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Abreu MHD, da Silva APL, Cavalcanti RVA, Cecilio Hallak Regalo S, Siéssere S, Gonçalves FM, de Araujo CM, Taveira KVM. Prevalence of chewing difficulty in older people in long-term care: A systematic review and meta-analysis. Gerodontology 2023; 40:10-25. [PMID: 34994001 DOI: 10.1111/ger.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/18/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many factors can influence chewing, including age. The ageing process causes morphophysiological changes in the body, including in the performance of the stomatognathic system, which directly affect chewing and swallowing. OBJECTIVE To determine the prevalence of chewing difficulty in older people in long-term care. METHODS We searched six electronic databases and the grey literature. Qualitative and quantitative analyses, including risk of bias, were performed on studies that met the inclusion criteria. The meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored by meta-regression. Risk of bias was determined using the Joanna Briggs Institute's Critical Appraisal Checklist. The certainty of evidence was verified using the GRADE tool. RESULTS Twelve articles were included in the meta-analysis. The pooled prevalence estimate was 35% (95% confidence interval, 0.19-0.54). As heterogeneity still persisted even after sensitivity analysis, the predictors of mean sample age and sample size were meta-regressed to assess whether these covariates explained the variance between effect sizes. The covariable sample size of the study included in the analysis explained 84.3% of the heterogeneity existing in the analysis (R2 = 84.3%; P = .0008). The risk of bias was low in three studies, eight studies had a moderate risk of bias and one study had a high risk of bias. As for the prevalence of chewing difficulty, the GRADE criteria were considered very low. CONCLUSION About one in three older people in long-term care have difficulty in chewing.
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Affiliation(s)
| | | | | | - Simone Cecilio Hallak Regalo
- Basic and Oral Biology Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Selma Siéssere
- Basic and Oral Biology Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Flávio Magno Gonçalves
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | - Karinna Veríssimo Meira Taveira
- Associated Postgraduate Program in Speech, Language and Hearing Sciences, Department of Morphology, Center of Biosciences, Federal University of Rio Grande do Norte, Natal, Brazil
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D’Anna T, Argo A, Albano GD, Puntarello M, Rizzo C, Guadagnino D, Zerbo S. Focus on Liability of Residences for Elderly and Sick People: A Case Series and Medico-Legal Issues. Healthcare (Basel) 2023; 11:healthcare11040539. [PMID: 36833073 PMCID: PMC9956670 DOI: 10.3390/healthcare11040539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Residences for elderly and sick people, self-sufficient or dependent, are varied. To date, the liability profiles of these structures are not clearly delineated, and increasingly often, their operating and organization criteria are entrusted to subnational, regional, or local regulations. Among the various deficits, there is the keeping of a complete and detailed documentation/diary of the patient, the lack of which can generate medico-legal problems. In this paper, we present three cases of guests in residences for a dependent person brought to the attention of the Institute of Forensic Medicine of the University Hospital of Palermo due to criminal proceedings, where the lack of existing documentation in the structure and, in some cases, the behavior of the professionals working there, led the evaluator to deduce the organization's culpability.
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Affiliation(s)
- Tommaso D’Anna
- Policlinic Hospital, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
- Correspondence: (T.D.); (A.A.); Tel.: +39-39-3771-4629 (T.D.); +39-09-1238-6301 (A.A.)
| | - Antonina Argo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
- Correspondence: (T.D.); (A.A.); Tel.: +39-39-3771-4629 (T.D.); +39-09-1238-6301 (A.A.)
| | - Giuseppe Davide Albano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Maria Puntarello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Chiara Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Daniela Guadagnino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Stefania Zerbo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
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Peroz I, Klein C. Influence of professional dental hygiene on oral and general health of retirement home residents: A comparative study. Clin Exp Dent Res 2021; 8:45-53. [PMID: 34472204 PMCID: PMC8874109 DOI: 10.1002/cre2.488] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives The oral status of nursing home residents is poor. This could compromise general health. The controlled study investigated the influence of quarterly professional dental hygiene interventions on oral and general health of elderly. Material and Methods 152 participants (mean age 84 years) of two residents' homes were examined. Parameters of general health, a questionnaire for caregivers, and oral parameters were evaluated at baseline and after 1 year. All caregivers were given one lesson on oral hygiene at baseline. In one home professional oral hygiene was performed every 3 months. Statistical analyses were done by Chi2 test for nominal data and t‐test for numeric data. Results There were no significant differences between both homes regarding general health. Some oral parameters—if any—may be positively influenced by the intervention such as pocket depth, and Denture Hygiene Index and alterations of the mucosa. Conclusions A quarterly professional hygiene is not able to influence general health and has—if any—little effect on oral health. This underlines the necessity for frequent interventions. An optimization of the health policy framework is necessary to allow caregivers more time for oral hygiene and to establish the accessibility of frequent professional health care for inhabitants in residents' homes.
