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Chu KY, Wright FAC, Naganathan V, Stanaway F, Tran J, Cockrell D. Provision of domiciliary dental service to residential aged care facilities: A 3-year descriptive summary. SPECIAL CARE IN DENTISTRY 2024; 44:787-796. [PMID: 37550797 DOI: 10.1111/scd.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023]
Abstract
AIM This cross-sectional descriptive study described the oral health status and types of domiciliary dental treatment received by residents living in residential care after an oral health assessment (OHAT). METHODS Twenty-one facilities were recruited where consenting participants received OHAT followed by a referral for further domiciliary dental treatments. Data were captured and stored as Reach-OHT database where 2017-2019 data were analyzed. RESULT Overall, 88% of residents consented. 69.1% were referred for treatment after completion of OHAT. More than half had one or more caries; 40% showed sign of periodontal disease; a higher proportion of dentate participants had an unsatisfactory level of oral cleanliness. Of those received domiciliary dental treatment, diagnostic and preventive service was the combination most frequently provided. These comprised an average of 71.9% of total treatment provided across the 3-year period. CONCLUSION This study contributes to the understanding and knowledge around the provision of domiciliary dental services in residential care. A large number of older people in residential care can be assessed and treated through a domiciliary service pathway. As the vast majority of services provided were diagnostic, preventive, and restorative care, the feasibility of utilizing the skillset of the entire dental team should be explored.
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Affiliation(s)
- Kuang-Yin Chu
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Australia
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Frederick Allan Clive Wright
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Australia
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Fiona Stanaway
- School of Public Health, University of Sydney, Sydney, Australia
| | - Juliette Tran
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Australia
| | - Deborah Cockrell
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney Local Health District, Concord, Australia
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Rasmussen IL, Halberg N, Jensen PS. 'Why doesn't anyone ask me'? Patients' experiences of receiving, performing and practices of oral care in an acute Orthopaedic Department. Scand J Caring Sci 2023; 37:1079-1090. [PMID: 37231993 DOI: 10.1111/scs.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/12/2023] [Accepted: 05/07/2023] [Indexed: 05/27/2023]
Abstract
AIMS AND OBJECTIVES Oral care is an integrated part of everyday life. Within nursing, barriers related to providing oral care often lead to unmet caring needs. Poor oral care is associated with a risk of respiratory and cardiovascular complications during hospitalisation. Knowledge on patients' perspectives of maintaining or receiving oral care during admissions are limited. Following the Fundamentals of Care (FOC) framework, this study uses a person-centred approach to explore patients' perceptions and experiences of receiving or performing oral care, including the nursing staff's clinical practices. METHODOLOGICAL DESIGN AND JUSTIFICATION A focussed ethnographic approach was used to explore patients' perspectives and clinical practices during acute admissions in an Orthopaedic Department. ETHICS ISSUES AND APPROVAL The local Data Protection Agency and the Ethics Committee approved the study. RESEARCH METHODS, RESULTS AND CONCLUSIONS Data were collected in an Orthopaedic ward at a Copenhagen University hospital, Hvidovre, and consisted of 14 days of field observations of clinical practices and 15 patient interviews. Data were analysed inductively using qualitative content analysis. Two themes were identified. The first, 'The purpose of oral care is defined by the eye of the beholder', describes the social implications for the patients and how patients reject the assumption of oral care being a transgressive act. The second, 'The unspoken need', focus on the lack of dialogue, including the limited provision of oral care and how the nursing staff assesses patients' ability to perform oral care (in)dependently without including the patients. CONCLUSION Oral care is related to the patient's psychological and physical well-being and affects social appearance. When oral care is provided respectfully, patients do not experience oral care as a transgressive act. Nursing staff's self-assessments of the patients' (in)dependency to perform oral care risk leading to incorrect care. Developing and implementing interventions applicable to the clinical practice is needed.
