
- Post-Doctoral Fellow, Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - David Drake
- Professor, Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Derek R Blanchette
- Biostatistician, Division of Biostatistics and Computational Biology, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Deborah V Dawson
- Morris Bernstein Professor of Dentistry, Professor of Biostatistics, Iowa Institute for Oral Health Research and the Departments of Pediatric Dentistry & Biostatistics, and the Interdisciplinary Programs in Genetics and in Informatics, University of Iowa, Iowa City, IA, USA
| | - Michael Kanellis
- Associate Dean for Patient Care, Professor, Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Daniel Caplan
- Professor and Head, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
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Jablonski RA, Kolanowski AM, Azuero A, Winstead V, Jones-Townsend C, Geisinger ML. Randomised clinical trial: Efficacy of strategies to provide oral hygiene activities to nursing home residents with dementia who resist mouth care. Gerodontology 2018; 35:365-375. [PMID: 30004139 DOI: 10.1111/ger.12357] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The purpose of this study was to test the efficacy of MOUTh (Managing Oral Hygiene Using Threat Reduction), a nonpharmacologic, relationship-based intervention vs. control on 2 primary outcomes for nursing home (NH) residents with dementia who resisted mouth care: (i) reduction in the occurrence and intensity of care-resistant behaviours (CRBs) and (ii) improvement in oral health. Two secondary outcomes were also examined: (i) the duration of mouth care and (ii) the completion of oral hygiene activities. BACKGROUND Persons with dementia who exhibit CRBs are at risk for inadequate mouth care and subsequent systemic illnesses. MATERIALS AND METHODS The study used a randomised repeated measures design. Recruitment occurred in 9 nursing homes that varied in size, ownership, reimbursement patterns and location. One hundred and one nursing home residents with dementia were randomised at the individual level to experimental (n = 55) or control groups (n = 46). One hundred participants provided data for the analyses. RESULTS Compared to the control group, persons in the experimental group had twice the odds of allowing mouth care and completing oral hygiene activities; they also allowed longer duration of mouth care (d = 0.56), but showed only small reductions in the intensity of CRBs (d = 0.16) and small differential improvements in oral health (d = 0.18). CONCLUSION The data suggest that this intervention facilitates mouth care among persons with dementia. The management of refusal behaviour may be a clinically more realistic approach than reducing or eradicating refusals.
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Affiliation(s)
- Rita A Jablonski
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.,Memory Disorders Clinic, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ann M Kolanowski
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vicki Winstead
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Maria L Geisinger
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
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Fjeld KG, Eide H, Mowe M, Sandvik L, Willumsen T. A 1-year follow-up of a randomized clinical trial with focus on manual and electric toothbrushes' effect on dental hygiene in nursing homes. Acta Odontol Scand 2018; 76:257-261. [PMID: 29239260 DOI: 10.1080/00016357.2017.1416166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE A 2-month randomized clinical trial (RCT) study comparing electric and manual toothbrushes used by residents in nursing homes showed significant reduction in plaque score for both groups. The aim of this follow up study was to study if the effect sustained in a longer perspective when toothbrushes were used according to resident's own preference. MATERIALS AND METHODS One year after baseline of the RCT-study, 100 participants were re-examined. The simplified oral hygiene index (OHI-S) was used as outcome measure on dental plaque. RESULTS The mean age was 86.6, 78.1% had three or more medical diagnoses and 52.2% had moderate to severe cognitive impairment. The mean number of natural teeth was 18.8. After 1 year, mean plaque scores was significantly reduced within the population, from 1.2 to 0.7 (p < .001). A total of 46 participants preferred to use an electric toothbrush and 54 preferred manual. No significant difference in plaque score was found between electric and manual toothbrushes. CONCLUSION After 1 year, the improvement in dental hygiene from the RCT study sustained for users of both electric and manual toothbrush. Focus upon tooth brushing seems to be efficient and both manual and electric toothbrushes should be available in nursing homes.
