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Ramos TMC, da Silva Alves ÁA, Apolinário TA, de Toledo FF, Gomes VE, Barbosa KGN, Sampaio AA, Ferreira RC. Challenges to conducting research on oral health with older adults living in long-term care facilities. BMC Oral Health 2024; 24:422. [PMID: 38580950 PMCID: PMC10998329 DOI: 10.1186/s12903-024-04204-x] [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: 11/03/2023] [Accepted: 03/29/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The challenges to conducting oral health studies involving older people in long-term care facilities (LTCFs) must be debated. OBJECTIVE This study aimed to investigate researchers' perceptions and experiences while conducting an epidemiological survey on oral health among older individuals residing in LTCFs. METHODS A qualitative study was conducted involving six researchers who utilized field diaries to record their impressions during data collection through interviews (older individuals (or their proxies), caregivers, and LTCF coordinators) and oral examinations of the older people participants. Additionally, researchers responded to open-ended questions about their experiences. The collected material was subjected to content analysis by two researchers. RESULTS The themes that emerged from the analysis were institutional context, aspects affecting the operationalization of the study, and data collection oriented by the clinical-functional profile of the older people. According to the researchers' perceptions, LTCF coordinators demonstrated concern for the study's benefits for older adults and the preservation of institutional routines during the research process. Caregivers emerged as vital sources of information, guiding researchers in navigating the challenges posed by the physical and mental complexities of the older people participants, necessitating empathy, sensitivity, and attentive listening from the researchers. The organization of materials and a streamlined data collection process proved essential for optimizing time efficiency and reducing stress for participants and researchers. CONCLUSION The researchers recognized the important role played by LTCF coordinators and formal caregivers, underscoring the significance of empathetic methodologies and streamlined data collection processes in mitigating the challenges inherent to research conducted within LTCFs.
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Affiliation(s)
- Thayse Mayra Chaves Ramos
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Álvaro Augusto da Silva Alves
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thais Andrade Apolinário
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Flávia Fonseca de Toledo
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Viviane Elisângela Gomes
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kevan Guilherme Nóbrega Barbosa
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Araújo Sampaio
- Department of Clinical, Pathology and Surgical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Elfituri AA, De Nova MJ, Najirad M. The impact of osteogenesis imperfecta severity on oral health-related quality of life in Spain: a cross-sectional study. Orphanet J Rare Dis 2024; 19:108. [PMID: 38459573 PMCID: PMC10921673 DOI: 10.1186/s13023-024-03096-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: 11/07/2023] [Accepted: 02/21/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Osteogenesis imperfecta (OI) affects dental and craniofacial development; therefore, it can influence oral health-related quality of life (OHRQoL). The objective of this study was to explore the influence of the severity of OI on OHRQoL in adults older than eighteen years residing in Spain. METHOD Adults with OI were recruited from the Spanish Association of Crystal Bone (AHUCE) foundation. OHRQoL was evaluated using the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14sp), oral hygiene habits, and a dental care survey. Clinical and radiological dental examinations were performed to evaluate the patients' oral conditions. RESULTS A total of 65 adults (n = 46 females) aged between nineteen and sixty-two years who were diagnosed with OI and classified as type I, III, and IV (n = 20, 14, and 31, respectively) participated in this research. The total OHIP-14sp scores were significantly greater (worse) for type III (23 [SD = 10]) and type IV (21.4 [SD = 12]) than for type I (13.8 [SD = 6]) (P < 0.05). The negative impact of OHRQoL was due to the association of type III OI with all domains except for the handicap domain, while type IV OI was associated with the physical disability, social disability, and handicap domains (P < 0.05 for all). CONCLUSION The severity of OI negatively impacted OHRQoL in adults. This association was statistically significant.
