Experiences and perceptions of oral health and oral health care among a sample of older New Zealanders

Acceptability of teledentistry use among residents and staff in aged residential care facilities in the Otago region of New Zealand

OBJECTIVES

To assess ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ, and identify end-user-level factors associated with its use.

BACKGROUND

Difficulty in accessing oral healthcare services is a key barrier to aged residential care (ARC) residents' oral health and well-being. Teledentistry offers a possible solution, yet studies on its acceptability in ARCs are sparse, especially in New Zealand (NZ). This study assessed ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ and identified end-user-level factors associated with its use.

MATERIALS AND METHODS

Rest home-level residents and care staff in ARC facilities in the Otago region of NZ were surveyed to assess their awareness of teledentistry, perceptions of benefit and comfort using teledentistry, and end-user-level factors associated with the feasibility of using it in ARCs.

RESULTS

One hundred residents and 77 care staff from 14 facilities participated. Three-quarters of resident participants thought that teledentistry was beneficial. Three in five resident participants were comfortable receiving remote dental consultations and care advice through teledentistry. Acceptability, as measured by perceived benefits and comfort, was lower among older participants. Staff participants were receptive to teledentistry use for residents and were comfortable facilitating remote dental consultations and care through teledentistry. No staff participants disagreed with the potential benefits of teledentistry for ARC residents.

CONCLUSION

Teledentistry would likely be acceptable to residents and staff in ARC facilities in NZ, contributing to residents' improved access to oral health care and improved oral health and well-being.

Recommendations for improving dental care for dentate home-based older people: A qualitative New Zealand study

BACKGROUND AND OBJECTIVE

A small number of national studies have explored the barriers to older people accessing dental care; however, to date none have investigated older people's recommendations for overcoming these barriers.

METHODS

Semi-structured interviews were conducted with 40 dentate older people (65 years and over) who resided in New Zealand's Otago region and received home-support. A joint inductive thematic analysis was undertaken, based on the constant comparative method.

RESULTS

Recommendations for boosting community-dwelling older people's access to dental care included publicly funding or subsiding the cost of dental care for older people, aligning the pension with the real cost of living, and making the environment at Work and Income less hostile and the emergency dental grant more readily available, making dental clinics more accessible, initiating domiciliary dental care, having mobile dental clinics visit neighbourhoods with high proportions of older people, as well as subsidised transport to the dental clinic. Other suggestions were having GPs, pharmacists and social workers emphasise oral health during appointments, along with dental education campaigns.

CONCLUSION

In order to boost the rates of dental care access among older New Zealanders who receive home support, multiple structural changes are necessary, but these should primarily focus on reducing the cost and increasing accessibility.

Independent older adults perspectives on oral health

OBJECTIVES

The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services.

METHODOLOGY

An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes.

RESULTS

Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health.

CONCLUSIONS

Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults.

Transition from being OK to NOT OK with tooth loss among a selection of older people in Iran: a qualitative study

BACKGROUND

Several studies have covered oral health and dental decay in old age, but these studies mostly applied standard quantitative tools and did not include consideration of older people's views on oral problems, partial edentulism in particular.

OBJECTIVE

To explore people's perceptions in terms of the transition from being OK to NOT OK with tooth loss among a selection of older people in Iran.

MATERIALS AND METHODS

A qualitative content analysis study was chosen for the research by interviewing 15 older people using open-ended questions. Criteria for participation in the study were as follows: fitting the Kennedy class I or class I modification I category, having a minimum of four teeth but not more than 20 and being aged 60 years or more. The recorded interviews were then transcribed, and a coding process was applied based on a qualitative, conventional content analysis.

RESULTS

The four main themes that emerged were as follows: (i) gradual realisation of the need to deal with the problem; (ii) the search for information on dental health; (iii) the challenge of adaptation; and (iv) tendency towards dental rehabilitation.

CONCLUSION

The turning point in the transition from being OK to NOT OK seemed to be associated with an edentulous crisis that had occurred from another problem such as stomach ache, distention, or nocturnal dyspnoea due to swallowing food that had not been properly chewed and had an affect on an elderly person's life, physically and mentally. It is important to recognise the concept of healthy eating in relation to edentulism.

Change in Oral Impacts on Daily Performances (OIDP) with increasing age: testing the evaluative properties of the OIDP frequency inventory using prospective data from Norway and Sweden

BACKGROUND

Oral health-related quality of life, OHRQoL, among elderly is an important concern for the health and welfare policy in Norway and Sweden. The aim of the study was to assess reproducibility, longitudinal validity and responsiveness of the OIDP frequency score. Whether the temporal relationship between tooth loss and OIDP varied by country of residence was also investigated.

METHODS

In 2007 and 2012, all inhabitants born in 1942 in three and two counties of Norway and Sweden were invited to participate in a self-administered questionnaire survey. In Norway the response rates were 58.0% (4211/7248) and 54.5% (3733/6841) in 2007 and 2012. Corresponding figures in Sweden were 73.1% (6078/8313) and 72.2% (5697/7889), respectively.

RESULTS

Reproducibility of the OIDP in terms of intra-class correlation coefficient (ICC) was 0.73 in Norway and 0.77 in Sweden. The mean change scores for OIDP were predominantly negative among those who worsened, zero in those who did not change and positive in participants who improved change scores of the reference variables; self-reported oral health and tooth loss. General Linear Models (GLM) repeated measures revealed significant interactions between OIDP and change scores of the reference variables (p < 0.05). Stratified analysis revealed that the mean OIDP frequency score worsened in participants who became dissatisfied- and improved in participants who became satisfied with oral health. Compared to participants who maintained all teeth, those who lost teeth were more likely to experience improvement and worsening of OIDP across both countries. The two-way interaction between country and tooth loss was not statistically significant.

CONCLUSIONS

Changes in OIDP at the individual level were more pronounced than the percentage distribution of OIDP at each point in time would suggest. The OIDP frequency score showed promising evaluative properties in terms of acceptable longitudinal validity, responsiveness and reproducibility among older people in Norway and Sweden. This suggests that the OIDP instrument is able to detect change in the oral health status that occurred over the 5 year period investigated. Norwegian elderly were more likely to report worsening in OIDP than their Swedish counterparts. Disease prevention should be at focus when formulating the health policy for older people.