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Affiliation(s)
- Katrine Gahre Fjeld
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University College of Southeast-Norway, Drammen, Norway
| | - Morten Mowe
- Medical Clinic, Oslo University Hospital and Inst. Clinical Medicine, University of Oslo, Oslo, Norway
| | - Leiv Sandvik
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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31
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Petti S. Elder neglect-Oral diseases and injuries. Oral Dis 2018; 24:891-899. [PMID: 29029370 DOI: 10.1111/odi.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 12/11/2022]
Abstract
Elder neglect (EN) is the failure of a designated caregiver to meet the needs of a dependent older person. World EN prevalence, meta-analyzed in this study, is 1.0% or 1.8% according to different statistical methods. Referring alleged EN cases to Adult Protective Services (APSs) by healthcare workers (HCWs) is mandatory in many countries. However, only few claims are substantiated, as EN could be confused with Self-Neglect, and neglect could be unintentional or due to caregiver unawareness. Screening tools are inaccurate, and their use is discouraged by public health organizations, because they lead to too many false positives, which engulf the already overwhelmed APSs. HCWs need effective tools with objective judgments, which do not hamper the HCW-caregiver-patient rapport and prevent lawsuits when allegations are unfounded. Orofacial EN manifestations (poor oral/denture hygiene, lack of needed/improper dentures, dry mouth, skin/mucosal rashes) are essential Forensic Markers of EN. I classified EN-associated oral diseases according to the unmet needs into four groups: (1) traumatic injuries due to lack of caregiver vigilance (e.g., maxillofacial fractures); (2) diseases due to oral hygiene deficiency (e.g., root caries); (3) diseases typical of the elderly with late/no diagnosis (e.g., oral cancer); and (4) diseases typical of the elderly exacerbated by psychological distress (e.g., oral lichen planus).
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Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Ab Malik N, Mohamad Yatim S, Abdul Razak F, Lam OLT, Jin L, Li LSW, McGrath C. A multi-centre randomised clinical trial of oral hygiene interventions following stroke-A 6-month trial. J Oral Rehabil 2017; 45:132-139. [PMID: 29090475 DOI: 10.1111/joor.12582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 12/01/2022]
Affiliation(s)
- N. Ab Malik
- Periodontology and Dental Public Health; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
- Faculty of Dentistry; Universiti Sains Islam Malaysia; Kuala Lumpur Malaysia
| | - S. Mohamad Yatim
- Department of Medical Rehabilitation; Hospital Serdang; Kajang Selangor Malaysia
| | - F. Abdul Razak
- Department of Oral & Craniofacial Sciences; Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
| | - O. L. T. Lam
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - L. Jin
- Periodontology and Dental Public Health; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - L. S. W. Li
- Tung Wah Hospital; Sheung Wan Hong Kong SAR China
| | - C. McGrath
- Periodontology and Dental Public Health; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
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Lai CKY, Ho LYW, Chin KCW, Kwong EWY. Survival prediction among nursing home residents: A longitudinal study. Geriatr Gerontol Int 2017; 18:428-433. [PMID: 29139197 DOI: 10.1111/ggi.13197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/11/2017] [Accepted: 09/12/2017] [Indexed: 11/29/2022]
Abstract
AIM To determine the survival time and predictors of survival of residents in a nursing home. METHODS Nursing home residents admitted from June 2008 (when the nursing home started operating) to December 2012 (n = 230) to a new nursing home in Hong Kong were prospectively followed. The predictors of survival in the residents were assessed annually, with the exception of those who did not want to continue with the study, or were hospitalized, discharged from the nursing home or died, to compare changes occurring from 2008 to 2012. Cox's regression analysis was used to examine the predictors of survival. RESULTS A total of 66 of the nursing home residents (28.7%) died during the study period. The median length of survival was 20.46 months. Sex, the number of diseases, depressive symptoms, cognitive status and nutritional status were found to be significant predictors of survival. CONCLUSIONS It is crucial for healthcare providers to offer quality care to residents in long-term care to enhance their well-being in the final sojourn of their lives. Although there are no consistent reports of predictors in the international literature, it is important to address the modifiable predictors, as this might lead to improvements in the quality of life of the residents. Geriatr Gerontol Int 2018; 18: 428-433.
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Affiliation(s)
- Claudia Kam Yuk Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Lily Yuen Wah Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Kenny Chi Wing Chin
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Enid Wai Yung Kwong
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
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Abstract
Oral hygiene care is neglected in long-term care (LTC) due to patient-, staff-, and systems-level barriers. A dementia-specific oral hygiene program, implemented and evaluated in a Department of Veterans Affairs LTC unit, addressed barriers to oral care at multiple levels. Improved staff competency, access to oral care supplies, and standardized documentation systems were accompanied by reduced oral plaque and gingivitis, demonstrating the feasibility and benefits of direct care staff providing improved oral hygiene in LTC.