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Affiliation(s)
- Amira Ahmed Elfituri
- Faculty of Dentistry, Complutense University, Pza. Ramon y Cajal, Moncloa-Aravaca, Madrid, Spain.
| | - Manuel Joaquín De Nova
- Faculty of Dentistry, Complutense University, Pza. Ramon y Cajal, Moncloa-Aravaca, Madrid, Spain
| | - Mohammadamin Najirad
- Department of Orthodontics, Faculty of Dentistry, University of Toronto, Toronto, Canada
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Villacorta-Siegal N, Joseph K, Gardner S, Smith J, Gallucci CE, Aleong R, Chvartszaid D. Integration of a dental hygienist into the interprofessional long-term care team. Gerodontology 2024; 41:125-140. [PMID: 38146174 DOI: 10.1111/ger.12734] [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] [Accepted: 12/10/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND To address poor oral health of residents in long-term care homes (LTCH), this study explored the process of integrating an educational resource and a dental hygienist on the interprofessional care team. METHODS This convergent mixed-methods study took place at a 472-bed LTCH in Toronto, Canada from February to August 2018. Nurses employed at the LTCH participated in the study. During the study period, a dental hygienist was integrated into an interprofessional LTCH team. Nurses completed an online eLearning module about using the Oral Health Assessment Tool (OHAT) when referring residents' oral health concerns to a. Pre/post knowledge quizzes, module feedback and satisfaction surveys were administered. A retrospective chart review examined OHAT use and compared nurse and dental hygienist oral health assessments. Two cycles of semi-structured interviews with five nurses explored experiences with the eLearning module, OHAT and integration of the dental hygienist into the team. RESULTS Nurses scored well on the knowledge quizzes and reported comfort in using the OHAT to refer oral concerns to a dental hygienist; however, actual use was minimal. oral health issues were under-reported by nurses on the Resident Assessment Instrument-Minimum Data Set (RAI-MDS); the dental hygienist reported significantly more debris, teeth lost and carious teeth (all P < 0.0001). Qualitative analysis indicated that the nurses valued dental hygienist integration into the team. Using knowledge mobilisation practices, a new oral health referral tool was developed. CONCLUSIONS This study highlights the feasibility and desirability of an oral health eLearning module, practical assessment tools and participation of a dental hygienist on the LTCH interprofessional care team.
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Affiliation(s)
- Nelly Villacorta-Siegal
- Department of Dentistry, Alpha Omega Dental Center, Baycrest Hospital, Toronto, Ontario, Canada
| | - Karen Joseph
- Kunin-Lunenfeld Centre for Applied Research & Evaluation, Baycrest Academy for Research & Education, Toronto, Ontario, Canada
| | - Sandra Gardner
- Kunin-Lunenfeld Centre for Applied Research & Evaluation, Baycrest Academy for Research & Education, Toronto, Ontario, Canada
| | - Jagger Smith
- Department of Dentistry, Alpha Omega Dental Center, Baycrest Hospital, Toronto, Ontario, Canada
| | - Christina E Gallucci
- Kunin-Lunenfeld Centre for Applied Research & Evaluation, Baycrest Academy for Research & Education, Toronto, Ontario, Canada
| | - Rosanne Aleong
- Kunin-Lunenfeld Centre for Applied Research & Evaluation, Baycrest Academy for Research & Education, Toronto, Ontario, Canada
| | - David Chvartszaid
- Department of Dentistry, Alpha Omega Dental Center, Baycrest Hospital, Toronto, Ontario, Canada
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Wong FMF, Shie HWH, Kao E, Tsoi HM, Leung WK. Educational Programme on Knowledge, Attitudes, and Practice of Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Case-Control Study. Geriatrics (Basel) 2024; 9:16. [PMID: 38392103 PMCID: PMC10888457 DOI: 10.3390/geriatrics9010016] [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: 11/20/2023] [Revised: 12/30/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Much attention has been paid to advocate proper oral care/hygiene provision by healthcare providers in long-term care institutions (LTCIs). This study aimed to evaluate the effects of an oral health education (OHE) programme (intervention) on knowledge, attitudes, and practice (KAP) of healthcare providers in providing oral care/hygiene to older residents in LTCIs. METHODS A case control study was conducted at two LTCIs, with one assigned as the intervention group and the other as the control group. A KAP survey was administered before and after the intervention, and oral status was assessed by standardized clinical photographs taken before and after oral hygiene provision on three older residents. RESULTS A total of 40 healthcare providers (20 in intervention and 20 in control groups) participated, with the attitudes and overall KAP significantly improved in the intervention group after the OHE programme. Interestingly, the knowledge of those in the control LTCI was significantly declined at re-evaluation (mean scores were from 17.25 to 14.30), indicating inadequate oral health and care training despite having more experience in taking care of older people. Significant differences in practice were observed between the two groups after the OHE programme (p = 0.006). The three older residents exhibited poor oral health and multiple oral problems. CONCLUSIONS This study revealed that the OHE programme effectively improved attitudes of the healthcare providers and provided a sustaining effect on attitude towards oral health and oral care. However, there were still inadequacies in oral hygiene provision by some healthcare providers, possibly due to unattended oral diseases and hygiene needs, as well as personal and environmental barriers that merit further investigation. Regular evaluation and enforcement of oral care/hygiene provision in LTCIs are necessary to maintain oral health and prevent dental and gum diseases in older residents. Immediate referral for dental treatment is recommended for older people with signs of dental/oral disease(s).
