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Suzuki H, Furuya J, Nakagawa K, Hidaka R, Yoshimi K, Shimizu Y, Saito K, Hatanaka Y, Mukai T, Itsui Y, Tohara H, Minakuchi S. Impact of oral health management by nurses and dental professionals on oral health status in inpatients eligible for the Nutrition Support Team: A longitudinal study. J Oral Rehabil 2024; 51:938-946. [PMID: 38366354 DOI: 10.1111/joor.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/25/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE As the participation of dental professionals in multidisciplinary care is often limited, instructions on oral health management provided by dental professionals to other professionals are important to achieve transdisciplinary oral health management; however, the effectiveness of such instructions remains unclear. In this longitudinal study, we aimed to determine the impact of oral health management provided by dental professionals and nurses instructed on oral health management by dental professionals on the oral health of inpatients eligible for a Nurition Support Team (NST). METHODS The study participants were 117 patients (66 men and 51 women, mean age: 71.9 ± 12.5 years) who received oral health management during the NST intervention period. The participants received oral health management from nurses (Ns group) or dental professionals (D group). The nurses who conducted the oral health management received instructions from dental professionals. Oral health was assessed at the beginning and end of the NST intervention using the Oral Health Assessment Tool (OHAT). RESULT The Ns and D groups showed significant improvements in the total OHAT scores at the end of the NST intervention. Both groups showed significant improvements in the OHAT subitems of lip, tongue, gums and tissues, saliva, oral cleanliness and dental pain, while only the D group showed a significant improvement in the denture subitem. CONCLUSION Effective oral health management provided by dental professionals or by nurses trained by them improved the oral health status of inpatients eligible for NST at an acute-care hospital.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
| | - Junichi Furuya
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yukue Shimizu
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Keiko Saito
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Yukiko Hatanaka
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
| | - Tomoko Mukai
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
| | - Yasuhiro Itsui
- Medical Education Research and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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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. Spec Care Dentist 2024; 44:787-796. [PMID: 37550797 DOI: 10.1111/scd.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Sekimoto Y, Matsuo K, Sakai A, Shibata S, Minakuchi S. Improvement of oral function and its impact on oral food intake in subacute stroke patients: A prospective study with dental intervention. J Oral Rehabil 2024. [PMID: 38651211 DOI: 10.1111/joor.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The association between oral food intake and oral function during the subacute stage of stroke is not well known. OBJECTIVE To investigate (1) oral function changes in subacute stroke patients and (2) association between oral function and oral intake status at several time points. METHODS In a prospective study involving 324 stroke patients at a convalescent rehabilitation unit, four oral function parameters (maximum tongue pressure, MTP; lip-tongue motor function, LTMF; maximum occlusal force, MOF and oral health assessment tool, OHAT) were quantitatively measured upon admission (T0), at 1 month (T1) and 2 months (T2). Oral feeding status was assessed using the Functional Oral Intake Scale (FOIS) and divided based on the FOIS score into the dysphagic and regular diet groups. The changes in oral functions at the three time points were tested using generalized estimating equation analysis. The association between FOIS groups and oral functions at T1 and T2 was analysed by means of logistic regression analysis. RESULTS All oral function parameters improved significantly over time during the hospital stay (mean differences: 4.9 for MTP, 0.6 for LTMF, 1.1 for MOF and -1.8 for OHAT). The FOIS groups were significantly associated with MTP (p < .05) and OHAT (p < .05) at both T1 and T2. CONCLUSION Our findings suggest that oral function significantly improves in patients during subacute stroke rehabilitation and better oral health can be associated with better oral intake. Improved oral function through dental intervention and oral rehabilitation may contribute to gains in oral food intake.
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Affiliation(s)
- Yu Sekimoto
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Dentistry, PL General Hospital, Medical Corporation Hosho, Tokyo, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayu Sakai
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Ishibashi H, Enomoto Y, Takaoka S, Aoki K, Nagai H, Yamagata K, Ishibashi-Kanno N, Uchida F, Fukuzawa S, Tabuchi K, Bukawa H, Suzuki Y, Yanagawa T. Analysis of predictors of fever after aortic valve replacement: Diabetic patients are less likely to develop fever after aortic valve replacement, a single-centre retrospective study. J Perioper Pract 2024:17504589241232503. [PMID: 38590001 DOI: 10.1177/17504589241232503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Postoperative temperature dysregulation affects the length of hospital stay and prognosis. This study evaluated the factors that influence the occurrence of fever in patients after aortic valve replacement surgery. METHODS Eighty-seven consecutive patients who underwent aortic valve replacement surgery were included. Patients' age, sex and body mass index; presence of diabetes mellitus; operation time; blood loss; blood transfusion volume; preoperative and postoperative laboratory findings; presence or absence of oral function management; and fever >38°C were retrospectively analysed through univariate and multiple logistic regression analyses. RESULTS Among the variables, only diabetes mellitus status was significantly associated with fever ⩾38°C. Postoperatively, patients with diabetes mellitus were significantly less likely to develop fever above 38°C and a fever rising to 38°C. CONCLUSIONS This study shows that the presence of comorbid diabetes mellitus decreases the frequency of developing fever >38°C after aortic valve replacement surgery.
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Affiliation(s)
- Hiroshi Ishibashi
- Doctoral program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- Department of Cardiology, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yoshiharu Enomoto
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Shohei Takaoka
- Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kazuhiro Aoki
- Department of Cardiology, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hiroki Nagai
- Department of Oral and Maxillofacial Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Kenji Yamagata
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naomi Ishibashi-Kanno
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Fumihiko Uchida
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Fukuzawa
- Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, Tsukuba, Japan
| | - Katsuhiko Tabuchi
- Department of Molecular and Cellular Physiology, School of Medicine, Shinshu University, Matsumoto, Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasuyuki Suzuki
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
- Department of Cardiovascular Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toru Yanagawa
- Department of Oral and Maxillofacial Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
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Vijayan SK, Bhattarai B, Narayanan S. Awareness, Knowledge and Practice Patterns of Oral Health and Hygiene among Speech-Language Pathologists in India. Indian J Otolaryngol Head Neck Surg 2024; 76:1862-1873. [PMID: 38566661 PMCID: PMC10982219 DOI: 10.1007/s12070-023-04432-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/03/2023] [Indexed: 04/04/2024] Open
Abstract
Individuals with communication and swallowing disorders often exhibit poor oral health and hygiene (OHH), that can lead to further complications. OHH assessment and management is a part of scope of practice of Speech-Language Pathologists (SLPs). The study aims to determine the level of awareness, knowledge and practice patterns of OHH amongst the SLPs in India. A questionnaire with 20-item and three sections was developed to assess the awareness and knowledge regarding OHH among SLPs. A total of 162 participants responded to the survey. 93.2% participants were aware of the importance of OHH, however 42.6% participants did not feel confident enough to assess the same. A majority (82.7%) agreed that poor OHH can lead to different health complications. 38.8% of the participants responded that they assessed oral health only sometimes and 54.3% reported that they never used any standard screening/assessment tools to assess oral health. Only a very small percentage of participants (28.65%) counselled the patients for maintenance of oral hygiene and more than 40% never recommended appropriate OHH practices during management. Though a vast majority were aware of the importance of OHH and consequences of poor OHH, they did not feel confident and consequently did not incorporate OHH during clinical practice. Though the scope of SLP includes oral care assessment and management, Indian SLPs were not practicing this. Hence, the clinical and academic curriculum should focus on topics pertaining to oral health assessment and management, which will improve the quality-of-service delivery of the SLPs.
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Affiliation(s)
- Syam Krishna Vijayan
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka 570006 India
| | - Biraj Bhattarai
- Speech-Language Pathologist, All India Institute of Speech and Hearing, Mysuru, Karnataka 570006 India
| | - Swapna Narayanan
- Centre for Swallowing Disorders, All India Institute of Speech and Hearing, Mysuru, Karnataka 570006 India
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Rathbun KP, Bourgault AM, Sole ML. Probable Non-Ventilator-Associated Hospital-Acquired Pneumonia: A Case Report. Crit Care Nurse 2024; 44:49-58. [PMID: 38555965 DOI: 10.4037/ccn2024693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Non-ventilator-associated hospital-acquired pneumonia is a preventable health care-associated infection accounting for 1 in 14 hospital deaths. Clinical factors influencing this condition include oral health and bacteria and oral care. This case report addresses diagnostics and clinical variables related to non-ventilator-associated hospital-acquired pneumonia and emphasizes the importance of prevention. CLINICAL FINDINGS A 90-year-old woman was admitted to the hospital with shortness of breath and generalized weakness from new-onset atrial fibrillation and suspected heart failure exacerbation. During the hospitalization, her oral health status declined and oral bacterial colonization shifted, with Neisseria becoming the most common oral bacterial genus around the time of development of probable non-ventilator-associated hospital-acquired pneumonia. DIAGNOSIS The patient had new respiratory symptoms and a chest radiograph positive for pneumonia on day 4 and was subsequently diagnosed with probable non-ventilator-associated hospital-acquired pneumonia. INTERVENTIONS Intravenous antibiotic treatment was initiated. Oral care was completed on only 2 of 7 days. The patient received limited ambulation assistance and encouragement from staff and family members. No dysphagia screening was documented. OUTCOMES On day 6, the patient was discharged with oral antibiotics to her independent living facility with home health care. CONCLUSIONS Consistent oral care, early and frequent physical activity, and measures aimed to reduce aspiration risk are key interventions for all hospitalized patients to prevent non-ventilator-associated hospital-acquired pneumonia. Further research is warranted to assess shifts in oral bacteria and general oral health during hospitalization, which could provide clinically meaningful data on risk for non-ventilator-associated hospital-acquired pneumonia.