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Affiliation(s)
- Ingrid Peroz
- Department for Prosthodontics, Charité - University Medicine of Berlin, Charité Centre for Dentistry, Gerodontology and Craniomandibular Disorders, Berlin, Germany
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Oliveira MB, Lopes FF, Rodrigues VP, Alves CMC, Hugo FN. Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly. CIENCIA & SAUDE COLETIVA 2018; 23:3663-3674. [PMID: 30427439 DOI: 10.1590/1413-812320182311.26182016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 11/15/2016] [Indexed: 12/22/2022] Open
Abstract
This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.
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Affiliation(s)
- Marisa Borges Oliveira
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Fernanda Ferreira Lopes
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Vandilson Pinheiro Rodrigues
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Claudia Maria Coelho Alves
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Maranhão. Avenida dos Portugueses s/n, Bacanga. 65080-805 São Luís MA Brasil.
| | - Fernando Neves Hugo
- Centro de Pesquisas em Odontologia Social, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Olerud E, Hagman-Gustavsson ML, Gabre P. Oral health status in older immigrants in a medium-sized Swedish city. SPECIAL CARE IN DENTISTRY 2016; 36:328-334. [PMID: 27458173 DOI: 10.1111/scd.12195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of the study was to investigate oral health and oral care habits among older immigrants to Sweden from countries outside the Nordic region. METHOD Participants ≥60 years of age from senior social centers for immigrants were invited to attend oral examinations. Data was collected on the number of teeth, dentures, caries, periodontal status, saliva secretion, and plaque scores. Participants also described their general health and oral care habits. RESULTS Fourteen men and 28 women, median age 71.5 years, participated. Seventeen percent were edentulous, women often than men. Three out of four had caries and 63% had gingival bleeding. Two-thirds brushed their teeth twice per day and 60% had visited dental services in the last 2 years. CONCLUSION The group had a high prevalence of oral diseases and discomfort. They used dental services and brushed their teeth less frequently than Swedish populations of the same age.
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Affiliation(s)
- Eva Olerud
- Public Dental Health, Uppsala County Council, Sweden
| | | | - Pia Gabre
- Public Dental Health, Uppsala County Council, Sweden. .,Department of Cariology, Institute of Odontology, The Sahlgrens, ka Academy, University of Gothenburg, Gothenburg, Sweden.
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The impact of oral health on taste ability in acutely hospitalized elderly. PLoS One 2012; 7:e36557. [PMID: 22570725 PMCID: PMC3343000 DOI: 10.1371/journal.pone.0036557] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 04/06/2012] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate to what extent various oral health variables are associated with taste ability in acutely hospitalized elderly. Background Impaired taste may contribute to weight loss in elderly. Many frail elderly have poor oral health characterized by caries, poor oral hygiene, and dry mouth. However, the possible influence of such factors on taste ability in acutely hospitalized elderly has not been investigated. Materials and Methods The study was cross-sectional. A total of 174 (55 men) acutely hospitalized elderly, coming from their own homes and with adequate cognitive function, were included. Dental status, decayed teeth, oral bacteria, oral hygiene, dry mouth and tongue changes were recorded. Growth of oral bacteria was assessed with CRT® Bacteria Kit. Taste ability was evaluated with 16 taste strips impregnated with sweet, sour, salty and bitter taste solutions in 4 concentrations each. Correct identification was given score 1, and maximum total taste score was 16. Results Mean age was 84 yrs. (range 70–103 yrs.). Total taste score was significantly and markedly reduced in patients with decayed teeth, poor oral hygiene, high growth of oral bacteria and dry mouth. Sweet and salty taste were particularly impaired in patients with dry mouth. Sour taste was impaired in patients with high growth of oral bacteria. Conclusion This study shows that taste ability was reduced in acutely hospitalized elderly with caries activity, high growth of oral bacteria, poor oral hygiene, and dry mouth. Our findings indicate that good oral health is important for adequate gustatory function. Maintaining proper oral hygiene in hospitalized elderly should therefore get high priority among hospital staff.
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Olerud E, Hagman-Gustafsson ML, Gabre P. Oral status, oral hygiene, and patient satisfaction in the elderly with dental implants dependent on substantial needs of care for daily living. SPECIAL CARE IN DENTISTRY 2012; 32:49-54. [DOI: 10.1111/j.1754-4505.2012.00236.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Strömberg E, Hagman-Gustafsson ML, Holmén A, Wårdh I, Gabre P. Oral status, oral hygiene habits and caries risk factors in home-dwelling elderly dependent on moderate or substantial supportive care for daily living. Community Dent Oral Epidemiol 2011; 40:221-9. [DOI: 10.1111/j.1600-0528.2011.00653.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Samson H, Berven L, Strand GV. Long-term effect of an oral healthcare programme on oral hygiene in a nursing home. Eur J Oral Sci 2009; 117:575-9. [PMID: 19758255 DOI: 10.1111/j.1600-0722.2009.00673.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article reports on the long-term effect of an oral healthcare programme aimed at improving and maintaining the oral hygiene of elderly residents in a nursing home. The method was based on (i) motivation and oral-care training of the nursing staff, (ii) production of picture-based oral-care procedure cards, (iii) distribution of adequate oral-care equipment, (iv) practical implementation of new routines, and (v) assessment of results attained. The level of oral hygiene in the nursing home was assessed using the mucosal-plaque score (MPS) index. Overall evaluation was made before the start of the study, after 3 months, and eventually after 6 yr. Before implementation of the oral healthcare programme, 36% of the residents had an acceptable score. Six years later, the proportion was 70%. The evaluation showed that the introduction of such an oral healthcare programme significantly improved the oral hygiene of the residents on a long-term basis. However, 30% of the residents did not achieve an acceptable score because they were very ill or dying, aggressive or wanted to brush their teeth themselves.