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35
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Choi JS, Yi YJ, Donnelly LR. Oral health of older residents in care and community dwellers: nursing implications. Int Nurs Rev 2017; 64:602-609. [PMID: 29034970 DOI: 10.1111/inr.12417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor oral health is associated with a reduced quality of life and serious illnesses. Consequently, nurses need to be more aware of oral health to improve the general health of residents in care. AIM To evaluate and compare oral health behaviours and levels of salivary haemoglobin and dental biofilm acidogenicity, which can be used to evaluate oral disease activity, between residents and community dwellers in South Korea. METHODS This cross-sectional study included 133 participants: 64 residents and 69 community dwellers. All participants completed a questionnaire and tests to measure their salivary haemoglobin and dental biofilm acidogenicity. RESULTS A higher percentage of community dwellers than of residents brushed their teeth three times a day, cleaned their tongue, used interdental cleaning devices and had visited a dental clinic within 1 year. The levels of salivary haemoglobin and dental biofilm acidogenicity tended to be higher in residents than in community dwellers. CONCLUSION Residents showed poorer oral health behaviours and higher levels of gingival bleeding and acid production by oral bacteria than did community dwellers. IMPLICATIONS FOR NURSING PRACTICE Nursing staff should enhance their monitoring of oral hygiene status and provide quality oral care to residents through cooperation with dental professionals. IMPLICATIONS FOR NURSING AND HEALTH POLICY Policymakers should be aware that oral health is an essential component of improving general health and well-being and therefore strive to develop policies to promote oral care services provided to residents. Nursing policies, such as mandating oral care and hands-on training in oral care for nursing staff, are important. We also suggest that factors related to oral care be added to the establishment or accreditation standards of care facilities.
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Affiliation(s)
- J S Choi
- College of Health Science, Gachon University, Incheon, Korea
| | - Y J Yi
- College of Nursing, Gachon University, Incheon, Korea
| | - L R Donnelly
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Hoben M, Kent A, Kobagi N, Huynh KT, Clarke A, Yoon MN. Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review. PLoS One 2017; 12:e0178913. [PMID: 28609476 PMCID: PMC5469468 DOI: 10.1371/journal.pone.0178913] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/09/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Poor oral health has been a persistent problem in nursing home residents for decades, with severe consequences for residents and the health care system. Two major barriers to providing appropriate oral care are residents' responsive behaviors to oral care and residents' lack of ability or motivation to perform oral care on their own. OBJECTIVES To evaluate the effectiveness of strategies that nursing home care providers can apply to either prevent/overcome residents' responsive behaviors to oral care, or enable/motivate residents to perform their own oral care. MATERIALS AND METHODS We searched the databases Medline, EMBASE, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science for intervention studies assessing the effectiveness of eligible strategies. Two reviewers independently (a) screened titles, abstracts and retrieved full-texts; (b) searched key journal contents, key author publications, and reference lists of all included studies; and (c) assessed methodological quality of included studies. Discrepancies at any stage were resolved by consensus. We conducted a narrative synthesis of study results. RESULTS We included three one-group pre-test, post-test studies, and one cross-sectional study. Methodological quality was low (n = 3) and low moderate (n = 1). Two studies assessed strategies to enable/motivate nursing home residents to perform their own oral care, and to studies assessed strategies to prevent or overcome responsive behaviors to oral care. All studies reported improvements of at least some of the outcomes measured, but interpretation is limited due to methodological problems. CONCLUSIONS Potentially promising strategies are available that nursing home care providers can apply to prevent/overcome residents' responsive behaviors to oral care or to enable/motivate residents to perform their own oral care. However, studies assessing these strategies have a high risk for bias. To overcome oral health problems in nursing homes, care providers will need practical strategies whose effectiveness was assessed in robust studies.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kha Tu Huynh
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Alix Clarke
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Minn N. Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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37
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Hoben M, Clarke A, Huynh KT, Kobagi N, Kent A, Hu H, Pereira RAC, Xiong T, Yu K, Xiang H, Yoon MN. Barriers and facilitators in providing oral care to nursing home residents, from the perspective of care aides: A systematic review and meta-analysis. Int J Nurs Stud 2017; 73:34-51. [PMID: 28531550 DOI: 10.1016/j.ijnurstu.2017.05.