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Affiliation(s)
- Kimberly Paige Rathbun
- Kimberly Paige Rathbun is a postdoctoral scholar at the University of Central Florida College of Nursing, Orlando, Florida
| | - Annette M Bourgault
- Annette M. Bourgault is an associate professor at the University of Central Florida College of Nursing and is the Editor of Critical Care Nurse
| | - Mary Lou Sole
- Mary Lou Sole is the Dean, a professor, and the Orlando Health Endowed Chair in Nursing at the University of Central Florida College of Nursing
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Matsuura D, Otaka Y, Asaumi S, Itano T, Chikamoto T, Yamori S, Murakami Y. Prediction of Oral Intake at Discharge with Early Assessment of Swallowing Function within 24 h after Admission: A Retrospective Cohort Study. Dysphagia 2024:10.1007/s00455-024-10699-x. [PMID: 38558178 DOI: 10.1007/s00455-024-10699-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
Dysphagia is one of the most common symptoms of stroke and can lead to other complications such as pneumonia, dehydration, and malnutrition. This retrospective cohort study evaluated the predictive value of a comprehensive swallowing assessment tool, the Mann Assessment of Swallowing Ability (MASA), in the acute phase of stroke for oral intake status at discharge. Among 1,133 consecutive patients with acute stroke, 512 patients whose swallowing function was assessed using the MASA within 24 h of admission were included. Data including demographic information, stroke severity, MASA, Oral Health Assessment Tool, body mass index, and serum albumin level were collected. Predictive factors for oral intake were analyzed using a multiple logistic regression model, and the receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of the MASA score for determining oral intake at discharge. Oral intake at discharge was established in 69.1% of the cohort (354/512). The multiple logistic regression analysis identified a higher MASA score, younger age, and higher serum albumin level as significant predictors of oral intake at discharge. The cutoff value of the MASA score for oral intake was 136.5 points, with an area under the ROC curve of 0.87. These findings suggest that the MASA is a valid tool for predicting oral intake in patients with dysphagia during the acute phase of stroke.
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Affiliation(s)
- Daisuke Matsuura
- Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan.
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Saki Asaumi
- Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Tomomi Itano
- Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Tetsushi Chikamoto
- Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
- Department of Rehabilitation, Fukuyama rehabilitation hospital, Hiroshima, Japan
| | - Shigeru Yamori
- Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Yusuke Murakami
- Department of Rehabilitation, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
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Yamaguchi K, Miyagami T, Imada R, Kushiro S, Yanagida R, Morikawa T, Nakagawa K, Yoshimi K, Naito T, Tohara H. Effect of poor oral health status at hospital admission on in-hospital outcomes of older patients with aspiration pneumonia. Eur Geriatr Med 2024; 15:489-496. [PMID: 38214864 DOI: 10.1007/s41999-023-00917-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/09/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE To investigate the effects of oral health status at admission on in-hospital outcomes and how it varies during hospitalization in older patients with aspiration pneumonia. METHODS This prospective cohort study involved patients aged ≥ 65 years who were admitted to an acute care hospital with a diagnosis of aspiration pneumonia. The patients' basic health information, length of hospital stay (LOS), and oral health assessment tool (OHAT), functional oral intake scale (FOIS), pneumonia severity index, and clinical frailty scale scores were recorded. Patients were divided into two groups based on their median OHAT scores, and intergroup changes were analyzed as a function of time. The relationship between the LOS, FOIS score upon discharge, and OHAT scores at admission was examined using multiple regression analysis. RESULTS Of the 89 participants (52 were men, with a mean age of 84.8 ± 7.9 years), 75 were discharged. The patients' oral health was measured weekly for 3 weeks after the initial assessment via the OHAT, wherein the median score was 7, with a significant between-group difference. Moreover, OHAT scores improved within both groups throughout their stay. OHAT scores at admission were independently associated with the LOS (B = 5.51, P = 0.009). CONCLUSION Poor oral health status at admission was associated with longer hospital stays. Both the high- and low-OHAT groups showed OHAT score improvements. Oral health status is critical in preventing the onset of and treating aspiration pneumonia.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Taiju Miyagami
- Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Seiko Kushiro
- Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Toru Morikawa
- Department of General Medicine, Nara City Hospital, 1-50-1 Tokijicho, Nara City, Nara, 630-8305, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Toshio Naito
- Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Ribeiro Bersaneti MD, Lobo RD, Brandão TB, Silva Souza RC, Poveda VDB. Oral hygiene in critically ill patients at a tertiary hospital in São Paulo, Brazil: a best practice implementation project. JBI Evid Implement 2024:02205615-990000000-00084. [PMID: 38505992 DOI: 10.1097/xeb.0000000000000413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVES This project aimed to promote evidence-based practices relat. ed to the oral health of critically ill patients in an intensive care unit in Brazil. INTRODUCTION The oral hygiene of patients on mechanical ventilation is an essential component of nursing care quality, and well-defined guidelines ensure appropriate care. Mechanical ventilation is associated with the risk of ventilator-associated pneumonia, which can increase mortality, length of stay, time on mechanical ventilation, and hospital costs. METHODS This project was guided by the JBI Evidence Implementation Framework, which consists of seven stages: (1) identification of the area of practice to be changed, (2) involvement of change agents, (3) context assessment and readiness for change, (4) review of practices against evidence-based audit criteria, (5) implementation of practice changes, (6) reassessment of practices using a follow-up audit and (7) consideration of the sustainability of changes in practice. RESULTS Four audit criteria were developed to evaluate compliance with best practices. In the follow-up audit, Criteria 1, 2, and 3 obtained compliance of ≥ 80%. Thus, for Criterion 1, all the patients on mechanical ventilation for more than 24 hours were evaluated by the oral medicine team, resulting in 100% compliance. For Criterion 2 on appropriate oral hygiene measures, a compliance rate of 80% was achieved. For Criterion 3, 39 professionals (90.7%) participated in educational activities related to the oral health protocol for critically ill patients, obtaining 90.7% compliance. For Criterion 4 regarding patients being evaluated before receiving any oral health care, improvement was low (only 50%), revealing the need for further improvement. CONCLUSION This best practice project improved the professional practice of nursing staff and increased compliance with best practices for the oral health of critically ill patients. SPANISH ABSTRACT http://links.lww.com/IJEBH/A175.
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Affiliation(s)
| | | | | | | | - Vanessa de Brito Poveda
- Brazilian Centre for Evidence-based Healthcare: A JBI Centre of Excellence, School of Nursing of the University of São Paulo, São Paulo, Brazil
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Song H, Wei Y, Wang Y, Zhang J. The mediating effect of nutrition on oral frailty and fall risk in community-dwelling elderly people. BMC Geriatr 2024; 24:273. [PMID: 38504156 PMCID: PMC10953286 DOI: 10.1186/s12877-024-04889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Population aging is accelerating, particularly in Asian countries. Falls are the leading cause of unintentional injuries in the elderly over 60 years old in China. Hence, it is crucial to anticipate the risk factors associated with fall risk. We aimed to explore whether oral frailty and fall risk were reciprocally related and whether nutrition mediated their association. METHODS From October 2022 to March 2023, a total of 409 elderly individuals from the Yangzhou community were selected using the convenience sampling method. Cross-sectional data on older adults' oral frailty, nutrition, and fall risk were collected using questionnaires. Data analysis was performed using SPSS 27.0 and PROCESS macro. RESULTS The fall risk score was 1.0 (ranging from 0 to 4.0), with 107 cases (26.2%) identified as being at risk of falling. Spearman correlation analysis revealed a positive correlation between oral frailty and the risk of falls (rs = 0.430, P < 0.01). Nutrition was found to have a negative correlation with both oral frailty and fall risk (rs=-0.519、-0.457, P < 0.01). When controlling for covariates, it was observed that nutrition mediated the relationship between oral frailty and falls. The mediating effect value accounted for 48.8% of the total effect (P < 0.01). CONCLUSIONS Oral frailty was significantly associated with fall risk, and nutrition might be a mediating factor for adverse effects of oral frailty and fall risk. Enhancing the nutrition of older individuals is a vital approach to mitigating fall risk among those with oral frailty.
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Affiliation(s)
- Huizi Song
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yulian Wei
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
- Taizhou People's Hospital, Jiangsu, Taizhou, China
| | - Yan Wang
- Department of Geriatrics, Northern Jiangsu Peoples Hospital, Yangzhou, Jiangsu Province, China
| | - Jiahui Zhang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China.
- Department of Geriatrics, Northern Jiangsu Peoples Hospital, Yangzhou, Jiangsu Province, China.
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Gu L, Zhang J, Chen W, Weng Y, Chen L, Zhang L. Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study. BMC Geriatr 2024; 24:272. [PMID: 38504192 PMCID: PMC10953076 DOI: 10.1186/s12877-024-04870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 03/04/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs). METHODS The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT). RESULTS The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP. CONCLUSIONS This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents. TRIAL REGISTRATION ChiCTR2000035236 (registration date: 04/08/2020).
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Affiliation(s)
- Liyan Gu
- Department of Neurology, NO. 905 Hospital of PLA Navy, Naval Medical University, 1328 Huashan Road, 200052, Shanghai, China
- Key Laboratory of Ministry of Education for Geriatric Long-term Care, Shanghai, China
| | - Jingwen Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Yanqiu Weng
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Lan Chen
- Nursing Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
| | - Lingjuan Zhang
- Key Laboratory of Ministry of Education for Geriatric Long-term Care, Shanghai, China.
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
- Shanghai Quality Control Center of Geriatric Care, 168 Changhai Road, Shanghai, 200043, China.