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Affiliation(s)
| | | | - Enoch Kao
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Hoi Mei Tsoi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Julkunen L, Saarela R, Roitto HM, Kautiainen H, Pitkälä K, Mäntylä P, Hiltunen K. Oral frailty among dentate and edentate older adults in long-term care. BMC Geriatr 2024; 24:48. [PMID: 38212720 PMCID: PMC10782602 DOI: 10.1186/s12877-023-04605-7] [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: 06/04/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The objectives of this study were to compare oral frailty (OFr) among edentate and dentate older adults living in long-term care facilities (LTCF) and to clarify how edentulism and oral disease burden (ODB) of dentate older adults are associated with OFr. METHODS The population of this study comprised 94 edentate and 209 dentate residents in LTCF in Helsinki, Finland, who had previously participated in a nutritional study. The participants underwent a clinical oral examination. The dentate residents were further divided into three ODB groups based on asymptotic dental score. The edentate and different ODB groups were compared with each other regarding demographics and oral and medical findings. OFr was defined as ≥ 2 of following: having a diet of soft/pureed food, residue of food in the oral cavity, inability to keep the mouth open during examination, unclearness of speech, dry mouth. The association between OFr and edentulousness and various levels of ODB was analyzed by a multivariate logistic model. RESULTS Participants with low ODB had significantly less OFr than their edentate peers (p = 0.009). Furthermore, the edentate and dentate with high ODB had similar odds for OFr. CONCLUSIONS Edentulousness and high ODB are equally harmful conditions and may predispose to OFr. This study suggests that maintaining healthy natural teeth and good oral health (low ODB) may protect against OFr. TRIAL REGISTRATION The Ethics Committee of the Hospital District of Helsinki and Uusimaa approved the protocols for the nutritional status and oral healthcare studies and the merging of the data, including patient medical records (Register number HUS/968/2017).
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Affiliation(s)
- Lina Julkunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Riitta Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, Finland
| | - Hanna-Maria Roitto
- Faculty of Medicine (Clinicum), University of Helsinki, Helsinki, Finland
- Geriatric Clinic, Helsinki Hospital, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Kaisu Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
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Jämsä H, Laitala ML, Kaakinen P, Ylöstalo P, Syrjälä AM. Implementation of oral hygiene practices in nursing homes - a qualitative approach among supervisor nurses. Acta Odontol Scand 2024; 82:25-32. [PMID: 37671640 DOI: 10.1080/00016357.2023.2252493] [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: 04/13/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES This study describes daily oral health care in private enhanced service housing units and nursing homes in Finland using a qualitative method. METHODS Nineteen supervisor nurses were interviewed in the six largest cities in Finland. The interviews consisted of semi-structured questions. The interviews were then transcribed and analyzed using inductive content analysis. RESULTS The qualitative content analysis revealed five main categories: diet, education in the oral health of older people, oral care equipment and taking care of them, caring for the mouths of residents, and professional oral health care. The results revealed that sugary snacks were given daily in the units and there was a need for oral health care education. The dental equipment of residents was taken care of well and the oral health of the residents was taken care of moderately well. Furthermore, there was a need for co-operation between dental professionals and only half of the residents had an individual oral care plan. CONCLUSIONS It can be concluded that based on this qualitative study, the implementation of daily oral health care in most nursing homes and enhanced housing units seems to be at a sufficient level and more oral health-related practical and theoretical education is needed.