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/30/2017] [Accepted: 05/08/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Oral health of nursing home residents is generally poor, with severe consequences for residents' general health and quality of life and for the health care system. Care aides in nursing homes provide up to 80% of direct care (including oral care) to residents, but providing oral care is often challenging. Interventions to improve oral care must tailor to identified barriers and facilitators to be effective. This review identifies and synthesizes the evidence on barriers and facilitators care aides perceive in providing oral care to nursing home residents. METHODS We systematically searched the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We also searched by hand the contents of key journals, publications of key authors, and reference lists of all studies included. We included qualitative and quantitative research studies that assess barriers and facilitators, as perceived by care aides, to providing oral care to nursing home residents. We conducted a thematic analysis of barriers and facilitators, extracted prevalence of care aides reporting certain barriers and facilitators from studies reporting quantitative data, and conducted random-effects meta-analyses of prevalence. RESULTS We included 45 references that represent 41 unique studies: 15 cross-sectional studies, 13 qualitative studies, 7 mixed methods studies, 3 one-group pre-post studies, and 3 randomized controlled trials. Methodological quality was generally weak. We identified barriers and facilitators related to residents, their family members, care providers, organization of care services, and social interactions. Pooled estimates (95% confidence intervals) of barriers were: residents resisting care=45% (15%-77%); care providers' lack of knowledge, education or training in providing oral care=24% (7%-47%); general difficulties in providing oral care=26% (19%-33%); lack of time=31% (17%-47%); general dislike of oral care=19% (8%-33%); and lack of staff=22% (13%-31%). CONCLUSIONS We found a lack of robust evidence on barriers and facilitators that care aides perceive in providing oral care to nursing home residents, suggesting a need for robust research studies in this area. Effective strategies to overcome barriers and to increase facilitators in providing oral care are one of the most critical research gaps in the area of improving oral care for nursing home residents. Strategies to prevent or manage residents' responsive behaviors and to improve care aides' oral care knowledge are especially needed.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Alix Clarke
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Kha Tu Huynh
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Huimin Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | | | - Tianyuan Xiong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Kexin Yu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Hongjin Xiang
- Ultrasound Department, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
| | - Minn N Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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Effect of an oral healthcare programme on care staff knowledge and attitude regarding oral health: a non-randomised intervention trial. Clin Oral Investig 2017; 22:281-292. [DOI: 10.1007/s00784-017-2110-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
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39
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Ohno T, Heshiki Y, Kogure M, Sumi Y, Miura H. Comparison of Oral Assessment Results Between Non-Oral and Oral Feeding Patients: A Preliminary Study. J Gerontol Nurs 2017; 43:23-28. [PMID: 27845809 DOI: 10.3928/00989134-20161109-05] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/30/2016] [Indexed: 01/14/2023]
Abstract
In the current study, evaluation and comparison of oral status was performed to confirm the necessity of oral care for non-oral feeding patients. The study involved patients consulting an attending physician in one hospital's Department of Dentistry for oral care. Based on the feeding method, participants were divided into two groups: (a) non-oral (n = 66) and (b) oral (n = 66) feeding. Characteristics and Oral Assessment Guide scores were compared between groups. The non-oral feeding group had significantly worse scores than the oral feeding group. The non-oral feeding group also showed significantly lower voice-, swallowing-, saliva-, and tongue-related scores. The poor oral status of non-oral feeding patients was clarified. The results suggest the importance of oral care for non-oral feeding patients. [Journal of Gerontological Nursing, 43(4), 23-28.].
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40
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Hoeksema AR, Spoorenberg SLW, Peters LL, Meijer HJA, Raghoebar GM, Vissink A, Wynia K, Visser A. Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly: a cross-sectional study. Oral Dis 2017; 23:526-536. [DOI: 10.1111/odi.12644] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/30/2016] [Accepted: 01/16/2017] [Indexed: 01/11/2023]
Affiliation(s)
- AR Hoeksema
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - SLW Spoorenberg
- Department of Health Sciences, Community and Occupational Medicine; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - LL Peters
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - HJA Meijer
- Departments of Oral and Maxillofacial Surgery and Fixed and Removable Prosthodontics; Dental School; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - GM Raghoebar
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - K Wynia
- Department of Health Sciences, Community and Occupational Medicine; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - A Visser
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
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41
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Jablonski-Jaudon RA, Kolanowski AM, Winstead V, Jones-Townsend C, Azuero A. Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care. J Gerontol Nurs 2017; 42:15-23; quiz 24-5. [PMID: 26934969 DOI: 10.3928/00989134-20160212-05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/14/2016] [Indexed: 11/20/2022]
Abstract
The purpose of the current article is to describe a personalized practice originally conceived as a way to prevent and minimize care-resistant behavior to provide mouth care to older adults with dementia. The original intervention, Managing Oral Hygiene Using Threat Reduction Strategies (MOUTh), matured during the clinical trial study into a relationship-centered intervention, with emphasis on developing strategies that support residents' behavioral health and staff involved in care. Relationships that were initially pragmatic (i.e., focused on the task of completing mouth care) developed into more personal and responsive relationships that involved deeper engagement between mouth care providers and nursing home (NH) residents. Mouth care was accomplished and completed in a manner enjoyable to NH residents and mouth care providers. The MOUTh intervention may also concurrently affirm the dignity and personhood of the care recipient because of its emphasis on connecting with older adults.