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Kusaka S, Haruta A, Kawada-Matsuo M, Nguyen-Tra Le M, Yoshikawa M, Kajihara T, Yahara K, Hisatsune J, Nomura R, Tsuga K, Ohge H, Sugai M, Komatsuzawa H. Oral and rectal colonization of methicillin-resistant Staphylococcus aureus in long-term care facility residents and their association with clinical status. Microbiol Immunol 2024; 68:75-89. [PMID: 38230847 DOI: 10.1111/1348-0421.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
Staphylococcus aureus is a commensal bacterium in humans, but it sometimes causes opportunistic infectious diseases such as suppurative skin disease, pneumonia, and enteritis. Therefore, it is important to determine the prevalence of S. aureus and methicillin-resistant S. aureus (MRSA) in individuals, especially older adults. In this study, we investigated the prevalence of S. aureus and MRSA in the oral cavity and feces of residents in long-term care facilities (LTCFs). S. aureus was isolated from the oral cavity of 61/178 (34.3%) participants, including 28 MRSA-positive participants (15.7%), and from the feces of 35/127 (27.6%) participants, including 16 MRSA-positive participants (12.6%). S. aureus and MRSA were isolated from both sites in 19/127 individuals (15.0%) and 10/127 individuals (7.9%), respectively. Among 19 participants with S. aureus isolation from both sites, 17 participants showed the same sequence type (ST) type. Then, we analyzed the correlation of S. aureus and MRSA in the oral cavity and rectum with the participant's condition. S. aureus and MRSA positivity in the oral cavity was significantly related to tube feeding, while there was no correlation of rectal S. aureus/MRSA with any factors. Our findings regarding the oral inhabitation of MRSA and its risk factors indicate the importance of considering countermeasures against MRSA infection in LTCFs.
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Affiliation(s)
- Satoru Kusaka
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Miki Kawada-Matsuo
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Mi Nguyen-Tra Le
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshiki Kajihara
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Junzo Hisatsune
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroki Ohge
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Motoyuki Sugai
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hitoshi Komatsuzawa
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chen YC, Ku EN, Lin CW, Tsai PF, Wang JL, Yen YF, Ko NY, Ko WC, Lee NY. Tongue pressure during swallowing is an independent risk factor for aspiration pneumonia in middle-aged and older hospitalized patients: An observational study. Geriatr Gerontol Int 2024; 24 Suppl 1:351-357. [PMID: 38111274 DOI: 10.1111/ggi.14769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/29/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
AIM To evaluate oral frailty features present in hospitalized older patients with aspiration pneumonia. METHODS We enrolled hospitalized patients aged ≥50 years and classified them into three groups: the community-acquired, aspiration, and non-community-acquired pneumonia groups. Oral frailty was defined as meeting three or more criteria from the following: choking, and decreased occlusal force, masticatory function, tongue-lip motor function, tongue pressure, and tongue pressure during swallowing. RESULTS Of 168 patients enrolled, the incidence of aspiration pneumonia was 23.9% (17/71) in patients admitted with pneumonia as the primary diagnosis. The occlusal force and masticatory function were significantly poorer and tongue pressure and tongue pressure during swallowing were significantly lower in the aspiration pneumonia group than in the other two groups. A higher number of chronic comorbidities, poor oral health, and lower tongue pressure during swallowing were significantly associated with aspiration pneumonia. A tongue pressure during swallowing of <10.32 kPa might be a cutoff point for predicting the risk of aspiration pneumonia. CONCLUSIONS Hospitalized patients aged ≥50 years with multiple comorbidities, poor oral hygiene, and oral frailty during swallowing are at a higher risk of developing aspiration pneumonia, especially when their tongue pressure during swallowing is <10.32 kPa. Aspiration pneumonia is a preventable disease. Healthcare professionals should incorporate tongue pressure measurements or other screening tools into routine clinical practice to facilitate the early detection of this condition and intervention. Geriatr Gerontol Int 2024; 24: 351-357.
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Affiliation(s)
- Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - En-Ni Ku
- Department of Nursing, Taipei Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Che-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Fang Tsai
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jiun-Ling Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Fen Yen
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chieh Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Yao Lee
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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15
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Lee HH, Melbye EL. Nursing home caregivers' acceptance of, and experiences with, a new digital intervention for oral healthcare: A qualitative feasibility study. Gerodontology 2024; 41:68-82. [PMID: 37294037 DOI: 10.1111/ger.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The objectives of the present study were to qualitatively investigate nursing home caregivers' acceptance of, and experiences with, a new digital intervention for oral healthcare after a period of real-life testing in three nursing homes located in Rogaland county, Norway. BACKGROUND Nursing home caregivers report numerous barriers when it comes to provision of adequate oral care for care-dependent older adults. Among the reported barriers are lack of knowledge and skills, care-resistant behaviours, lack of adequate routines and documentation systems for oral health, a high workload, and unclear responsibilities. To overcome these barriers, a digital tool named SmartJournal was developed to assist caregivers in preserving nursing home residents' oral health. MATERIALS AND METHODS Semistructured interviews were performed with selected caregivers (n = 12) taking part in SmartJournal testing. A theory-driven thematic analysis based on technology acceptance model was conducted. RESULTS SmartJournal was generally described as a userfriendly and useful tool. The initial reaction of the participants was mixed; some were positive, some had concerns, but many seemed to have a neutral stance to the intervention. Both barriers and facilitating factors for SmartJournal usage were revealed. Interestingly, the usage gradually changed from norm-based to routine-based behaviour during the test period. Although the tool was well-accepted, as demonstrated with study participants' willingness to use it in the future, they had several suggestions for improvements to further adapt it to a nursing home setting. CONCLUSION Results from the present study provide valuable information on questions about SmartJournal acceptance and intervention delivery, thereby preparing the ground for a larger scale evaluation study assessing measurable effects of SmartJournal usage in nursing homes.
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16
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Nakao M, Shimosato M, Sakane N, Nakashima T. Association between poor oral health and overall mortality in palliative care patients: An analysis using time-dependent receiver operating characteristic curves. Spec Care Dentist 2024; 44:513-519. [PMID: 37191549 DOI: 10.1111/scd.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/30/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023]
Abstract
AIMS To determine the Oral Health Assessment Tool (OHAT) critical score in palliative care patients and the optimal timing for predicting mortality using time-dependent receiver operating characteristic (ROC) curves. METHODS AND RESULTS A retrospective observational study was conducted on 176 patients treated by the palliative care team of our medical center between April 2017 and March 2020. Oral health was assessed using the OHAT. Prediction accuracy was evaluated using the area under the curve (AUC) analysis, sensitivity, and specificity, using time-dependent ROC curves. Overall survival (OS) was compared using Kaplan-Meier curves with the log-rank test; hazard ratios (HRs) adjusted for covariates were calculated using a Cox proportional hazard model. A OHAT score of 6 was shown to best predict 21-day OS (AUC 0.681, sensitivity 42.2%, specificity 80.0%). The median OS was significantly shorter in patients with total OHAT scores ≥6 than in patients with scores < 6 (21 days vs. 43 days, p = .017). For individual OHAT items, the unhealthy status of the lips and tongue was associated with decreased OS (HR = 1.91; 95% confidence interval [CI], 1.19-3.05 and adjusted HR = 1.48; 95% CI, 1.00-2.20). CONCLUSION Predicting disease prognosis based on patient oral health can enable clinicians to provide timely treatment.
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Affiliation(s)
- Mifumi Nakao
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Maiko Shimosato
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takeshi Nakashima
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
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Bakker MH, de Smit MJ, Valentijn A, Visser A. Oral health assessment in institutionalized elderly: a scoping review. BMC Oral Health 2024; 24:272. [PMID: 38402181 PMCID: PMC10893687 DOI: 10.1186/s12903-024-04025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.
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Affiliation(s)
- M H Bakker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
| | - M J de Smit
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Valentijn
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- Department of Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Hu S, Li X. An analysis of influencing factors of oral frailty in the elderly in the community. BMC Oral Health 2024; 24:260. [PMID: 38383363 PMCID: PMC10882750 DOI: 10.1186/s12903-024-03946-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/27/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the current situation of oral frailty (OF) in the elderly in the community in China and analyse its influencing factors. METHODS Using convenience sampling, 380 elderly people from three communities in our city were selected as participants in the study. The Oral Frailty Index-8, the Frailty Scale, the Oral Health Assessment Tool, the Mini-nutritional Assessment Scale and the Pittsburgh Sleep Quality Index were used to investigate and analyse OF influencing factors. RESULTS In this study, the 380 elderly participants were categorized into three groups: frailty, pre-frailty, and non-physical frailty, based on their responses to the questionnaires.The influencing factor analysis showed that age, gender, education level, frailty score, frailty stage, number of dentures, dry mouth, subjective chewing difficulty, oral health score and sleep quality were the influencing factors of OF in the elderly in the community (R2 = 0.712, F = 434.73, P < 0.05). The evaluation of the prediction results showed that the frailty score (area under the curve [AUC]: 0.751, 95% confidence interval [CI]: 0.683-0.862), subjective chewing difficulty (AUC: 0.765, 95% CI: 0.655-0.831) and sleep quality (AUC: 0.736, 95% CI: 0.652-0.781) had a higher predictive value for OF. CONCLUSION The main OF influencing factors in the elderly in the community are age, gender, education level, physical frailty (PF) score, PF stage, number of dentures, dry mouth, subjective chewing difficulties, oral health score and sleep quality. Nursing staff should pay attention to the OF of the elderly in the community and take targeted intervention measures in time to reduce and control OF occurrence and progression.
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Affiliation(s)
- Shuying Hu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, Sichuan Province, China
| | - Xia Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, Sichuan Province, China.