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Affiliation(s)
| | - Marja-Liisa Laitala
- Research Unit of Population Health, Department of Cariology, Endodontology and Pedodontics, University of Oulu, Finland
- Oulu University Hospital and Medical Research Center, Oulu, Finland
| | - Pirjo Kaakinen
- Research Unit of Health Sciences and Technology, University of Oulu, Finland
| | - Pekka Ylöstalo
- Research Unit of Population Health, University of Oulu, Finland
- Oulu University Hospital and Medical Research Center, Oulu, Finland
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Anna-Maija Syrjälä
- Research Unit of Population Health, Department of Periodontology and Geriatric Dentistry, University of Oulu, Finland
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Tepox-Puga SM, Rocha-Ortiz JA, Medina-Solís CE, Castrejón-Pérez RC, Sánchez-García S, Borges-Yáñez SA. Prevalence, and Risk Indicators of Coronal and Root Caries in Mexican Older Adults in Nursing Homes. Clin Cosmet Investig Dent 2023; 15:333-347. [PMID: 38107875 PMCID: PMC10723588 DOI: 10.2147/ccide.s439342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023] Open
Abstract
Background Several factors are associated with coronal and root caries in older persons. The purpose of this study was to determine the experience, prevalence, and risk indicators (socioeconomic, sociodemographic, and dental variables) of coronal and root caries in older persons residing in nursing homes in Mexico. Methods A cross-sectional study was carried out in 227 dentate participants with natural teeth. Convenience sample, where all dentate residents were invited to participate. The dependent variables were coronal caries and root caries, which were determined through an oral clinical examination. The independent variables were sociodemographic factors, location, type of center, surfaces free of dental biofilm and calculus, surfaces with recession, retainers in contact with surfaces with recession, xerostomia, smoking, and the previous use of dental services. The binary logistic regression model was used in the analysis. Results The mean age of the participants in this study was 77.7±8.8 years, and 69.2% were women. Moreover, 71.8% live in long-term care facilities, and 48.0% live in Mexico City. The prevalence of coronal and root caries was found to be 67.8% and 50.7%, respectively. Being male and living in Mexico City were risk indicators for coronal caries, and with a 1% increase in surfaces with no biofilm, the risk decreased by 2%. Being widowed, having government or no social security, denture retainers, and coronal caries were risk indicators for root caries, while the utilization of dental services indicated lower risk. Conclusion Several variables that differ in nature were found to be risk indicators for coronal and root caries. Coronal caries increases the risk of root caries. Prevention should be aimed at identifying persons at higher risk, and dental care should be improved for persons living in long-term care institutions.
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Affiliation(s)
| | | | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Roberto Carlos Castrejón-Pérez
- Department of Geriatric Clinical and Epidemiological Research, National Institute of Geriatrics, National Institutes of Health, México City, México
| | - Sergio Sánchez-García
- Epidemiological and Health Services Research Unit, Aging Area, National Medical Center “Siglo XXI”, Mexican Institute of Social Security, Ciudad de Mexico, Mexico
| | - Socorro Aída Borges-Yáñez
- Department of Dental Public Health, Graduate and Research Division, Dental School, National Autonomous University of Mexico, University City, México City, Mexico
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Puranen T, Hiltunen K, Kautiainen H, Suominen MH, Salminen K, Mäntylä P, Roitto HM, Pitkälä KH, Saarela RKT. Relationship between oral frailty, health-related quality of life, and survival among long-term care residents. Eur Geriatr Med 2023; 14:1307-1315. [PMID: 37728853 PMCID: PMC10754726 DOI: 10.1007/s41999-023-00859-x] [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: 11/24/2022] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE We evaluated oral frailty (OFr) and its association with health-related quality of life (HRQoL), energy and protein intake, and survival among older long-term care residents. METHODS This cross-sectional study with a 3-year follow-up for survival assessed 349 residents in long-term care facilities (73% female, mean age 82 years). We defined OFr with six signs (dry mouth, food residue on oral surfaces, unclear speech, inability to keep mouth open or pain expression during the clinical oral examination, diet pureed/soft) and OFr severity was categorized as Group 1, (mild) = 0-1 signs, Group 2 (moderate) = 2-4 signs, and Group 3 (severe) = 5-6 signs. We measured HRQoL with 15D instrument, and energy and protein intake by a 1- to 2-day food record. Mortality was retrieved from central registers on March 2021. RESULTS Of the residents, 15% had 0-1, 67% 2-4 and 18% 5-6 OFr signs. HRQoL decreased linearly from Group 1 to Group 3. OFr correlated with such dimensions of HRQoL as mobility, eating, speech, excretion, usual activities, mental function, and vitality. We found no association between OFr categories and energy and protein intake. Survival decreased linearly from Group 1 to Group 3. CONCLUSIONS OFr was common among older long-term care residents and OFr severity predicts poorer outcomes. The six oral signs denoting OFr may be used at the bedside to screen residents at risk for OFr.