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Affiliation(s)
- Isabella Lund Rasmussen
- The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
| | - Nina Halberg
- The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
- Center of Health Promotion and Health Strategies, Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Pia Søe Jensen
- The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
- Center of Health Promotion and Health Strategies, Department of People and Technology, Roskilde University, Roskilde, Denmark
- Department of Clinical Research, Copenhagen University Hospital, Hvidovre, Denmark
- Research Unit Nursing and Health Care, Health, Aarhus University, Aarhus, Denmark
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da Mata C, Allen PF. Providing Oral Healthcare to Older Patients-Do We Have What It Takes? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6234. [PMID: 37444082 PMCID: PMC10341455 DOI: 10.3390/ijerph20136234] [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: 05/15/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023]
Abstract
Over the past decades, there has been an increase in the number of natural teeth that are maintained into older age, and this has represented an increase in the need for more complex dental treatment for this population. A trained workforce is needed in order to provide dental care to the different groups of elderly. Currently, the undergraduate training in gerodontology offered by dental schools seems to be limited, with great variation among dental schools worldwide. Given the heterogeneity of elderly groups, it is unlikely that new graduates from dental schools can be deemed competent to deal with the different groups of elderly. In this article, barriers to oral healthcare's provision to older adults are discussed, including the lack of appropriately trained dental professionals. Training pathways are discussed, including the preparation of undergraduate education to provide a suitable foundation to be developed further in postgraduate education. It is also proposed that older adults are classified according to their dependency level and each level is managed by properly trained dental professionals. In order to upskill general dental practitioners to care for these patients, postgraduate certification programmes could be structured to provide additional training. Furthermore, the development of geriatric oral health educational programmes for non-dental healthcare workers is recommended.
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Affiliation(s)
- Cristiane da Mata
- Department of Restorative Dentistry, Cork Dental School and Hospital, University College Cork, T12 E8YV Cork, Ireland
| | - Patrick Finbarr Allen
- Oral Health Services Research Centre, University College Cork, T12 E8YV Cork, Ireland;
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van der Putten GJ, de Baat C. An Overview of Systemic Health Factors Related to Rapid Oral Health Deterioration among Older People. J Clin Med 2023; 12:4306. [PMID: 37445340 DOI: 10.3390/jcm12134306] [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: 04/24/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration in older individuals, and to explore the implications of these factors for both general healthcare and oral healthcare provision. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal caregivers. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.
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Affiliation(s)
- Gert-Jan van der Putten
- Orpea Dagelijks Leven, 7327 AA Apeldoorn, The Netherlands
- Department of Dentistry, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Cees de Baat
- Fresh Unieke Mondzorg, 2411 NT Bodegraven, The Netherlands
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de Souza VGL, Herkrath FJ, Garnelo L, Gomes AC, Lemos UM, Parente RCP, Herkrath APCDQ. Contextual and individual factors associated with self-reported tooth loss among adults and elderly residents in rural riverside areas: A cross-sectional household-based survey. PLoS One 2022; 17:e0277845. [PMID: 36413557 PMCID: PMC9681076 DOI: 10.1371/journal.pone.0277845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tooth loss is an oral health condition with high prevalence and negative impact on quality of life. It is the result of the history of oral diseases and their treatment as well as provision of dental care and access to dental services. Socioeconomic characteristics are determinants of tooth loss and living in rural areas is also a risk factor for its incidence. OBJECTIVE To identify contextual and individual factors associated with self-reported tooth loss among adults and elderly people living in rural riverside areas. METHODS A cross-sectional household-based survey was conducted in 2019 with rural riverside communities on the left bank of the Rio Negro River, Manaus, Amazonas. These communities are covered by a fluvial health team and two riverside health teams. Interviews were conducted in a representative random sample of dwellers aged ≥ 18 years, using electronic forms to obtain information on oral health conditions, demographic and socioeconomic characteristics, and use of and access to health services. The outcome was self-reported tooth loss. After the descriptive analysis of the data, a multilevel Poisson regression analysis was performed to estimate the prevalence ratio for the outcome. Variables with p-value ≤0.20 in the bivariate analyses were included in the multiple analysis considering the hierarchy between individual and contextual variables in the multilevel model. Variables with p-value ≤0.10 were kept in the final model and the significance level adopted was 0.05. RESULTS 603 individuals from 357 households were assessed (mean age 44.1 years). The average number of missing teeth was 11.2 (±11.6); 27.4% of individuals had lost more than 20 teeth (non-functional dentition) and 12.1% were completely edentulous. Contextual characteristic of primary healthcare offered was associated with the outcome. The tooth loss was lower in territories covered by riverside health teams. At individual level, tooth loss was greater in older individuals who had experienced dental pain over the past six months and whose sugar consumption was high. Black or brown individuals, individuals whose household income was higher, those who were on the Bolsa Família cash transfer program, those who consulted a dentist over the past year, and those who reported satisfaction with their teeth/oral health reported less tooth loss. CONCLUSION Tooth loss was associated with contextual territorial factors related to the healthcare service and individual demographic, behavioral, socioeconomic, and service-related characteristics as well as self-perceived oral health conditions. The findings suggest that actions focused on the oral health of these populations involve not only changes in the healthcare service organization, but also intersectoral policies that contribute to reducing social inequalities.