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Kenny C, Regan J, Balding L, Higgins S, O'Leary N, Kelleher F, McDermott R, Armstrong J, Mihai A, Tiernan E, Westrup J, Thirion P, Walsh D. Oxaliplatin-related dysphagia: Mixed-methods study. BMJ Support Palliat Care 2024:spcare-2023-004486. [PMID: 38326014 DOI: 10.1136/spcare-2023-004486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES To evaluate participant-reported atypical dysphagia symptoms and their association with oxaliplatin treatment. METHODS This observational study recruited 73 adults with solid tumours outside the head, neck or upper gastrointestinal tract. All had dysphagia, were in hospital or hospice and were treated by Medical Oncology, Radiation Oncology or Palliative Care. Participants reported their experiences of swallowing difficulties by semistructured interview. Oral Health Assessment Tool was used to ensure swallow difficulties were not due to mucositis. Responses were transcribed and analysed by content analysis. Atypical difficulties were examined for association with oxaliplatin treatment by Fischer's Exact. RESULTS Oxaliplatin treatment was associated with three unusual dysphagia symptoms: problems with cold or hot bolus (p=0.01), pins and needles (p=0.001) and throat spasm (p=0.035). Carbonation was problematic for one participant. Chemotherapy commencement coincided with swallow problem onset for 67%. Dysphagia symptoms were unrelated to mucositis (p=0.165). CONCLUSIONS Swallowing difficulties in oxaliplatin-treated patients are atypical and attributable to chemotherapy commencement. Previous research suggests that dysphagia is triggered by cold exposure, but hot and carbonated boluses also caused problems here. Dysphagia symptoms and triggers should be studied more fully to help patients safely enjoy their meals and prevent food avoidance, which could exacerbate malnutrition.
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Affiliation(s)
- Ciarán Kenny
- Department of Clinical Speech and Language Studies, University of Dublin Trinity College, Dublin, Ireland
| | - Julie Regan
- Department of Clinical Speech and Language Studies, University of Dublin Trinity College, Dublin, Ireland
| | - Lucy Balding
- Our Lady's Hospice and Care Services, Dublin, Ireland
| | | | - Norma O'Leary
- Our Lady's Hospice and Care Services, Dublin, Ireland
| | | | - Ray McDermott
- Tallaght University Hospital, Dublin, Ireland
- Beacon Hospital, Sandyford, Ireland
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Lee WY, Marc O'Donnell J, Kuo SY. Effects of preoperative oral care on bacterial colonisation and halitosis in patients undergoing elective surgery: A randomised controlled study. Intensive Crit Care Nurs 2024; 80:103532. [PMID: 37793316 DOI: 10.1016/j.iccn.2023.103532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES To evaluate the effects of single-dose chlorhexidine oral care on bacterial colonisation and halitosis in patients undergoing elective surgery. RESEARCH METHODOLOGY We conducted a two-arm parallel, single-blinded, randomised controlled trial. The intervention group (n = 102) received preoperative oral care with 0.12% chlorhexidine gluconate, and the control group (n = 105) received standard care. The data of the microbiological cultures between the groups were compared at the time of tracheal intubation, at extubation and 30 min after surgery. The presence of halitosis was measured using a survey questionnaire administered to the anaesthesia nurses assigned to the patients. RESULTS At baseline, no significant differences were found between the intervention and control groups for bacterial colonisation or halitosis. After the intervention, there was no significant difference in microbiological culture, including gram-positive, gram-negative bacilli and cocci results, between the two groups (p > 0.05). The presence of halitosis in the intervention group was significantly lower than in the control group during intubation (p < 0.0001) and at 30 min after surgery (p < 0.02). Regression analysis indicated that receiving oral was protective towards halitosis, while poor oral health was a risk factor. CONCLUSIONS Preoperative oral care using a single dose of chlorhexidine significantly improved the patients' halitosis in the perioperative period, but no significant effect was found on bacterial colonisation. Further studies are needed regarding the safe use of chlorhexidine for oral care. IMPLICATION FOR CLINICAL PRACTICE Oral hygiene using chlorhexidine could be beneficial in improving halitosis for anaesthesia personnel who take care of intubated adult patients undergoing elective surgery with general anaesthesia.
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Affiliation(s)
- Wen-Yi Lee
- Second Degree Bachelor of Science in Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - John Marc O'Donnell
- Department of Nurse Anesthesia, Director, University of Pittsburgh Nurse Anesthesia Program, Senior Associate Director, Winter Institute for Simulation, Education and Research (WISER) VB 360A, 3500 Victoria St., Pittsburgh, PA 15261, United States.
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
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Ninomiya S, Fujii W, Matsumoto E, Yamaguchi K, Hiratsuka M. Association between tongue pressure and oral status and activities of daily living in stroke patients admitted to a convalescent rehabilitation unit. Clin Exp Dent Res 2024; 10:e825. [PMID: 38037529 PMCID: PMC10860403 DOI: 10.1002/cre2.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Clarifying how tongue pressure in convalescent stroke patients affects oral condition and activities of daily living (ADL) is important for developing oral rehabilitation programs and for rehabilitation care to reacquire ADL. OBJECTIVE To clarify how tongue pressure is associated with oral status, ADL, and nutritional status in stroke patients. METHODS Sixty-eight patients aged 77.9 ± 10.0 years participated. The Japanese version of the Oral Health Assessment Tool was used to evaluate oral status. Data such as the ADL index functional independence measure (FIM), nutritional intake method, serum albumin, and body mass index were extracted from medical records. To examine factors associated with tongue pressure, multiple regression analysis was performed adjusting for confounding factors. The level of statistical significance was set at p < .05. RESULTS In recovery phase stroke patients, tongue pressure was significantly lower in the total assistance group than in the partial assistance/independent group. In addition, tongue pressure was significantly lower in tube feeding patients than in oral feeding patients. FIM cognition score was an independent factor that had a significant effect on tongue pressure. CONCLUSION These findings suggest that ADL status also affects tongue pressure, thus patients' ADL including the FIM cognition subscale should also be evaluated while measuring tongue pressure.
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Affiliation(s)
- Shizuka Ninomiya
- Division of DentistryFukuoka Rehabilitation HospitalFukuokaJapan
- Graduate School of Dentistry, Department of Oral Health SciencesKyushu Dental UniversityKitakyushuJapan
| | - Wataru Fujii
- Unit of Interdisciplinary Promotion, School of Oral Health Sciences, Faculty of DentistryKyushu Dental UniversityKitakyushuJapan
| | - Erika Matsumoto
- Graduate School of Dentistry, Department of Oral Health SciencesKyushu Dental UniversityKitakyushuJapan
| | | | - Masao Hiratsuka
- Division of DentistryFukuoka Rehabilitation HospitalFukuokaJapan
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22
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van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GHD. The Dutch version of the Oral Health Assessment Tool: Translation and inter-rater reliability among community nurses. Int J Dent Hyg 2024; 22:140-147. [PMID: 37093920 DOI: 10.1111/idh.12678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES Translating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter-rater reliability among community nurses. METHODS The original version of the OHAT was translated following the five stages of the 'Guidelines for the Process of Cross-Cultural Adaptation'. After a forward and backward translation, consensus on the pre-final version was obtained in an expert panel discussion. This version was pre-tested on its comprehensibility among 31 nurses and hereafter finalized. Then, inter-rater reliability of the OHAT-NL was determined by two trained nurses during oral assessments of 37 care-dependent community-dwelling older people. Intraclass correlation coefficient (ICC) and the Cohen's kappa statistic for individual items were estimated. RESULTS Feedback from nurses in the pre-test did lead to minor changes of the OHAT-NL. Inter-rater reliability was good (ICC 0.79; 95% CI 0.63-0.89) on the total score. Agreement on item level ranged from fair to very good, the kappa ranged from 0.36-0.89. CONCLUSIONS OHAT is now available in Dutch having good inter-rater reliability among trained community nurses. Future research can further validate the OHAT-NL and develop intervention according to total OHAT-NL scores.
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Affiliation(s)
- Harm H J van Noort
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Anne Harderwijk
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Reinier Akkermans
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gert-Jan van der Putten
- Medical Department, Orpea Dagelijks Leven, Apeldoorn, The Netherlands
- Department of Oral Function and Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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23
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Uemura Y, Shibata R, Ishikawa S, Takemoto K, Murohara T, Watarai M. The association between oral health status and physical function in elderly patients with acute heart failure. Clin Exp Dent Res 2024; 10:e824. [PMID: 38104262 PMCID: PMC10860531 DOI: 10.1002/cre2.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the association between oral health status and the decline in physical function during hospitalization in elderly patients with acute heart failure. MATERIALS AND METHODS We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Oral health problems were defined as a revised oral assessment guide score ≥9. RESULTS Oral health problems were identified in 66.2% of the patients. Patients with oral health problems had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with oral health problems than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate analyses. CONCLUSIONS Oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients.
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Affiliation(s)
| | - Rei Shibata
- Department of Advanced Cardiovascular TherapeuticsNagoya University Graduate School of MedicineNagoyaJapan
| | | | | | - Toyoaki Murohara
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaJapan
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24
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Hong SW, Baek JH, Kim K, Kang JH. Complex interplay of oral health, muscle and bone metabolism, and frailty in older individuals. Clin Oral Investig 2024; 28:116. [PMID: 38270679 DOI: 10.1007/s00784-024-05521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To investigate molecular and clinical background of associations among oral health, muscle and bone metabolism, and frailty incidence in patients with fall and fracture history. MATERIALS AND METHODS In total, 88 elderly participants (mean age 71.9 ± 5.8 years) with the distal radius fractures were included. Participants were divided into three groups based on an Oral Health Assessment Tool score. Fried criteria and Mini-nutritional assessments were adopted to diagnose frailty and malnutrition, respectively. Blood samples were collected and analyzed for serum levels of bone turnover markers, proteins, insulin-like growth factor-1, 25-hydroxyvitamin D, and inflammatory cytokines. The mRNA levels of markers of inflammation, muscle synthesis and wasting, and muscle homeostasis regulator in the pronator quadratus muscle were analyzed. RESULTS Patients with deteriorated oral health demonstrated a higher prevalence of frailty and malnutrition. Significantly lower serum levels of total protein and higher concentrations of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected in patients with poor oral health. Significant interaction effects between oral health and frailty level in gait speed, serum TNF-α, IL-1β, and total protein levels were exhibited. Significantly different mRNA expression levels in the pronator quadratus muscle of TNF-α, IL-1β, NF kB, MYOG, and FOXO1 following the oral health were detected. CONCLUSION This study highlights relationship between oral health, nutritional uptake, systemic inflammation, and their combined impact on muscle and bone metabolism, ultimately affecting frailty development in the aging populations. CLINICAL RELEVANCE A comprehensive understanding of mutual interactions among oral health, nutrition, and inflammation is essential for managing frailty.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Jeong-Hwa Baek
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Kwangyeon Kim
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-Ro, Yeongtong-Gu, Suwon, Gyeonggi-Do, 16499, Republic of Korea.