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42
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Wikström M, Kareem KL, Almståhl A, Palmgren E, Lingström P, Wårdh I. Effect of 12-month weekly professional oral hygiene care on the composition of the oral flora in dentate, dependent elderly residents: A prospective study. Gerodontology 2016; 34:240-248. [PMID: 27990688 DOI: 10.1111/ger.12256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study the effect of weekly professional oral hygiene care on the proportion of micro-organisms associated with good oral health, caries, and periodontal and soft tissue diseases in oral biofilms in dentate, dependent elderly residents. BACKGROUND Assisted oral hygiene care reduces the plaque score and number of micro-organisms in the oral biofilms in elderly residents. Less is known about the effect on the quality/composition of the remaining oral flora. MATERIALS AND METHODS Participants comprised 33 residents in the study and 35 in the control group. Dental status (≥10 natural teeth and no removable dentures to be included), plaque score, salivary secretion rate and prescription medicines were recorded. Duplicate samples, collected from supragingival plaque and tongue, were analysed using cultivation technique. Differences between and within groups were analysed using one-way and two-way ANOVA, respectively. RESULTS At the baseline, the number of teeth in the participants (mean age, 83.7 ± 7.4 years) was 22.0 ± 4.5. The number of prescription medicines was 9.4 ± 4.5. Seventy-six per cent had low salivary secretion rate. Fifty per cent had "visible thick" supragingival plaque. At the 12-month registration, "no visible" or "visible but thin" plaque was recorded in 92% in the study group. The proportions of bacteria associated with good oral health and periodontal diseases were decreased over time, while the frequency and proportions of micro-organisms associated with caries and soft tissue infection were unaffected or increased. CONCLUSION The results indicate that assisted oral hygiene care alone is not sufficient to regain an oral microbial flora associated with good oral health in dentate, dependent elderly residents.
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Affiliation(s)
- Maude Wikström
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dental Medicine and Academic Centre of Gerodontics, Karolinska Institute, Huddinge, Sweden
| | - Kawa L Kareem
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annica Almståhl
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erika Palmgren
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Lingström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Wårdh
- Department of Dental Medicine and Academic Centre of Gerodontics, Karolinska Institute, Huddinge, Sweden
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43
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Paredes-Rodríguez VM, Torrijos-Gómez G, González-Serrano J, López-Pintor-Muñoz RM, López-Bermejo MÁ, Hernández-Vallejo G. Quality of life and oral health in elderly. J Clin Exp Dent 2016; 8:e590-e596. [PMID: 27957276 PMCID: PMC5149097 DOI: 10.4317/jced.53317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/06/2016] [Indexed: 11/24/2022] Open
Abstract
Background We want to assess quality of life in elderly patients in relation to the number of remaining teeth, the number of ingested drugs and xerostomía and to determine the correlation between an increased intake of drugs and a greater feeling of dry mouth and to know the most commonly used measures to control xerostomia. Material and Methods 30 subjects aged between 65 and 95 years (14 males, 16 females) completed the OHIP questionnaire to determine quality of life. For oral status, the number of remaining teeth according to WHO criteria and xerostomia using the xerostomia index (XI) were studied. In cases of dry mouth sensation, the measures to alleviate it were asked. Results The average quality of life according to the OHIP rate is 19.23 (Dt = 10.58), being 56 the worst quality of life. The Pearson correlation coefficient indicates that quality of life is not related to the number of remaining teeth (r = -0.046; p = 0.810) nor the number of ingested drugs (r = 0.226; p = 0.23) but a greater sensation of dry mouth is related to a poorer quality of life (r = 0.678; p = 0.230). There is no association between the number of ingested drugs and the xerostomia index (r = 0.144; p = 0.447). The most frequently measures used against dry mouth were drinking water (21 subjects) and sugarless candies (15 subjects). Conclusions Quality of life is not related to the number of remaining teeth nor the number of ingested drugs. However, a higher level of xerostomia was significantly associated with a poorer quality of life. There is no association between the number of drugs ingested and xerostomia index. Sugarless candies and drinking water are the more frequently used measures to alleviate dry mouth. Key words:Quality of life, oral health, elderly.