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Affiliation(s)
| | - Fernando José Herkrath
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
- Superior School of Health Siences, State University of Amazonas, Manaus, Amazonas, Brazil
| | - Luiza Garnelo
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
| | - Andréia Coelho Gomes
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
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Madero-Cabib I, Reyes C. Employment Trajectories Across the Life Course and Oral Health Among Older Persons in a Developing Country. J Appl Gerontol 2022; 41:1397-1406. [PMID: 35050804 DOI: 10.1177/07334648211065745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A significant research gap on socioeconomic determinants of oral health among older persons is that socioeconomic indicators, like employment status, have essentially been problematized and measured using a cross-sectional approach. Based on a life course approach, and using data from a population-representative, face-to-face and longitudinal-retrospective survey focused on older people in Chile (N = 802), we reconstructed representative types of individual employment trajectories and measured their association with different oral health indicators in old age. Our results show that employment trajectories characterized by continuous, formal, full-time employment have a protective effect for multiple oral health indicators among older people. Our study demonstrates the need for public policies on oral health in old age to incorporate a life course approach and to consider the negative impact of constantly working in informal employment or being out of the labor market permanently, particularly in countries like Chile where temporary and informal employment has risen steadily.
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Affiliation(s)
- Ignacio Madero-Cabib
- Instituto de Sociología and Departamento de Salud Pública, 28033Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carla Reyes
- Departamento de Salud Pública, 28033Pontificia Universidad Católica de Chile, Santiago, Chile
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Oda K, Montayre J, Parsons J, Boyd M. Oral Care in Hospital Settings: Breaking the Vicious Circle of Older Adult Deconditioning. J Gerontol Nurs 2021; 47:7-12. [PMID: 34044682 DOI: 10.3928/00989134-20210507-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hospitalized older adults frequently develop aspiration pneumonia, swallowing dys-function (dysphagia), and sarcopenia. In the current study, we propose a framework that incorporates these three factors into a vicious circle that leads to deconditioning, a condition frequently experienced by this vulnerable population. Viewing aspiration pneumonia, dysphagia, and sarcopenia, along with their interrelationships through the lens of this vicious circle, illuminates the critical role that oral health plays in deconditioning. Moreover, this framework highlights oral care as a key nursing intervention for reducing deconditioning in hospitalized older adults. Supporting this view, several studies have shown that oral care can improve health outcomes for hospitalized older adults. However, despite oral care being an essential nursing intervention that restores oral function and promotes patient wellness, it is one of the most neglected nursing interventions. Missed oral care occurs due to staff's limited awareness of its significance for care-dependent older adults in hospital settings. We hope that this vicious circle paradigm helps raise awareness of the significance of oral care to prevent deconditioning in hospitalized older adults. [Journal of Gerontological Nursing, 47(6), 7-12.].