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25
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Hara R, Todayama N, Tabata T, Mukai T, Hatanaka Y, Watanabe M, Kuwazawa M, Hironaka S, Kawate N, Furuya J. Association between oral health status and functional independence measure on admission in convalescent hospitalized patients. BMC Oral Health 2024; 24:63. [PMID: 38195416 PMCID: PMC10777547 DOI: 10.1186/s12903-023-03667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/14/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Oral health management has become increasingly important for acute inpatients. Older patients often require extended periods of medical care, and oral health management is necessary in the convalescent period following the acute period. During the convalescent period, oral health management remains unclear as convalescent hospitals have limited dental resources, and effective dental care must be provided if the objective of hospitalization is to improve life functions. This study aimed to clarify the relationship between daily functioning and oral health status at the time of admission to a convalescent hospital to aid in improving daily functioning in the convalescent period. METHODS We included patients admitted to the rehabilitation department of a specific convalescent hospital from January to December 2021. A total of 375 patients were included in the study, with complete data records. At admission, we gathered information from the medical records, including the patient's age, sex, primary disease, Charlson Comorbidity Index, Mini Nutritional Assessment Short-Form (MNA-SF), Functional Oral Intake Scale (FOIS), Functional Independence Measure (FIM), number of teeth, and Oral Health Assessment Tool (OHAT). Statistical analysis was conducted using SPSS Ver. 27, with a significance level of 5%. RESULTS The mean age of the 375 participants (189 men and 186 women) was 75.0 ± 12.1 years (range, 42-97 years), and over 80% were > 65 years. About 30% of major diseases could be attributed to strokes and fractures, followed by spinal cord and spine diseases. In non-stroke patients, multiple regression analysis using FIM motor, FIM cognitive, and FIM and OHAT total scores as objective variables showed that higher total scores of MNA-SF, FOIS, and lower modified Rankin Scale and OHAT were significantly associated with better FIMs. Lower OHAT scores were significantly associated with lower FOIS and MNA-SF scores, male sex, having fewer teeth, and poor dietary patterns. CONCLUSIONS The convalescent period is an opportune time to provide intensive dental care due to the generally stable condition and extended hospital stay. Our results suggest that oral health management, such as dysphagia rehabilitation and denture treatment, is important for maintaining and improving independence, a key objective of convalescent rehabilitation, and malnutrition improvement.
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Affiliation(s)
- Ryuzo Hara
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Ota, Tokyo, Japan
| | - Naoki Todayama
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Ota, Tokyo, Japan
| | - Tomohiro Tabata
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Ota, Tokyo, Japan
| | - Tomoko Mukai
- Division of Oral Function Management, Department of Oral Health Management, School of Dentistry, Showa University, Ota, Tokyo, Japan
| | - Yukiko Hatanaka
- Division of Oral Function Management, Department of Oral Health Management, School of Dentistry, Showa University, Ota, Tokyo, Japan
| | - Masataka Watanabe
- Division of Oral Function Management, Department of Oral Health Management, School of Dentistry, Showa University, Ota, Tokyo, Japan
| | - Miki Kuwazawa
- Division of Oral Function Management, Department of Oral Health Management, School of Dentistry, Showa University, Ota, Tokyo, Japan
- Fujigaoka Hospital Hospitaly Dentistry, Yokohama, Kanagawa, Japan
| | - Shouji Hironaka
- Department of Hygiene and Oral Health, School of Dentistry, Showa University, Shinagawa, Tokyo, Japan
| | - Nobuyuki Kawate
- Department of Rehabilitation Medicine, School of Medicine, Showa University, Shinagawa, Tokyo, Japan
| | - Junichi Furuya
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Ota, Tokyo, Japan.
- Division of Oral Function Management, Department of Oral Health Management, School of Dentistry, Showa University, Ota, Tokyo, Japan.
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Neves RN, Matos MA, Carvalho IP. Communicating Risks and Food Procedures through a Visual Poster for Caregivers of Patients with Dysphagia in Inpatient Care: Usability and Impact. Healthcare (Basel) 2024; 12:148. [PMID: 38255038 PMCID: PMC10815349 DOI: 10.3390/healthcare12020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 01/24/2024] Open
Abstract
Food-related procedures are a part of rehabilitation interventions for dysphagia. However, studies show that professional-caregiver communication is often lacking in dysphagia, risking caregivers' knowledge, understanding, and practice of those procedures, with negative consequences for patient safety and rehabilitation. The aim of this study was to evaluate caregivers' perspectives about the utility of a poster designed to communicate dysphagia-related risks and food procedures for caregivers of patients in inpatient care. The impact of caregivers' exposure to the poster on patients' dysphagia-related health was additionally explored. The poster was placed by the beds of a randomly assigned group of patients (n = 21). Their caregivers responded to a questionnaire about the poster's utility. In addition, to explore whether the caregiver exposure to the poster could already have some effect on patient dysphagia-related health, patient risk of aspiration, food swallowing capacity, nutritional status, and oral cavity health were assessed before and one month after placement of the poster, and the poster-exposed group was compared with a (randomly-assigned) non-exposed group (n = 21). Data were analyzed with descriptive statistics and generalized linear models based on analyses of covariance. All caregivers across various education levels reported noticing, reading, and understanding the poster (100%). Nearly all reported that the poster added new information to their knowledge (17 out of 21). In the additional analysis, the patients in the poster-exposed group showed greater improvements in the health outcomes, compared with the non-exposed group, although the effects were statistically non-significant within this study's one-month period. A poster with pictorial information was effective in increasing awareness about dysphagia-specific information among caregivers of patients in inpatient care and can be used as an augmentative means of information, with potential benefits for patient safety and rehabilitation.
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Affiliation(s)
- Rafaela Nogueira Neves
- Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Maria Assunção Matos
- Department of Speech and Language Therapy, Aveiro School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Agras do Crasto, Edifício 30, 3810-193 Aveiro, Portugal;
- CINTESIS@RISE, Aveiro School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Irene P. Carvalho
- Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
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27
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Moynihan P, Teo JL. Exploring Oral Function, Protein Intake, and Risk of Sarcopenia: A Scoping Review. JDR Clin Trans Res 2024; 9:4-20. [PMID: 36883673 PMCID: PMC10725128 DOI: 10.1177/23800844231157259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Sarcopenia is loss of both muscle mass and function with age and is associated with inadequate protein intake. However, evidence to suggest an association with oral health is less clear. OBJECTIVE To scope peer-reviewed published evidence (2000-2022) pertaining to oral function in relation to sarcopenia and/or protein intake in older people. METHODS CINAHL, Embase, PubMed, and Scopus were searched. Included were peer-reviewed studies measuring oral function (e.g., tooth loss, salivary flow masticatory function, strength of muscles of mastication, and tongue pressure) and a measure of protein intake and/or a measure of sarcopenia (appendicular muscle mass and function). Full article screening was conducted by 1 reviewer with a random 10% screened in duplicate by a second reviewer. Relevant content pertaining to study type, country of origin, measures of exposure, and outcomes and key findings was mapped and the balance of data showing a positive versus null association of oral health with outcomes charted. RESULTS Of 376 studies identified, 126 were screened in full, yielding 32 included texts, of which 29 were original articles. Seven reported intake of protein and 22 reported measures of sarcopenia. Nine distinct oral health exposures were identified, with ≤4 studies relating to any one of these measures. Most data were cross-sectional in nature (27 studies) and from Japan (20 studies). The balance of data showed associations between tooth loss and measures of sarcopenia and protein intake. However, the balance of data pertaining to any association between chewing function, tongue pressure, or indices of oral hypofunction and sarcopenia was mixed. CONCLUSION A broad range of oral health measures have been studied in relation to sarcopenia. The balance of data suggests that tooth loss is associated with risk, but data pertaining to the oral musculature and indices of oral hypofunction are mixed. KNOWLEDGE TRANSFER STATEMENT The findings of this research will increase awareness among clinicians of the amount and nature of evidence pertaining to the relationship between oral health and risk of compromised muscle mass and function, including data showing that loss of teeth is associated with increased risk of sarcopenia in older people. The findings highlight to researchers the gaps in the evidence and where further research and clarification of the relationship between oral health and risk of sarcopenia is warranted.
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Affiliation(s)
- P.J. Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - J-L. Teo
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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28
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Yang H, Xiao J, Cui S, Zhang L, Chen L. Oral Health Assessment Tools for Elderly Adults: A Scoping Review. J Multidiscip Healthc 2023; 16:4181-4192. [PMID: 38148947 PMCID: PMC10750773 DOI: 10.2147/jmdh.s442439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose The aim of this study was to synthesize the Oral Health Assessment Tool for elderly adults and determine its psychosocial properties. Methods We conducted a scoping review. The Arkey and O'Malley methodology was employed to conduct scoping reviews involving the exploration of both national and international databases, as well as a manual search of the reference lists of the selected studies. We focused on oral health assessment tools for elderly adults (>60 years). The review report adhered to the standards outlined in the PRISMA-ScR guidelines. The study protocol was officially filed with the Open Science Framework. Results A total of 19 documents were included. The literature search included a time frame ranging from 1995 to 2023 and covered a diverse range of 13 countries. Of the 19 assessment tools examined, it was found that only the Oral Assessment Sheet had multidimensional characteristics, while the remaining tools were unidimensional in nature. The evaluation of oral health assessment tools was conducted across several contexts, including nursing homes, geriatric facilities, communities, and hospitals. A total of eleven studies underwent reliability testing, whereas two studies were alone validated for validity and did not undergo reliability testing. Additionally, seven studies were exclusively validated for reliability and did not undergo validity testing. Conclusion Multidimensional oral health assessment tools for elderly adults that integrate social and psychological aspects need to be developed and validated. It is necessary to develop oral health assessment tools based on hospitalized elderly patients to meet the oral and dental health needs of elderly patients.