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Affiliation(s)
- Taija Puranen
- Social Services, Health Care and Rescue Services Division, Development Support, City of Helsinki, P.O. Box 6008, 00099, Helsinki, Finland.
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Karoliina Salminen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Hanna-Maria Roitto
- Department of Medicine, University of Helsinki, Helsinki, Finland
- Social Services, Health Care and Rescue Services, Helsinki Hospital, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Riitta K T Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, Helsinki, Finland.
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Hiltunen K, Vehkalahti MM. Why and when older people lose their teeth: A study of public healthcare patients aged 60 years and over in 2007-2015. Gerodontology 2023; 40:326-333. [PMID: 36151752 DOI: 10.1111/ger.12657] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This register-based study on public sector patients aged 60 years and over assessed annual age-specific volume of and reasons for tooth extractions as well as changes in these across the period 2007-2015. BACKGROUND Alongside the rapidly ageing population, the demand for public oral healthcare services is growing. Damaged teeth may induce a long-lasting inflammation burden in old age. MATERIALS AND METHODS Data used the electronic documentation of oral healthcare procedures recorded according to healthcare regulation. The study population consisted of all patients over 60 years of age (n = 216 059) who were treated 2007-2015 in public oral health care available to all citizens of Helsinki, Finland. Data for the 9-year time series included reasons for tooth extractions and were aggregated by patient age into 5-year groups. Statistical analyses included rates and proportions, mean values, correlation coefficients and linear regression modelling. RESULTS Extraction patients (n = 48 623) were more likely in the older age groups: 21.8% in the age group 60-64 and 27.5% in the age group 90+. Mean number of tooth extractions among all patients was 0.4 per patient and 1.7 per extraction patient. Among all tooth extractions (n = 82 677), main reasons were caries 29.5%, apical periodontitis 19.4%, tooth remnant 19.4% and periodontitis 18.0%. Tooth remnant predominated as extraction reason in the oldest age groups, while apical periodontitis displayed an upward trend by calendar year. CONCLUSION Tooth extractions attributable to caries were common in all old-age groups, tooth remnant extractions were most common in older age groups, and apical periodontitis abounded as extraction reason during 2007-2015.
