Effectiveness of an oral health education programme for older adults using a workbook

Comparison of the Effects of Oral Hygiene Instruction Methods on Oral Hygiene and Self-Perception in Older Adults: A Randomized Controlled Trial

Background: Age-related conditions, such as being misinformed, having limited oral health literacy, and the loss of manual dexterity, autonomy, or visual acuity, may act as barriers to oral health. The aim of this study was to evaluate the effectiveness of two different oral hygiene instruction methods on oral hygiene and the self-perception of oral health in older adults. Methods: This randomized controlled trial included participants aged 65 and older who completed a questionnaire on socio-economic factors, self-perceived oral health, and oral hygiene behaviours. Oral hygiene status was assessed using the Oral Hygiene Index-Simplified (OHI-S). Participants were randomly allocated into two different groups, according to the method of oral hygiene instruction: a "General Approach" (GA) (n = 28) and a "Personalized Technique" (PT) (n = 26). After two months, a follow-up session was conducted. Data were analysed using descriptive and inferential methodologies. Results: The GA and PT methods were effective in promoting oral hygiene behaviours, with a significant increase in the use of interdental devices, but no significant differences were found between the two methods. Self-perceived oral health did not change significantly, neither after the instruction nor between methods. Significant improvements were achieved with both methods for the OHI-S, with significant differences between the two methods for the Calculus Index, where the PT achieved better results. Conclusions: Oral hygiene education leads to improvements in the adoption of oral hygiene behaviours and clinical indicators. Furthermore, a personalized approach promoted better results in clinical indicators.

Effectiveness of mobile augmented reality-integrated oral health education for community-dwelling older adults: A randomized controlled trial

BACKGROUND & PURPOSE

Oral health education helps older adults optimize their oral health. However, traditional lecture-based oral health education has limitations, exacerbated by the COVID-19 pandemic. Mobile augmented reality (MAR) has emerged as an alternative educational method. This study compared the effectiveness of MAR-integrated oral health education with that of lecture-based education and no education.

METHODS

This parallel, randomized controlled, open-label trial enrolled 75 older adults from six activity centers. The participants were randomly assigned, by a random number table technique, to the lecture-based, MAR, or control group. Data on oral healthcare-related knowledge, self-efficacy, and oral health status were collected through questionnaires and oral examinations at baseline, immediately after the intervention, and at a 2-week follow-up. The MAR system's usability was assessed. Statistical analyses, comprising descriptive statistics and inferential tests, were performed.

RESULTS

Data from 61 participants were analyzed, 22 in the lecture-based group, 20 in the MAR group, and 19 in the control group. Both lectures and MAR education significantly improved oral health status. However, changes in knowledge and self-efficacy scores were significantly different only for the MAR versus control group (p = .002 and .001, respectively). The MAR group demonstrated better knowledge and self-efficacy retention than did the lecture-based group, without significant difference. Usability assessment revealed potential for improvement in the MAR system.

CONCLUSIONS

MAR-integrated oral health education enhanced the knowledge, self-efficacy, and oral health status of community-dwelling older adults. However, addressing technology adoption and usability challenges is vital. Longer-term evaluations and broader geographical studies are recommended.

Oral health and healthy ageing: a scoping review

BACKGROUND

Good oral health is an important part of healthy ageing, yet there is limited understanding regarding the status of oral health care for older people globally. This study reviewed evidence (policies, programs, and interventions) regarding oral health care for older people.

METHODS

A systematic search of six databases for published and grey literature in the English language by the end of April 2022 was undertaken utilising Arksey and O'Malley's scoping review framework.

RESULTS

The findings from oral health policy documents (n = 17) indicated a lack of priorities in national health policies regarding oral health care for older people. The most common oral health interventions reported in the published studies (n = 62) included educational sessions and practical demonstrations on oral care for older adults, nurses, and care providers. Other interventions included exercises of facial muscles and the tongue, massage of salivary glands, and application of chemical agents, such as topical fluoride.

CONCLUSION

There is currently a gap in information and research around effective oral health care treatments and programs in geriatric dental care. Efforts must be invested in developing guidelines to assist both dental and medical healthcare professionals in integrating good oral health as part of healthy ageing. Further research is warranted in assessing the effectiveness of interventions in improving the oral health status of the elderly and informing approaches to assist the integration of oral health into geriatric care.

A mobile augmented reality-integrated oral health education for community dwelling older adults: A pilot study

Background/purpose

Providing oral healthcare education can be an optimal strategy for imparting knowledge and developing self-care skills for older adults to enhance their oral health conditions. However, traditional passive lecture-based education programs have several limitations. Integrating mobile augmented reality (MAR) into oral health education can potentially enhance the effectiveness of the education by mitigating those limitations. The objectives of this study are to develop and evaluate the effectiveness of MAR-integrated oral health education. The objectives of this study were to develop and evaluate the effectiveness of MAR-integrated oral health education.