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Affiliation(s)
- Heng Yang
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Jiechenming Xiao
- Department of Nursing, Huangyan Hospital, Wenzhou Medical University, Taizhou, Zhejiang, People’s Republic of China
| | - Shaomei Cui
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Liyan Zhang
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Lixia Chen
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
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Suzuki H, Furuya J, Nakagawa K, Hidaka R, Nakane A, Yoshimi K, Shimizu Y, Saito K, Itsui Y, Tohara H, Minakuchi S. Factors influencing the selection of oral healthcare providers in multidisciplinary Nutrition Support Team for malnourished inpatients: A cross-sectional study. J Oral Rehabil 2023; 50:1446-1455. [PMID: 37574822 DOI: 10.1111/joor.13565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Oral health management involving dental professionals in a multidisciplinary Nutritional Support Team (NST) is effective collaborative care. However, the indicators for the triage of oral health management requirements and selection of oral healthcare providers remain unclear. OBJECTIVE This cross-sectional study included inpatients with malnutrition and aimed to investigate the factors associated with determining the need for oral health management involving dental professionals and selecting primary oral healthcare providers when needed. METHODS Participants included 255 inpatients (154 males and 101 females, mean age 69.7 ± 14.4 years) aged ≥20 years who underwent oral assessment by the NST between April 2016 and July 2019. Participants were assigned to the following groups: good oral health group, oral health management by nurses under the supervision of dental professionals group, and oral health management by dental professionals group. The comprehensive oral health status was investigated using the Oral Health Assessment Tool (OHAT). The total OHAT score ranges from 0 to 16, with a higher score indicating a poorer oral environment. RESULTS The total OHAT score had a significant correlation with the need for oral health management by dental professionals. Inpatients with denture problems required oral health management from dental professionals. The optimal cutoff value of the total OHAT score for determining the need for oral health management was four. CONCLUSION The need for oral health management by dental professionals increased with worsening oral health status, especially denture problems. The OHAT score could be used to triage inpatients who require oral health management collaborated with dental professionals.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Junichi Furuya
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Ota-ku, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
- Clinical Department of Dentistry, Japan Community Health-care Organization Tokyo Shinjuku Medical Center, Shinzyuku-ku, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Yukue Shimizu
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Japan
| | - Keiko Saito
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Japan
| | - Yasuhiro Itsui
- Medical Education Research and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
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30
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Shimizu A, Ohno T, Fujishima I, Kayashita J, Momosaki R, Nishioka S, Wakabayashi H. Impact of Poor Oral Health Status on Swallowing Function Improvement in Older Dysphagic Patients. Cureus 2023; 15:e51249. [PMID: 38288242 PMCID: PMC10823192 DOI: 10.7759/cureus.51249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Background This study aimed to explore the relationship between poor oral health status and improvement in swallowing function in older patients with dysphagia across various clinical settings, including acute and post-acute care environments. Methods This retrospective cohort study encompassed patients aged 65 years and older with dysphagia. Oral health status was assessed using the oral health assessment tool (OHAT) or the revised oral assessment guide (ROAG). In this study, an OHAT score of ≥3 or an ROAG score of ≥13 indicated poor oral health status. The primary outcome measured was the change in the food intake level scale (FILS) score, which reflects swallowing function, during the observation period. The association between changes in FILS score and poor oral health status was analyzed using a multivariable linear regression model. Results The study included 361 older patients with dysphagia (mean age 82.7 ± 7.7 years; 47.3% male), of whom 82.5% had poor oral health. A negative association was found between poor oral health status and improvement in FILS score at the endpoint (partial regression coefficient: -0.523, 95% confidence interval: -0.99 to -0.06, P=0.026). Conclusions Our findings underscore the negative impact of poor oral health status on the improvement of swallowing function and emphasize the importance of oral health interventions for older patients. Further study on oral health interventions' effects on improving swallowing function in older patients with dysphagia is warranted.
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Affiliation(s)
- Akio Shimizu
- Department of Food and Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, JPN
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, JPN
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, JPN
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, JPN
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, JPN
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki, JPN
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Shinjuku-ku, JPN
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Takagi S, Maeda K, Shimizu A, Yuasa H, Yamauchi K, Sakai H. Associations between oral health status and short-term functional outcomes in hospitalized patients aged over 65 years with acute ischemic stroke: a retrospective observational study. Clin Oral Investig 2023; 27:7635-7642. [PMID: 37953327 DOI: 10.1007/s00784-023-05352-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To assess the associations between oral health status and short-term functional outcomes in hospitalized patients aged over 65 years with acute ischemic stroke. MATERIALS AND METHODS This retrospective observational analysis included older adult patients (age, ≥ 65 years) admitted for acute ischemic stroke. The oral health status at admission was evaluated using the Oral Health Assessment Tool (OHAT). Patients were categorized into the normal oral health (OHAT score, 0-2) or poor oral health (OHAT score, ≥ 3) group. Stroke severity, Functional Oral Intake Scale (FOIS), and medical history were compared. Multivariate analysis was used to determine the association between the OHAT score and modified Rankin Scale (mRS) score at discharge, FOIS score at discharge, and length of hospital stay. RESULTS The study comprised 129 patients (mean age: 78.8 ± 7.7 years). The poor oral health group (n = 22) had a higher stroke severity and lower FOIS scores than the normal oral health group (n = 107). The poor oral health group exhibited significantly higher rates of moderate to severe disability at discharge (odds ratio = 9.18, 95% confidence interval [CI]: 1.74-48.30, P = 0.009), lower FOIS scores at discharge (β = -0.96, 95% CI: -1.71 to -0.20, P = 0.014), and longer hospital stays (β = 10.70, 95% CI: 0.80-20.61, P = 0.034) than the other group. CONCLUSION In older patients with acute ischemic stroke, poor oral health status at admission was associated with worse short-term functional outcomes, including increased disability, dysphagia, and longer hospital stay. CLINICAL RELEVANCE Assessing and addressing the oral health status of this population can potentially improve short-term functional outcomes and enhance comprehensive stroke care.
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Affiliation(s)
- Sahoko Takagi
- Department of Nutrition Management, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Keisuke Maeda
- Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, Japan.
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Akio Shimizu
- Department of Food and Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, Japan
| | - Hidemichi Yuasa
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Toyohashi Medical Center, Toyohashi, Japan
| | - Keita Yamauchi
- Department of Neurosurgery, National Hospital Organization Toyohashi Medical Center, Toyohashi, Japan
| | - Hideki Sakai
- Department of Neurosurgery, Toyohashi Heart Center, Toyohashi, Japan
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Haresaku S, Kubota K, Miyoshi M, Obuse M, Aoki H, Nakashima F, Muramatsu M, Maeda H, Uchida S, Miyazono M, Iino H, Naito T. A Survey of Oral Assessment and Healthcare Education at Nursing Schools in Japan. Int Dent J 2023; 73:804-811. [PMID: 36347715 PMCID: PMC10658431 DOI: 10.1016/j.identj.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the performance of oral assessment and health care education at nursing schools across Japan to identify problems and the need for oral health professional support. METHODS The participants were the academic staff in charge of oral health care education in the basic, adult, gerontological, and home nursing fields of 295 schools in Japan that offered a bachelor's degree in nursing. A questionnaire was sent to 1180 heads of the nursing fields of these schools. They were requested to have oral health care educators complete the survey; data on the performance of oral assessment and health care education and human resources allocated were collected through a questionnaire. RESULTS A total of 311 (26%) questionnaires were returned, 196 (63%) of which were completed by oral health care educators. Regarding the performance of oral assessment education, the majority (71%) of them spent less than 2 hours in teaching, and only 24.5% taught the usage of oral assessment tools. Regarding the performance of oral health care education, more than 90% spent less than 2 hours in lecture-based and practical oral health care education, respectively. Less than half taught the association of periodontal diseases with diabetes and cardiovascular diseases and use of fluoride for caries prevention in the lectures, and only approximately 30% taught the usage of an interspace brush or dental floss. Moreover, less than 10% of oral health professionals taught oral health care in lectures or practical oral health care. CONCLUSIONS This study revealed problems associated with oral assessment and health care education in Japanese nursing schools. To address these, support from oral health care professionals is required. Further studies are also required to reveal problems in oral assessment and health care education in other nursing schools that do not offer a bachelor's degree programme in Japan and other countries.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan.
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Maki Miyoshi
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Mika Obuse
- Graduate School of Nursing Science, St. Luke's International University, Chuo-ku, Tokyo, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | | | - Masumi Muramatsu
- School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
| | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Souhei Uchida
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Mami Miyazono
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Hidechika Iino
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Sawara-ku, Fukuoka, Japan
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Maitre Y, Collet S, Denis F, Amador G. The oral care practices and needs of older adults in nursing homes: Assessment of carers and patients. Sante Publique 2023; 35:77-82. [PMID: 38040648 DOI: 10.3917/spub.hs1.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Good oral health preservation in nursing homes is hampered by the lack of caregivers, who are often inadequately trained, which has an impact on patients’ quality of life. The aim was to assess caregivers’ practices and the objective and perceived oral care needs of patients in nursing homes. A cross-sectional survey was conducted between September 15 and November 24, 2021, in three nursing homes in Mayenne (France). A self-administered questionnaire was used to identify oral care practices and caregivers’ training needs. The care needs and oral health related quality of life of patients were assessed by a single dental surgeon using the OHAT and the GOHAI questionnaire. Assessments were done with 30.8 percent of caregivers, and 40.0 percent and 36.2 percent of patients for OHAT and GOHAI respectively. Oral cavity and prosthesis examinations were systematically carried out by 4.9 percent and 24.4 percent of caregivers respectively. Fifty percent of the nurses had never performed oral care. A need for practical training was expressed by 75.6 percent of the caregivers. The mean GOHAI and OHAT scores were 56.17 ± 5.69 and 6.01 ± 2.42. These scores were significantly correlated (rho=-0.34; p=0.002). Preventive oral care in nursing homes is necessary to maintain residents’ quality of life. Efforts must be made to provide training for caregivers and to simplify oral care procedures for patients.
