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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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Taani MH, Ellis J, Okunseri C, Wagner KL. Oral Care Among Older Adults in Assisted Living Facilities. Res Gerontol Nurs 2023; 16:106-107. [PMID: 37224446 DOI: 10.3928/19404921-20230515-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
| | - Julie Ellis
- University of Wisconsin-Milwaukee, College of Nursing Milwaukee, Wisconsin
| | | | - Kathryn L Wagner
- Department of Economics, College of Business Administration Marquette University Milwaukee, Wisconsin
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Gillone A, Martinez Luna AA, Wu Q, Camargo G, Moss ME, Murata RM, Pardi V, Paquette DW. Racial and ethnic disparities in periodontal health among adults seeking dental care in rural North Carolina communities: A retrospective study. J Periodontol 2022; 94:364-375. [PMID: 36321899 DOI: 10.1002/jper.22-0137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 08/16/2022] [Accepted: 09/20/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Population studies consistently demonstrate a greater prevalence of chronic diseases, including oral diseases, among underrepresented minorities. This retrospective study aimed to measure and describe the prevalence and extent of periodontitis among adults seeking dental care within an academic practice-based network in rural North Carolina. METHODS This study used de-identified electronic health record (EHR) data from 2011 to 2017 of adult dentate patients (aged ≥30 years) seeking dental care who received a comprehensive periodontal examination at one of nine networked clinical centers. Periodontitis prevalence was calculated using CDC/AAP case definitions, along with extent (%) scores for periodontal parameters. Comparisons focused on age, sex, race, ethnicity, tobacco use, diabetes status, payer or insurance status, plaque scores, and the number of teeth. RESULTS EHR data for 10,544 adult patients (60.5% female) indicated 79.8% had some form of periodontitis. This patient population was diverse: 22.6% Black, 4.4% American Indian, and 53.8% White, with 4.8% self-identified as Hispanic. Patients 50 years and older showed greater mean extent scores for clinical attachment levels relative to patients 30 to 49 years. Males exhibited greater periodontitis than females (p = 0.001). Blacks showed significantly (p < 0.001) greater periodontitis prevalence relative to Whites. Hispanics also showed a greater prevalence of periodontitis (p < 0.001) relative to non-Hispanics. Significantly greater periodontitis was also noted for tobacco users (p < 0.001) but not for diabetes or payer status. A multiple logistic regression analysis of periodontitis prevalence confirmed significant associations for periodontitis for age, sex, race, ethnicity, tobacco use, high plaque scores, and the number of teeth (p < 0.001), but not diabetes or payer status. CONCLUSIONS The data document that racial and ethnic inequalities in periodontal health occur within the population of adults residing in rural communities in North Carolina and seeking dental care.
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Affiliation(s)
- Alex Gillone
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Acela A Martinez Luna
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Qiang Wu
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Gerard Camargo
- Office of Business Operations and Financial Affairs, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Mark E Moss
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Ramiro Mendonca Murata
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Vanessa Pardi
- Department of Foundational Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - David W Paquette
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
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Lowman SG, Zimmerman S, Ward K, Weintraub JA. Family perceptions of mouth care for assisted living residents with dementia: Implications for care. Geriatr Nurs 2021; 42:926-934. [PMID: 34098447 DOI: 10.1016/j.gerinurse.2021.05.002] [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: 02/01/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
Mouth care is an important component of care for persons with dementia in assisted living (AL). However, there is little information about family member knowledge, beliefs, and experiences with resident oral health. Family perceptions and involvement in care may impact oral and systemic health for AL residents. Therefore, semi-structured interviews to assess these domains were conducted with 23 adult family members of AL residents with dementia, from 9 AL communities. Thematic analysis found that families identified (1) the centrality of oral health to well-being; (2) organizational influences on mouth care; (3) mouth care in the context of dementia; and (4) collaboration to facilitate mouth care. Family perspectives can provide useful guidance for collaborative interventions that support oral health and mouth care in AL.