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Affiliation(s)
| | - Gema Torrijos-Gómez
- DDS. Collaborator Professor. Faculty of Odontology. Complutense University of Madrid. Department of Stomatology IV
| | - José González-Serrano
- DDS. Master Student. Faculty of Odontology. Complutense University of Madrid. Department of Stomatology III
| | - Rosa-María López-Pintor-Muñoz
- DDS, PhD. Associate Professor. Faculty of Odontology. Complutense University of Madrid. Department of Stomatology III
| | - Miguel-Ángel López-Bermejo
- MD, DDS, PhD. Head Professor. Faculty of Odontology. Complutense University of Madrid. Department of Stomatology IV
| | - Gonzalo Hernández-Vallejo
- MD, DDS, PhD. Head Professor. Faculty of Odontology. Complutense University of Madrid. Department of Stomatology III
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44
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Hoeksema AR, Peters LL, Raghoebar GM, Meijer HJA, Vissink A, Visser A. Oral health status and need for oral care of care-dependent indwelling elderly: from admission to death. Clin Oral Investig 2016; 21:2189-2196. [PMID: 27896484 PMCID: PMC5559562 DOI: 10.1007/s00784-016-2011-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 11/16/2016] [Indexed: 11/29/2022]
Abstract
Objectives The objective of this study is to assess oral health and oral status of elderly patients newly admitted to a nursing home from admission until death. Materials and methods Oral health, oral status, need for dental care, cooperation with dental treatment, and given dental care were assessed by two geriatric dentists in all new long-stay patients (n = 725) admitted to a nursing home between January 2009 and December 2013. All patients were followed from admission until death or until they left the nursing home. Results At admission, dementia patients were significantly older than somatic patients; median [IQR] ages were, respectively, 85 [79–89] and 81 [76–87] (p = 0.001). In addition, edentulous patients were significantly older than patients with remaining teeth, 83 [79–89] versus 80 [74–86] (p = 0.001) years. Thirty percent of the admitted patients died within 12 months after admission. A small minority (20%) of the patients had their own teeth. In this group, poor oral hygiene (72%), caries (70%), and broken teeth (62%) were frequently observed. Edentulous patients were significantly more cooperative with treatment than patients with remaining teeth (64 versus 27%). Finally, significantly less professional dental care was given to edentulous patients when compared to patients with remaining teeth (median 90 [IQR 60–180] versus 165 [75–375] min). Conclusion When compared to edentulous elderly patients, patients with remaining teeth were younger at admittance, were more often non-cooperative, and had a poorer oral health and higher need for dental care. Clinical relevance It is important that health care workers ensure adequate oral health and dental care to frail elderly, especially for elderly with remaining teeth.
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Affiliation(s)
- Arie R Hoeksema
- Department of Oral and Maxillofacial Surgery, BB70, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, the Netherlands.,Oral Health Care Center 'Mondzorgcentrum Winschoten', Winschoten, the Netherlands
| | - Lilian L Peters
- Department of Oral and Maxillofacial Surgery, BB70, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, BB70, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, the Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, BB70, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, the Netherlands.,Department of Oral Function and Prosthetic Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, BB70, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, the Netherlands
| | - Anita Visser
- Department of Oral and Maxillofacial Surgery, BB70, University of Groningen, University Medical Center Groningen, PO Box 30.001, NL-9700, RB, Groningen, the Netherlands.