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Affiliation(s)
- Yoann Maitre
- Collège national des chirurgiens-dentistes universitaires en santé publique, France
- UFR odontologie, université de Nantes
- CHU de Nantes
| | | | - Frédéric Denis
- Collège national des chirurgiens-dentistes universitaires en santé publique, France
- UFR odontologie, université de Tours
- EA 75-05 éducation, éthique, santé, faculté de médecine, université François-Rabelais, Tours
| | - Gilles Amador
- Collège national des chirurgiens-dentistes universitaires en santé publique, France
- UFR odontologie, université de Nantes
- CHU de Nantes
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Chou KR, Huang MS, Chiu WC, Chen YH, Chen YY, Xiao Q, Yang SC. A comprehensive assessment of oral health, swallowing difficulty, and nutritional status in older nursing home residents. Sci Rep 2023; 13:19914. [PMID: 37964096 PMCID: PMC10645724 DOI: 10.1038/s41598-023-47336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/12/2023] [Indexed: 11/16/2023] Open
Abstract
Declines in oral consumption and swallowing function are common reasons which may elevate the risk of malnutrition in the older adults. This study aimed to provide valuable information and contribute to the existing body of knowledge in this field as well as highlight the importance of a comprehensive assessment of oral health, swallowing function, and nutritional status in long-term care residents. This was a cross-sectional study. Thirty-nine participants were recruited from a nursing home. The comprehensive assessment was evaluated in participants, including oral health (Oral Health Assessment Tool (OHAT)), swallowing function (Functional Oral Intake Scale (FOIS) and Eating Assessment Tool (EAT)-10), and nutritional status (Mini Nutritional Assessment-Short Form (MNA-SF). The average age of participants was 80.4 ± 11.7 years, and 46% of these older adults were found to be at the risk of malnutrition. There was a negative correlation between the OHAT and MNA-SF scores. In addition, subjects with poor oral health (OHAT score = 5~8), oral consumption of a modified diet (FOIS score = 4~6), and reduced swallowing function (EAT-10 score ≥ 3) were more likely to be at risk of malnutrition. A comprehensive evaluation of oral health and swallowing function was closely connected with the nutritional status of older nursing home dwellers.
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Affiliation(s)
- Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Mao-Suan Huang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chun Chiu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsiu Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yu-Yoh Chen
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Qian Xiao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Suh-Ching Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Melbye EL, Bull VH, Hidle KS. Assessment of the SmartJournal Intervention for Improved Oral Care in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e46926. [PMID: 37801358 PMCID: PMC10589829 DOI: 10.2196/46926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Poor oral health is common in nursing home residents, and health care professionals report numerous barriers when it comes to the provision of oral care for care-dependent older adults, such as a lack of oral health knowledge and skills, care-resistant behaviors in residents, lack of adequate oral care routines, insufficient systems for documentation of issues related to oral health, a high workload, and unclear responsibilities. An intervention, SmartJournal, has been developed to assist health personnel in preserving older patients' oral health. SmartJournal is a digital tool with three components: (1) documentation of oral hygiene routines; (2) monthly oral health assessment; and (3) education on geriatric oral care. An updated framework for research on complex interventions has been used to guide the various phases in the development of this intervention. This study focuses on the evaluation phase. OBJECTIVE We aim to assess (1) the effectiveness of SmartJournal use in enhancing nursing home caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) whether SmartJournal use results in improved oral health for nursing home residents. METHODS We will use a cluster randomized controlled trial to assess impacts of SmartJournal use as specified under study objectives. Nursing homes located in Rogaland, Norway, will be recruited and randomly assigned to an intervention and a control group. The intervention group will be provided with tablets containing SmartJournal and support from research staff, while the control group will continue with existing oral care routines. Both groups will receive oral hygiene packages. The intervention will last for 12 weeks. Measurements will be performed in both groups at baseline, 3 months, and 9 months and include (1) a survey assessing caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) assessment of oral health status in residents using mucosal-plaque score as a primary outcome measure. Analyses will include descriptive statistics and statistical techniques to look for changes and differences in the study variables within and between the intervention and control groups throughout the study period. Associations between study variables will also be investigated. RESULTS Recruitment of nursing homes for the intervention and control groups was completed in February 2023. Recruitment of individual participants (ie, nursing home residents and caregivers) is ongoing, and baseline measurements are being performed consecutively. Results are expected to be ready for analyses in fall 2024. CONCLUSIONS We aim to assess the effects of SmartJournal use on oral care and oral health in nursing homes. Results from this work may inform further development and implementation of SmartJournal and similar digital tools aiming to enhance health care services offered to care-dependent people. Finally, SmartJournal may have potential as a learning tool in educational programs for nurses and other health care professionals. TRIAL REGISTRATION ClinicalTrials.gov NCT05724043; https://clinicaltrials.gov/study/NCT05724043. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46926.
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Affiliation(s)
| | - Vibeke Hervik Bull
- Research Department, Oral Health Centre of Expertise Rogaland, Stavanger, Norway
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Chau RCW, Li GH, Tew IM, Thu KM, McGrath C, Lo WL, Ling WK, Hsung RTC, Lam WYH. Accuracy of Artificial Intelligence-Based Photographic Detection of Gingivitis. Int Dent J 2023; 73:724-730. [PMID: 37117096 PMCID: PMC10509417 DOI: 10.1016/j.identj.2023.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVES Gingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs. METHODS Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement. RESULTS A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50. CONCLUSIONS Artificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients' plaque control.
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Affiliation(s)
- Reinhard Chun Wang Chau
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Guan-Hua Li
- School of Information Engineering, Guangdong University of Technology, Guangzhou, China
| | - In Meei Tew
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Khaing Myat Thu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wai-Lun Lo
- Department of Computer Science, Hong Kong Chu Hai College, Hong Kong Special Administrative Region, China
| | - Wing-Kuen Ling
- School of Information Engineering, Guangdong University of Technology, Guangzhou, China
| | - Richard Tai-Chiu Hsung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China; School of Information Engineering, Guangdong University of Technology, Guangzhou, China; Department of Computer Science, Hong Kong Chu Hai College, Hong Kong Special Administrative Region, China.
| | - Walter Yu Hang Lam
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China; Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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Shoaee S, Heydari M, Hessari H, Mehrdad N, Khalilazar L, Hatami B, Sharifi F. Development and initial validation of the Comprehensive Geriatric Oral Health Assessment Tool. Clin Exp Dent Res 2023; 9:879-886. [PMID: 37767734 PMCID: PMC10582220 DOI: 10.1002/cre2.791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES Improving the oral health of the elderly is crucial to improving their general health and quality of life. To reach this goal, it is necessary to start with a comprehensive oral health assessment and a detailed treatment plan. The aim of this study was, therefore, to develop a comprehensive Oral Health Assessment Tool for the geriatric population. MATERIAL AND METHODS Following a panel of experts' consultation, a clinical form and a self-assessment questionnaire were developed, encompassing eight domains: dental caries, periodontal diseases, partial and complete edentulism, oral soft tissue lesions, occlusion, xerostomia, temporomandibular joints, and oral or oral prostheses hygiene. Subsequently, a pilot study was conducted to appraise the clinical form and questionnaire involving 84 residents of an Iranian nursing home. After securing ethics approval, both the qualitative and quantitative aspects of the self-assessment questions' validity and reliability were assessed, and specificity and sensitivity were calculated. RESULTS The mean age of the participants was 69.8 (±4.1) years, and 86% had less than 12 years of education. The questions regarding the number of remaining teeth and the number of decayed teeth had the highest sensitivity (97% and 88%), respectively. Questions regarding the presence of periodontitis and gingivitis had the highest specificity (both 100%). CONCLUSIONS A Comprehensive Geriatric Oral Health Assessment Tool has been developed and its validity and reliability evaluated in a pilot study. It should now be further evaluated in larger studies.
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Affiliation(s)
- Shervan Shoaee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Research InstituteTehran University of Medical SciencesTehranIran
- Research Center for Caries Prevention, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad‐Hossein Heydari
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Research InstituteTehran University of Medical SciencesTehranIran
- School of DentistryShahid Beheshti University of Medical SciencesTehranIran
| | - Hossein Hessari
- Research Center for Caries Prevention, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Neda Mehrdad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Laleh Khalilazar
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Bahareh Hatami
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
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Hillebrecht AL, Waterkotte R, Ludwig E, Barbe AG. [Integrating risks for oral diseases into Structured Information Collection: A practice development project]. Pflege 2023. [PMID: 37772331 DOI: 10.1024/1012-5302/a000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Integrating risks for oral diseases into Structured Information Collection: A practice development project Abstract. Background: Deficient oral hygiene and oral diseases are highly prevalent among nursing staff. Up to now, there is no assessment for nursing professionals integrated in the daily nursing routine, which depicts the complex risks for oral diseases. The Structured Information Collection (SIS) is a concept to guide the nursing process and enables individual action planning. Aim: The aim was to integrate oral diseases as a nursing-relevant risk into the SIS and to develop an assessment instrument for oral hygiene deficits/diseases integrated into the SIS topic areas. Methods: Based on a literature search, 21 systematic reviews describing SIS topic areas and oral health risks were analysed by a panel of experts. The caregiver-relevant oral health risks identified in this way were compared with existing oral health assessment instruments and with screening criteria recommended in the German national expert standard for the promotion of oral health in care. Since none of the oral health assessments covers all nursing-relevant oral health risks and the recommended screening criteria of the expert standard, the area of "oral diseases" was integrated into the SIS as an additional category, and an oral health assessment adapted to the SIS was developed. Results: This article presents the SIS expanded to include nursing-relevant oral disease risk and the newly developed Oral Risk Assessment Prevention (Mu-RAP) for use by nurses. Conclusions: The SIS expanded to include oral disease and the Mu-RAP for identifying oral hygiene deficits/diseases cover all nursing-relevant oral health risks. Further studies on the applicability, reliability, and validity of the instrument, as well as on care-effective and patient-relevant effects of its use are needed.