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Affiliation(s)
- Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Miira M Vehkalahti
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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10
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Janssens L, Petrauskiene E, Tsakos G, Janssens B. Clinical and Subjective Oral Health Status of Care Home Residents in Europe: A Systematic Review. J Am Med Dir Assoc 2023; 24:1013-1019.e40. [PMID: 37105236 DOI: 10.1016/j.jamda.2023.03.021] [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: 12/21/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Several studies demonstrated the poor oral health of care home residents in Europe but there is no systematic overview of the relevant literature. The objective of this study was to systematically review the evidence on the clinical and subjective oral health outcomes of care home residents in Europe. DESIGN The study design is a systematic review. METHODS AND PARTICIPANTS All included publications presented data on clinical and/or subjective oral health outcomes in care home residents in Europe with no restrictions for language or study design. MEDLINE, Embase, and CINAHL were searched, including publications from January 2010 onward. Data extraction and quality assessment (Qualsyst tool) was performed by 2 researchers independently. Findings were synthesized narratively, lack in data homogeneity restricted the relevance of a meta-analysis. RESULTS Eighty-three papers from 18 countries were included in the systematic review, with a sample size ranging from 39 to 92,827 participants. Their mean age was older than 80 years. The residents had few natural teeth, with fewer than a third a functional natural dentition. Removable dentures were present in half to 80% of residents. A high prevalence of dental caries was reported. Oral hygiene was insufficient, for both natural teeth and removable dentures. Few residents had a healthy periodontium. Clinical treatment needs were found in most residents. Perceived treatment needs were high with at least one-third of care home residents reporting a need for care due to poor oral health. A fifth to half of the residents reported negative impacts of their oral condition on their everyday lives. CONCLUSION AND IMPLICATIONS This systematic review clearly highlights the poor oral health and high burden of oral conditions among care home residents across Europe, irrespective of country or health care system. There is need for substantial policy actions to improve oral health in care homes.
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Affiliation(s)
- Lynn Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium.
| | - Egle Petrauskiene
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Georgios Tsakos
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Barbara Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium
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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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He G, Wang Z, Hu C, Yang Y, Wang N, Shao L, You J. The effect of motivational interviewing based on the transtheoretical model on oral cleaning behavior of patients with periodontitis who have undergone implant restoration. Technol Health Care 2023; 31:541-549. [PMID: 37066949 DOI: 10.3233/thc-236048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND Implant-restored patients with periodontitis have a higher risk of developing peri-implantitis, and helping them develop oral cleaning habits is significant. OBJECTIVE To evaluate the effectiveness of motivational interviewing based on the transtheoretical model on the modification of oral cleaning behaviors of implant-restored patients with periodontitis. METHODS Patients with periodontitis (n= 70) who would receive dental implant treatment were included. And they were randomly divided into two groups: experimental (n= 35) and control (n= 35). Control patients received routine oral hygiene education, and those in the experimental group received motivational interviewing based on the transtheoretical model. Oral cleaning behavior was compared between the two groups before and after intervention. In addition, periodontal health status was compared on the day of implant restoration and three months later. RESULTS Compared to the control, the experimental group demonstrated significantly better oral hygiene behavior after intervention (P< 0.05). Three months after implant restoration, significantly better results were obtained by the experimental group in terms of mPLI and mSBI (P< 0.05). CONCLUSION Motivational interviewing based on the transtheoretical model can effectively improve the oral cleaning behavior and periodontal health of implant-restored patients with periodontitis.
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Affiliation(s)
- Guixin He
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Zou Wang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Hu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yujun Yang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Ning Wang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Longquan Shao
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Jie You
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Fogelholm N, Leskelä J, Manzoor M, Holmer J, Paju S, Hiltunen K, Roitto HM, Saarela RK, Pitkälä K, Eriksdotter M, Buhlin K, Pussinen PJ, Mäntylä P. Subgingival microbiome at different levels of cognition. J Oral Microbiol 2023; 15:2178765. [PMID: 36844899 PMCID: PMC9946326 DOI: 10.1080/20002297.2023.2178765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Oral health and declining cognition may have a bi-directional association. We characterized the subgingival microbiota composition of subjects from normal cognition to severe cognitive decline in two cohorts. Memory and Periodontitis (MINOPAR) include 202 home-living participants (50-80 years) in Sweden. Finnish Oral Health Studies in Older Adults (FINORAL) include 174 participants (≥65 years) living in long-term care in Finland. We performed oral examination and assessed the cognitive level with Mini Mental State Examination (MMSE). We sequenced the 16S-rRNA gene (V3-V4 regions) to analyse the subgingival bacterial compositions. The microbial diversities only tended to differ between the MMSE categories, and the strongest determinants were increased probing pocket depth (PPD) and presence of caries. However, abundances of 101 taxa were associated with the MMSE score. After adjusting for age, sex, medications, PPD, and caries, only eight taxa retained the significance in the meta-analyses of the two cohorts. Especially Lachnospiraceae [XIV] at the family, genus, and species level increased with decreasing MMSE. Cognitive decline is associated with obvious changes in the composition of the oral microbiota. Impaired cognition is accompanied with poor oral health status and the appearance of major taxa of the gut microbiota in the oral cavity. Good oral health-care practices require special deliberations among older adults.