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45
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Li C, Zhang Q, Ng L, Needleman I, Jie L, Walsh T. Oral care measures for preventing nursing home-acquired pneumonia. Cochrane Database Syst Rev 2016. [DOI: 10.1002/14651858.cd012416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Chunjie Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Department of Head and Neck Oncology; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Qi Zhang
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University; Department of Oral Implantology; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Linda Ng
- University of Queensland; School of Nursing and Midwifery; Mater Campus: JP Kelly Building South Brisbane Queensland Australia 4101
| | - Ian Needleman
- UCL Eastman Dental Institute; Unit of Periodontology and International Centre for Evidence-Based Oral Health; 256 Gray's Inn Road London UK WC1X 8LD
| | - Lin Jie
- West China Hospital of Stomatology, Sichuan University; Department of Oral Anaesthesiology and Intensive Care Unit; No 14, Section 3, South Renmin Road Chengdu China 610041
| | - Tanya Walsh
- The University of Manchester; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health; JR Moore Building Oxford Road Manchester UK M13 9PL
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46
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Martori E, Ayuso-Montero R, Willaert E, Viñas M, Peraire M, Martinez-Gomis J. Status of Removable Dentures and Relationship with Oral Candida
-Associated Factors in a Geriatric Population in Catalonia. J Prosthodont 2016; 26:370-375. [DOI: 10.1111/jopr.12551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Elisenda Martori
- Department of Prosthodontics, Faculty of Dentistry; University of Barcelona; Spain
| | - Raúl Ayuso-Montero
- Department of Prosthodontics, Faculty of Dentistry; University of Barcelona; Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL; L'Hospitalet de Llobregat Barcelona Spain
| | - Eva Willaert
- Department of Prosthodontics, Faculty of Dentistry; University of Barcelona; Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL; L'Hospitalet de Llobregat Barcelona Spain
| | - Miguel Viñas
- Department of Pathology and Experimental Therapeutics; University of Barcelona-IDIBELL and IINFACTS-CESPU; Penafiel Portugal
| | - Maria Peraire
- Department of Prosthodontics, Faculty of Dentistry; University of Barcelona; Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL; L'Hospitalet de Llobregat Barcelona Spain
| | - Jordi Martinez-Gomis
- Department of Prosthodontics, Faculty of Dentistry; University of Barcelona; Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL; L'Hospitalet de Llobregat Barcelona Spain
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Shiraishi A, Yoshimura Y, Wakabayashi H, Tsuji Y. Poor oral status is associated with rehabilitation outcome in older people. Geriatr Gerontol Int 2016; 17:598-604. [DOI: 10.1111/ggi.12763] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/13/2016] [Accepted: 01/29/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Ai Shiraishi
- Department of Dental Surgery; Kumamoto Rehabilitation Hospital; Kumamoto Japan
| | - Yoshihiro Yoshimura
- Department of Rehabilitation Medicine; Kumamoto Rehabilitation Hospital; Kumamoto Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine; Yokohama City University Medical Center; Yokohama Japan
| | - Yuri Tsuji
- Department of Dental Surgery; Kumamoto Rehabilitation Hospital; Kumamoto Japan
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48
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Goh CE, Guay MP, Lim MY, Lim SM, Loke SY, Toh HE, Nair R. Correlates of attitudes and perceived behavioural control towards oral care provision among trained and untrained nursing home caregivers in Singapore. J Clin Nurs 2016; 25:1624-33. [PMID: 27118105 DOI: 10.1111/jocn.13162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To investigate the perspectives of nursing home caregivers towards oral care and the determinants of their attitudes and perceived behavioural control. BACKGROUND There are few studies analysing nursing home caregivers' perspectives on the provision of oral care and factors correlated with these perspectives. DESIGN Cross-sectional study. METHODS Interviewer-administered survey questionnaires were completed by caregivers from five nursing homes in Singapore (n = 94). The rating-scale questionnaire items explored caregivers' attitudes, subjective norms and perceived behavioural control, as guided by the theory of planned behaviour. Demographic characteristics, oral care training received, years of work experience, oral hygiene behaviour and dental visit frequency of the caregivers, as well as organisational characteristics such as a requirement for oral care and the number of patients under their care, were obtained. RESULTS Caregivers had very positive attitudes towards the provision of oral care. Half of the caregivers lacked confidence in providing oral care without harming the patients and this was not different by oral care training received. Multivariable linear regression analysis found that receiving oral care training and having a requirement by the nursing home to provide oral care were related to higher attitude scores but not perceived behaviour control. Having more residents under their care and on-the-job caregiver training were associated with lower perceived behavioural control. CONCLUSIONS This study found that nursing home caregivers had positive attitudes towards providing oral care, but more modest perspectives about their ability to perform that behaviour. RELEVANCE TO CLINICAL PRACTICE These findings have useful implications for the oral care training of nursing home caregivers. While attitudes towards the importance of oral care may be positive among nursing home caregivers, our study suggests that future interventions should include practical skills training for oral care management and consider organisational strategies for encouraging oral care provision.