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Affiliation(s)
- Sarah G Lowman
- North Carolina Department of Health and Human Services, Division of Public Health, Oral Health Section, Raleigh, NC, United States; School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, United States; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kimberly Ward
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, United States
| | - Jane A Weintraub
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Linabarger M, Griffin SO, Hamilton EK. Utility of State-Based Basic Screening Survey Reports for National Oral Health Surveillance in Older Adults. Prev Chronic Dis 2021; 18:E31. [PMID: 33830915 PMCID: PMC8051855 DOI: 10.5888/pcd18.200471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Untreated dental disease and resulting tooth loss can diminish quality of life for older adults by limiting food choices and discouraging social interaction. Before the Basic Screening Survey (BSS) for older adults, no clinical data were available to monitor the oral health of older adults in long-term care (LTC) facilities at the national level or older adults overall at the state level. Although BSS is widely used, no guidelines exist to ensure the validity, reliability, and comparability of survey information across states. We examined BSS content to help establish reporting guidelines and synthesized findings across states for older adults living in LTC. Methods We systematically reviewed BSS reports published from 2011–2019, assessing how oral health outcomes were measured and reported. For reports that included statewide estimates for LTC residents, we calculated the mean, median, and ranges of 3 preventable oral health conditions and 4 indicators of tooth loss. Results We found wide variation in reporting of sampling, screening, and statistical methods, as well as in indicators of tooth loss. Median prevalence of untreated tooth decay and edentulism (total tooth loss) among LTC adults in 11 states was almost twice that for community-dwelling adults in a national survey. Conclusions The substantial variation in BSS reporting highlights the potential benefits of adopting standardized guidance, which could improve the utility of BSS. Poor oral health outcomes among LTC residents underscore the importance of systematic monitoring of the oral health of this vulnerable population.
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Affiliation(s)
- Molly Linabarger
- Deloitte Consulting LLP, 191 Peachtree St NE, Suite 2000, Atlanta, GA 30303. E-mail:
| | - Susan O Griffin
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Kistler CE, Scott J, Ward K, Zeigler R, Sullivan L, Tomlinson SE, Wretman CJ, Zimmerman S. Mouth Care in Assisted Living: Potential Areas for Improvement. J Am Med Dir Assoc 2020; 22:1190-1193.e2. [PMID: 33385333 DOI: 10.1016/j.jamda.2020.11.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Poor oral care may lead to systemic disease, and there is evidence that assisted living (AL) residents lack quality oral care; in AL, poor care may be due to staff knowledge and attitudes, as well as organizational barriers to providing care. OBJECTIVES Determine AL staff knowledge and attitudes regarding mouth care and barriers to changing care. DESIGN Self-administered repeated-measures questionnaires completed before and after oral care training. SETTING AND PARTICIPANTS A total of 2012 direct care staff and administrators from 180 AL communities. METHODS Nine knowledge questions and 8 attitude and practice intention questions, and open-ended questions regarding training and obstacles to providing oral care. RESULTS Overall, 2012 participants completed pretraining questionnaires, and 1977 completed posttraining questionnaires. Baseline knowledge was high, but staff were not uniformly aware of the systemic-oral link whereby mouth care affects pneumonia and diabetes. Almost all staff reported learning a new technique (96%), including for residents who resist care (95%). Suggested areas to improve mouth care included having more hands-on experience. The primary perceived obstacles to care centered around residents who resist care and a lack of time. CONCLUSIONS AND IMPLICATIONS Based on reports of having benefitted from training, AL staff overwhelmingly noted that new knowledge was helpful, suggesting the benefit of skills-based training, especially in dementia care. Mouth care in AL has been sorely understudied, and merits additional attention.
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Affiliation(s)
- Christine E Kistler
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Jessica Scott
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Kimberly Ward
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robin Zeigler
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Louise Sullivan
- College of Nursing, Salve Regina University, Newport, RI, USA
| | - Sarah E Tomlinson
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Christopher J Wretman
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sheryl Zimmerman
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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