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Affiliation(s)
- Heidi Samson
- Department of Clinical Dentistry - Gerodontology, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
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Jäger S, Köster-Schmidt A, Schade M, Heudorf U. Mundhygiene und Mundgesundheit bei Bewohnern von Altenpflegeheimen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2009; 52:927-35. [DOI: 10.1007/s00103-009-0940-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Samson H, Iversen MM, Strand GV. Oral care training in the basic education of care professionals. Gerodontology 2009; 27:121-8. [DOI: 10.1111/j.1741-2358.2009.00304.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mello ALSFD, Montoya JAG, Erdmann AL, Padilha DMP. Assistência à saúde bucal em residências geriátricas de Granada, Espanha e Santa Catarina, Brasil*. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2009. [DOI: 10.1590/1809-9823.200912012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Descrever a assistência à saúde bucal nas residências geriátricas da Província de Granada, Espanha, e Estado de Santa Catarina, Brasil, e comparar os dados obtidos. Metodologia: Trata-se de estudo exploratório, transversal. Os dados foram coletados por meio de questionário fechado, enviado pelo correio, para todas as residências geriátricas cadastradas em Granada (99) e Santa Catarina (78), em 2005. Resultados: O perfil das residências (29 em SC e 30 em Granada) foi semelhante, com predominância de instituições privadas. Não houve diferenças estatísticas significativas quanto aos residentes, exceto quanto ao número de instituições acima da mediana combinada para quantidade de mulheres e idosos totalmente dependentes, superiores em Granada. Embora as residências granadinas apresentassem maior número de profissionais da saúde, não houve diferenças quanto à insuficiente assistência à saúde bucal aos idosos, considerados: registro das condições de saúde bucal, circunstâncias em que essas condições são (re)avaliadas e realização sistemática de higiene bucal. Em face de um problema de saúde bucal apresentado pelo idoso, a família é comunicada, com maior frequência, nas residências granadinas. Conclusões: A assistência à saúde bucal não é prática sistemática nas instituições investigadas, em ambas as regiões, que transferem à família ou aos serviços locais de saúde o encaminhamento quando surgem problemas. Os procedimentos de higiene mais apontados foram escovação de dentes e próteses, porém práticas ineficazes são citadas. Foi frequente a alegação de falta de cooperação dos idosos para justificar a ausência de uma higiene bucal sistemática, revelando transferência de responsabilidades das instituições e cuidadores para o idoso.
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Wolden H, Strand GV, Gjellestad A. Caregivers' perceptions of electric versus manual toothbrushes for the institutionalised elderly. Gerodontology 2006; 23:106-10. [PMID: 16677184 DOI: 10.1111/j.1741-2358.2006.00114.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate how caregivers feel about the use of electric vs. manual toothbrushes for the elderly in long-term care. MATERIALS AND METHODS After electric toothbrushes had been accessible in an institution for 15 months, a self-administered questionnaire was distributed to the nursing staff. The questions posed were whether the electric toothbrushes were being used, how much time was spent on brushing and if electric toothbrushes simplified the provision of oral care for the residents. RESULTS The response rate was 79%. Of the 119 respondents, 78% replied that they always or frequently used an electric toothbrush. With regard to brushing times, 44% of the respondents reported that they spent less time on oral care procedures with an electric toothbrush than with a manual one. Equal amount of time for both types of toothbrushes was reported by 53%. Only 3% reported spending more time with an electric toothbrush than with a manual one. Oral care procedures were considered simpler with this device by 63% of the respondents, 22% registered no change and 15% found it more difficult. If patients suffering from dementia were considered separately, 45% found the procedures simpler when using electric toothbrushes, 24% registered no difference and 31% found it more difficult. CONCLUSION The findings indicate that when given the choice, the caregivers prefer to use electric toothbrushes rather than manual ones as they feel this is simpler and often less time-consuming.
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Affiliation(s)
- Heidi Wolden
- Department of Oral Sciences-Gerodontology, Center for Clinical Dental Research, Faculty of Dentistry, University of Bergen, Bergen, Norway. heidi.wolden@odont .uib.no
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