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Röhrig G, Pia S, Bussmann M, Kunter H, Noack MJ, Barbe AG. Do subjectively and objectively impaired oral health parameters influence geriatric assessment results in hospitalized geriatric patients? Eur Geriatr Med 2020; 11:465-474. [PMID: 32297265 DOI: 10.1007/s41999-020-00306-1] [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] [Received: 11/20/2019] [Accepted: 02/28/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Impaired oral health affects oral health-related quality of life (OHrQoL) in orthogeriatric hospitalized patients, and both might be associated with potential risk factors for functional impairment, based on the comprehensive geriatric assessment (CGA) and related blood laboratory values. As data on this field are scarce, we investigated possible associations between oral health, items of the geriatric oral health assessment instrument (GOHAI), CGA assessment tools, and relevant laboratory values. METHODS Explorative cross-sectional pilot study investigating oral and general health, OHrQoL, and functionality based on objective oral health, GOHAI, CGA, and routinely assessed laboratory parameters of orthogeriatric patients. Correlations (Spearman's rho and Pearson's) and regression analysis were performed for the dependent variables functionality, cognition, Mini-Nutritional Assessment, Falls Efficacy Scale (FES), and the 15-item geriatric depression scale (GDS). RESULTS Among all participants (N = 40), several GOHAI single items (GOHAI 1,4,5,7,10,11) correlated with certain CGA assessment results (fear of falling, Barthel index, handgrip power). Reduced subjective oral health (GOHAI, xerostomia) and objective oral health (oral hygiene index, root caries index, unstimulated salivation rate) correlated with reduced general health and CGA results (polypharmacy, handgrip power, FES, GDS). Anemia was seen in all participants, but no associations between reduced oral health and laboratory blood values were detected. CONCLUSION Our results demonstrate the association between impaired subjective and objective oral health, OHrQoL, and physical functional impairment among orthogeriatric patients. Impaired GOHAI item results at the dentist, and the association between GOHAI values and CGA results that implies an association between physical and oral health, should encourage a geriatric check based on CGA, and vice versa. Results encourage interdisciplinary cooperation between geriatricians and dentists, but also indicate the need for further research in this field. TRIAL REGISTRATION DRKS00013230.
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Affiliation(s)
- Gabriele Röhrig
- Zentrum für Spezialisierte Geriatrische Diagnostik, MVZ Medicum Köln Ost, Johann Classen Strasse 68, 51103, Cologne, Germany.
| | - Schmidt Pia
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - Michael Bussmann
- Department of Orthogeriatrics, Evangelisches Krankenhaus Köln Kalk, Buchforststrasse 2, 51103, Cologne, Germany
| | - Henning Kunter
- Department of Orthogeriatrics, Evangelisches Krankenhaus Köln Kalk, Buchforststrasse 2, 51103, Cologne, Germany
| | - Michael Johannes Noack
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Cologne, Kerpener Str. 32, 50931, Cologne, Germany
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Shigli K, Nayak SS, Jirge V, Srinagesh J, Murthy V, Gali S. Current status of gerodontology curriculum in India and other parts of the world: A narrative review. Gerodontology 2020; 37:110-131. [DOI: 10.1111/ger.12461] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/23/2019] [Accepted: 01/05/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Kamal Shigli
- Department of Prosthodontics D.Y. Patil Dental School Lohegaon Pune Maharashtra India
| | | | - Vasanti Jirge
- Department of Oral Medicine and Radiology KLE VK Institute of Dental Sciences Belgavi Karnataka India
| | | | - Varsha Murthy
- Department of Prosthodontics Sri Venkateshwaraa Dental College Pondicherry India
| | - Sivaranjani Gali
- Department of Prosthodontics Faculty of Dental Sciences M.S. Ramaiah University of Applied Sciences Bangalore India
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Impact of oral health status on oral intake ability prognosis after pneumonia in older patients: a retrospective cohort study. Eur Geriatr Med 2019; 10:899-903. [DOI: 10.1007/s41999-019-00237-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/29/2019] [Indexed: 02/05/2023]
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