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Affiliation(s)
- Nele Fogelholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jaakko Leskelä
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Muhammed Manzoor
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jacob Holmer
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Susanna Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Hanna-Maria Roitto
- Department of Neurosciences, University of Helsinki, Helsinki, Finland.,Internal medicine and rehabilitation, Division of Geriatrics, Helsinki University Hospital Helsinki, Finland.,Population health unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Kt Saarela
- Department of Social Services and Health Care, Oral Health Care, Helsinki, Finland
| | - Kaisu Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Kåre Buhlin
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Pirkko J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Päivi Mäntylä
- School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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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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Chen L, Gu L, Li X, Chen W, Zhang L. Translation, cross-cultural adaptation, and validation of the Chinese version of self-efficacy and attitudes for providing Mouth Care scale. PLoS One 2022; 17:e0271800. [PMID: 35867694 PMCID: PMC9307152 DOI: 10.1371/journal.pone.0271800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background
In recent years, oral care for older people has received extensive attention in long-term care facilities. The Self-Efficacy for Providing Mouth Care (SE-PMC) and Attitudes for Providing Mouth Care (A-PMC) scale evaluated the self-efficacy and attitude of nursing staff while providing oral care. However, whether this scale is valid and reliable for Chinese nursing staff in China remains unverified. This study aims to translate the English version of SE-PMC and A-PMC into Chinese and determine their reliability and validity.
Methods
After obtaining the author’s consent, the procedure for a double-back translation and cross-cultural adaptation was conducted to develop the Chinese version of SE-PMC and A-PMC. The validity and reliability of the Chinese version of SE-PMC and A-PMC were evaluated in a cross-sectional observational study with 852 nurses from 42 Geriatric Care Facilities (GCFs). Exploratory factor analysis (EFA) (n = 427) and confirmatory factor analysis (CFA) (n = 425) were conducted to test the construct validity and quality of the factor structures. We applied the item discrimination test and homogeneity test for item analysis. Cronbach’s alpha coefficient and split-half coefficient were adopted to evaluate internal consistency.
Results
The Chinese version of SE-PMC (11 items, 3 factors) and A-PMC (11 items, 2 factors) included 22 items, reflecting adequate construct validity and reliability. In addition, test-retest reliability was 0.809 for SE-PMC and 0.811 for A-PMC, evincing good stability. The Cronbach’s α coefficient of SE-PMC was 0.831, with each factor ranging from 0.793~0.906. The Cronbach’s α coefficient of the A-PMC was 0.768, with each factor ranging from 0.814~0.824. Item-Content Validity Index (I-CVI) of SE-PMC and A-PMC ranged from 0.84 ~1.00 and 0.82~1.00, respectively.
Conclusion
The Chinese version of SE-PMC and A-PMC was validated as a reliable assessment tool to evaluate the self-efficacy and attitude of nursing staff in GCFs for providing oral care in China.