Materials and methods

Twenty-four older adults from community dwellings participated in this study. The participants received MAR-integrated oral health education once at activity centers. Self-report questionnaires were utilized to assess oral healthcare-related knowledge and self-efficacy, and the usability score of the MAR system. The assessment was conducted before and after the educational program. Data were statistically analyzed using descriptive statistics and paired-t test.

Results

The mean scores of oral healthcare-related knowledge and self-efficacy showed a significant increase after the educational program, with P-values of <0.001 and 0.002, respectively. A majority of the participants exhibited a lack of knowledge and self-efficacy regarding the proper selection of toothpaste and interdental brushes. However, there was an improvement after the intervention. The usability score of the system was lower than the average level.

Conclusion

MAR-integrated oral health education effectively increases oral health-related knowledge and self-efficacy among community dwelling older adults. Still, the usability of the MAR system needs to be improved. Further investigation of long-term effects and clinical outcomes, and the inclusion of comparative groups are recommended for the future study.

The impact of health education interventions on oral health promotion among older people: a systematic review

BACKGROUND

One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people.

METHODS

Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP).

RESULTS

In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality.

CONCLUSION

This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field.

A Systematic Review of the Use of mHealth in Oral Health Education among Older Adults

Oral diseases are largely preventable. However, as the number of older adults is expected to increase, along with the high cost and various barriers to seeking continuous professional care, a sustainable approach is needed to assist older adults in maintaining their oral health. Mobile health (mHealth) technologies may facilitate oral disease prevention and management through oral health education. This review aims to provide an overview of existing evidence on using mHealth to promote oral health through education among older adults. A literature search was performed across five electronic databases. A total of five studies were identified, which provided low to moderate evidence to support using mHealth among older adults. The selected studies showed that mHealth could improve oral health management, oral health behavior, and oral health knowledge among older adults. However, more quality studies regarding using mHealth technologies in oral health management, oral health behavior, and oral health knowledge among older adults are needed.

Effectiveness of an oral health education programme using a mobile application for older adults: A randomised clinical trial

OBJECTIVE

To investigate the effectiveness of an oral health education programme using a mobile app for adults aged 65 years or older.

METHODS

Participants aged 65 or older were randomly allocated into non-app use (n = 25), app use (n = 22) and control (n = 26) groups. The non-app use group received lecture-based oral health education using PowerPoint presentations and participated in workbook activities twice a week for five weeks, whereas the app use group underwent oral health education using a smartphone app and workbook activities for five weeks. Before and after the intervention, a questionnaire survey and oral health examination were performed to examine changes in oral health-related indices.

RESULTS

The non-app use group showed significant changes, with a 2.1 increase in oral health knowledge score, 0.2 decrease in the O'Leary index and 0.6 decrease in tongue coating. The app use group showed significant changes, with a 3.1 increase in oral health knowledge score, a 2.5 increase in oral health perception, a 0.3 decrease in the O'Leary index and a 1.4 decrease in tongue coating. Repeated-measures ANOVA showed that interaction between time and group was significant only in tongue coating variable.

CONCLUSION

The smartphone app developed in this study carries the possibility to convey informative content for oral health education among older adults.

Effects of Integrative Cognitive Function Improvement Program on Cognitive Function, Oral Health, and Mental Health in Older People: A Randomized Clinical Trial

We aimed to investigate the effects of an integrative cognitive function improvement program that combined existing cognitive, emotional, and physical therapies on cognitive function, oral health, and mental health in elder participants. Participants were classified into one of the following groups: cognitively normal (CN; n = 18), mild cognitive impairment (MCI; n = 17), and control (n = 17). An integrative cognitive function improvement program was administered to the CN and MCI groups for six weeks. To measure cognitive function, electroencephalogram (EEG) and cerebral blood flow (CBF) were evaluated, and to measure oral health, the O'Leary index, Löe & Silness index, tongue coating, unstimulated saliva flow rate, and oral muscle strength were measured. To measure mental health status, mental health, happiness and social support were measured. The CN and MCI groups showed a significant change in EEG-based indices for awareness level and physical stress. Regarding oral health, the O'Leary and the Löe & Silness index score decreased significantly in the CN and MCI groups. Saliva flow rate increased significantly in the CN and MCI groups. In regards to mental health, the happiness score increased post-intervention in the CN and MCI groups. In conclusion, the integrative cognitive function improvement program was effective in improving cognitive function, oral health, and mental health of elder people.