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Affiliation(s)
- Charlene E Goh
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | | | - Shy Min Lim
- National University Hospital System, University Dental Cluster, Singapore
| | | | - Hui En Toh
- National Dental Centre Singapore, Singapore
| | - Rahul Nair
- Oral Sciences, School of Dentistry, NUS, Singapore
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49
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Hoben M, Hu H, Xiong T, Kent A, Kobagi N, Yoon MN. Barriers and facilitators in providing oral health care to nursing home residents, from the perspective of care aides-a systematic review protocol. Syst Rev 2016; 5:53. [PMID: 27056041 PMCID: PMC4823843 DOI: 10.1186/s13643-016-0231-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/30/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Unregulated care aides provide up to 80 % of direct resident care in nursing homes. They have little formal training, manage high workloads, frequently experience responsive behaviours from residents, and are at high risk for burnout. This affects quality of resident care, including quality of oral health care. Poor quality of oral health care in nursing homes has severe consequences for residents and the health care system. Improving quality of oral health care requires tailoring interventions to identified barriers and facilitators if these interventions are to be effective. Identifying barriers and facilitators from the care aide's perspective is crucial. METHODS We will systematically search the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We will include qualitative and quantitative research studies and systematic reviews published in English that assess barriers and facilitators, as perceived by care aides, to providing oral health care to nursing home residents. Two reviewers will independently screen studies for eligibility. We will also search by hand the contents of key journals, publications of key authors, and reference lists of all the studies included. Two reviewers will independently assess the methodological quality of the studies included using four validated checklists appropriate for different research designs. Discrepancies at any stage of review will be resolved by consensus. We will conduct a thematic analysis of barriers and facilitators using all studies included. If quantitative studies are sufficiently homogeneous, we will conduct random-effects meta-analyses of the associations of barriers and facilitators with each other, with care aide practices in resident oral health care, and with residents' oral health. If quantitative study results cannot be pooled, we will present a narrative synthesis of the results. Finally, we will compare quantitative findings to qualitative studies to identify hypothesized associations or effects not yet tested quantitatively. DISCUSSION This review will advance the development of effective strategies for improving quality of oral health care and highlight gaps in research on barriers and facilitators to providing oral health care to nursing home residents, as perceived by care aides. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015032454.
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Affiliation(s)
- Matthias Hoben
- Knowledge Utilization Studies Program (KUSP), Faculty of Nursing, University of Alberta, 5-006 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Huimin Hu
- West China College of Stomatology, Sichuan University, Sichuan, China
| | - Tianyuan Xiong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Minn N Yoon
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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50
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Hoben M, Kent A, Kobagi N, Yoon MN. Effective strategies to motivate nursing home residents in oral healthcare and to prevent or reduce responsive behaviours to oral healthcare: a systematic review protocol. BMJ Open 2016; 6:e011159. [PMID: 27013601 PMCID: PMC4809102 DOI: 10.1136/bmjopen-2016-011159] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 02/18/2016] [Accepted: 03/04/2016] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Oral healthcare in nursing homes is less than optimal, with severe consequences for residents' health and quality of life. To provide the best possible oral healthcare to nursing home residents, care providers need strategies that have been proven to be effective. Strategies can either encourage and motivate residents to perform oral healthcare themselves or can prevent or overcome responsive behaviours from residents when care providers assist with oral healthcare. This systematic review aims to identify studies that evaluate the effectiveness of such strategies and to synthesise their evidence. METHODS AND ANALYSIS We will conduct a comprehensive search in the databases MEDLINE, EMBASE, Evidence Based Reviews--Cochrane Central Register of Controlled Trials, CINAHL and Web of Science for quantitative intervention studies that assess the effectiveness of eligible strategies. 2 reviewers will independently screen titles, abstracts and retrieved full texts for eligibility. In addition, contents of key journals, publications of key authors and reference lists of all studies included will be searched by hand and screened by 2 reviewers. Discrepancies at any stage of the review process will be resolved by consensus. Data extraction will be performed by 1 research team member and checked by a second team member. 2 reviewers will independently assess methodological quality of studies included using 3 validated checklists appropriate for different research designs. We will present a narrative synthesis of study results. ETHICS AND DISSEMINATION We did not seek ethics approval for this study, as we will not collect primary data and data from studies included cannot be linked to individuals or organisations. We will publish findings of this review in a peer-reviewed paper and present them at an international peer-reviewed conference. TRIAL REGISTRATION NUMBER CRD42015026439.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Kobagi
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Minn N Yoon
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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