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Affiliation(s)
- Lan Chen
- Nursing Department, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital Affiliated to Naval Medical University, Shanghai, China
| | - Liyan Gu
- Department of Neurology, NO. 905 Hospital of PLA Navy, Shanghai, China
| | - Xianchen Li
- Clinical Research Center, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital Affiliated to Naval Medical University, Shanghai, China
| | - Lingjuan Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital Affiliated to Naval Medical University, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
- * E-mail:
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Oura R, Mäntylä P, Saarela R, Hiltunen K. Oral hypofunction and association with need for daily assistance among older adults in long-term care. J Oral Rehabil 2022; 49:823-830. [PMID: 35620888 PMCID: PMC9546329 DOI: 10.1111/joor.13345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/24/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral hypofunction (OHF) is related to occlusal status and bite force. It has specific symptoms and varying degrees of severity. OBJECTIVES OHF was determined with five signs. The relationships between OHF and need for assistance in oral hygiene, moving, eating, and occlusal status in older adults living in long-term care (LTC) were examined. METHODS A comprehensive clinical oral examination was conducted on 393 residents who lived in LTC in Helsinki, Finland. The five signs to determine OHF were mouth dryness, visible food residue on oral or denture surfaces, ability to keep the mouth open during examination, clearness of speech, and diet of pureed or soft food. Score points of 0-2 were given for each sign and the sum was categorized as mild, moderate, or severe OHF. Participants were divided into three groups accordingly, and occlusal status was determined based on contact units. In addition, nurses collected background information on number of medications and level of cognition. Need for assistance was based on oral hygiene, moving, and eating. RESULTS Of participants (n=319), 21% showed severe and 41% moderate OHF. Occlusal status differences between the OHF groups were significant. OHF severity associated linearly with increased severity of cognitive impairment and increased need for assistance in oral hygiene, eating, and moving. CONCLUSIONS OHF score based on the five signs can be used to determine OHF severity. OHF was common and associated with occlusal status, cognitive impairment, and need for assistance in oral hygiene, moving, and eating in older adults living in LTC.
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Affiliation(s)
- Riki Oura
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Kuopio University Hospital, Oral and Maxillofacial Diseases, Kuopio, Finland
| | - Riitta Saarela
- Department of Social Services and Health Care, Oral Health Care, City of Helsinki, Helsinki, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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Wang Q, Chen H, Jiang L. Assessment of the professional dental cleaning knowledge, behavior and medical compliance among dentists, medical doctors and non-medical staffs: a cross sectional study in Chongqing, China. BMC Oral Health 2022; 22:188. [PMID: 35590315 PMCID: PMC9118795 DOI: 10.1186/s12903-022-02226-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The professional dental cleaning (PDC) is an effective supplement that can make up for the lack of self-oral health care. Everyone should develop the habit of regular PDC. This study aimed to investigate the knowledge, behaviors and medical compliance of dentists, medical doctors and non-medical staffs about the PDC, identify the gaps, and provide information to help individuals develop healthy oral hygiene habit. MATERIALS AND METHODS A web-based survey with 21 questions designed based on the characteristics, the PDC knowledge, behaviors, and medical compliance of respondents. A cross-sectional study was conducted in the main districts of Chongqing, China, in the period of September-November 2020. A total of 456 respondents including 153 dentists, 137 medical doctors and 166 non-medical staffs in 3 communities and 4 hospitals were sampled online with multistage sampling and surveyed. The data was analyzed by chi-square test using IBM SPSS Statistics v. 21.0. RESULTS The cognitive level and behavior of dentists on the PDC was significantly better than that of medical doctors and non-medical staffs (p = 0.000-0.044). The rates of not knowing "dental plaque" were 32.85% and 61.45%, of the medical doctors and non-medical staffs. Meanwhile, most of them had misunderstanding about effects of the PDC. They thought it would whiten teeth (72.99%, 80.72%), damage gums (16.79%, 19.88%) and teeth (15.33%, 21.69%), and create bigger gaps between teeth (24.82%, 33.13%). In terms of gum health and the PDC behavior, significant differences were observed, 23.53% of dentists experienced irritated gum bleeding in the last 12 months, 42.28% did not have their teeth cleaned professionally in the last 12 months, even 7.84% never had it before. Compared with it, in the same situation, the ratios of medical doctors and non-medical staffs were about 60% experiencing irritated gum bleeding, 69.34% and 77.71% not experiencing the PDC in the last 12 months, up to 33.58% and 45.18% never experienced it before. 41 respondents (8.99%) disagreed with the reasonable and necessary medical behaviors before the PDC. CONCLUSION People's understanding about the PDC was insufficient, and many people, included some dentists, had not developed the habit of regular dental cleaning. Our study provided a new understanding of the PDC among dentists, medical doctors, and non-medical staffs, which may help to improve their awareness and behavior of oral hygiene health, and establish the multidisciplinary collaborations between dentists and medical doctors.
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Affiliation(s)
- Qian Wang
- College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hengzhu Chen
- College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China
| | - Lin Jiang
- College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China. .,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China.
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