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Affiliation(s)
- Anna-Lena Hillebrecht
- Department für Zahn-, Mund- und Kieferheilkunde, Klinik für Zahnärztliche Prothetik, Universitätsklinikum Freiburg, Deutschland
| | - Ramona Waterkotte
- Fort- und Weiterbildung, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Deutschland
| | - Elmar Ludwig
- Referat Alterszahnheilkunde, Landeszahnärztekammer Baden-Württemberg, Stuttgart, Deutschland
| | - Anna Greta Barbe
- Poliklinik für Zahnerhaltung und Parodontologie, Sektion Parodontologie, Zentrum für Zahn-, Mund- und Kieferheilkunde, Uniklinik Köln, Deutschland
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Assiri Ahmed H, Estrugo-Devesa A, Roselló Llabrés X, Egido-Moreno S, López-López J. The prevalence of elongated styloid process in the population of Barcelona: a cross-sectional study & review of literature. BMC Oral Health 2023; 23:674. [PMID: 37723455 PMCID: PMC10507983 DOI: 10.1186/s12903-023-03405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Styloid process (SP) is a cylindrical bony projection that originates from the inferior part of the petrous temporal bone just anteriorly to the stylomastoid foramen. Several nerves, muscles, and ligaments are related closely to the (SP). It is considered elongated when the measurement exceeds 30 mm. The overall prevalence of the styloid process is between 3.3% to 84.4%. The elongation of the styloid process (ESP) is associated with the manifestation of Eagle's Syndrome (ES) which is characterized by various types of pain in the head and neck region such as headache, tinnitus, otalgia, and trigeminal neuralgia. Eagle's syndrome occurs in 4-10.3% of individuals with an elongated styloid process (ESP). The objective of the study is to determine the prevalence of (ESP) in the patients who were treated in the Dental Hospital University of Barcelona (HOUB), to review the literature to spot the light on the different demographic data worldwide. METHODS The archived panoramic image in the University of Barcelona dental Hospital were consecutively retrieved to investigate the prevalence of (ESP). Of all digital panoramic radiographs (OPG), 400 met the inclusion criteria and were furtherly analyzed. The results are correlated with the participant's gender, age, and occurrence. Age is subcategorized into three groups. A chi-square test is used to measure the significant differences and the P-value is set at < 0.05 for the level of significance. RESULTS Among the included 400, we found 291 demonstrating (ESP). The prevalence of (ESP) which exceeds 30 mm is 72.75%. It is found that the most common morphological type is type 1 which is regarded as the uninterrupted (ESP) regardless of gender and age group. Concerning the calcification pattern, the most prevalent is the partial calcified (ESP) despite genders and age groups. CONCLUSION (OPG) is a sufficient tool for the screening of the elongated styloid process. Regarding the prevalence, our results are considered higher than previously reported prevalence in different populations using (OPG) radiography tool. A study on a wider spectrum of the Spanish population is recommended to further investigate the correlation between the elongated styloid process and the occurrence of Eagle's syndrome.
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Affiliation(s)
- Hassan Assiri Ahmed
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - Albert Estrugo-Devesa
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain.
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain.
| | - Xavier Roselló Llabrés
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - Sonia Egido-Moreno
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - José López-López
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
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Ho BV, van der Maarel-Wierink CD, de Vries R, Lobbezoo F. Oral health care services for community-dwelling older people with dementia: A scoping review. Gerodontology 2023; 40:288-298. [PMID: 36440580 DOI: 10.1111/ger.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/02/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether, and if so, which oral health care services for community-dwelling older people with dementia are available. BACKGROUND Oral health in people with dementia is poor compared with people without dementia. Although multiple oral health care interventions have previously been studied for older people living in nursing homes, little is known about interventions or services for community-dwelling older people with dementia. MATERIALS AND METHODS A literature search was performed in the databases Pubmed, Embase and CINAHL. The following search terms were used: "Dementia", "Oral health", "Dental health services" and "Older person". The term "dental health services" was intended to be an as broad as possible construct because limited search results were expected. RESULTS The search generated 1624 unique references, of which seven studies were eligible for inclusion (four cohort studies, one cross-sectional study, and two qualitative studies). The included studies described two actual oral health care services: a telephone help line on oral health and dementia, and a mobile geriatric dental programme in adult day health centres. A need was found for services and strategies specific to community-dwelling older people with dementia. One identified solution was an intervention with individually tailored daily oral hygiene self-care supported by the informal caregiver. Furthermore, increasing accessibility of oral health care professionals with treatment at other locations than their own practices, better collaboration between health care professionals and preventive oral health care are highly necessary. CONCLUSION There is limited evidence on the availability of oral health care services for community-dwelling older people with dementia, while a need was found for oral health care services that focus on good accessibility, oral hygiene self-care, preventive strategies and collaboration among health care professionals.
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Affiliation(s)
- Bach Van Ho
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Claar D van der Maarel-Wierink
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Matsuo H, Yoshimura Y, Fujita S, Maeno Y, Tanaka S. Association of poor oral health with increased incidence of dysphagia and impaired improvement in nutritional status among patients with acute heart failure: a prospective cohort study. Eur Geriatr Med 2023; 14:879-888. [PMID: 37310608 DOI: 10.1007/s41999-023-00810-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/29/2023] [Indexed: 06/14/2023]
Abstract
AIMS This study aimed to clarify the association between oral health and the incidence of dysphagia as well as the recovery of nutritional status and improvement of dysphagia in hospitalized patients with acute heart failure. METHODS Hospitalized patients with AHF were prospectively enrolled. Oral health was evaluated using the Japanese Version of the Oral Health Assessment Tool (OHAT-J) after circulation dynamics improved (defined as baseline), and participants were classified into good and poor oral health groups (OHAT-J 0-2 and ≧ 3, respectively). The primary outcome measure was the incidence of dysphagia evaluated using the Food Intake Level Scale (FILS) at baseline. Secondary outcome measures were nutritional status and FILS score at discharge. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Univariate and multivariate logistic regression analyses were used to determine the association between oral health and the study outcomes. RESULTS Of the 203 recruited patients (mean age, 79.5 years; 50.7% female), 83 (40.9%) were in the poor oral health group. Participants with poor oral health were significantly older, had lower skeletal muscle mass and strength, lower nutrient intake and nutritional status, worse swallowing status, as well as lower cognitive level, and physical function than those with good oral health. In multivariate logistic regression analyses, baseline poor oral health was significantly associated with the incidence of dysphagia (odds ratio = 1.036, P = 0.020), as well as with the improvement in nutritional status (odds ratio = 0.389, P = 0.046) and dysphagia (odds ratio = 0.199, P = 0.026) at discharge. CONCLUSIONS Poor baseline oral health was associated with the incidence of dysphagia, as well as with the lack of improvement in nutritional status and dysphagia in patients with acute heart failure.
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Affiliation(s)
- Haruyo Matsuo
- Department of Nursing, Kagoshima Medical Association Hospital, Kagoshima, Japan
| | - Yoshihiro Yoshimura
- Department of Rehabilitation Medicine, Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto, 869-1106, Japan.
| | - Shoji Fujita
- Department of Cardiology, Kagoshima Medical Association Hospital, Kagoshima, Japan
| | - Yuichi Maeno
- Department of Rehabilitation, Kagoshima Medical Association Hospital, Kagoshima, Japan
| | - Sayoko Tanaka
- Department of Nutritional Management, Kagoshima Medical Association Hospital, Kagoshima, Japan
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Rojo J, George A, Ramjan L, Hunt L, Salamonson Y. Development and psychometric testing of the attitude and confidence with oral healthcare among nursing students (ACORN) scale. Nurse Educ Pract 2023; 71:103736. [PMID: 37541080 DOI: 10.1016/j.nepr.2023.103736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 07/11/2023] [Accepted: 07/22/2023] [Indexed: 08/06/2023]
Abstract
AIM To develop and test the psychometric properties of the attitude and confidence with oral healthcare among nursing students (ACORN) scale. BACKGROUND Delivering oral healthcare is an essential component of care, which is often overlooked and omitted. A nurse's attitude or confidence may influence how oral healthcare is prioritised. To date, there are no scales that assess both attitude and confidence for nurses when undertaking oral healthcare and thus the ACORN scale was developed. METHODS The 24-item scale was developed following a three-stage process, which included concept identification and item construction, pilot testing, factorial and discriminant validity and reliability testing. The survey was distributed to nursing students to assess their attitude and confidence in providing oral healthcare. This study has been registered with the Registry of Efficacy and Effectiveness Studies (12940.1v1). RESULTS Using a before and after intervention survey design, the psychometric properties of the ACORN scale were examined with data collected from two student groups. Exploratory Factor Analysis yielded a two-factor structure, which was verified using Confirmatory Factor Analysis. Importantly, aggregated scale scores were able to detect differences in attitude and confidence following oral healthcare education (4.95 versus 5.66, p < 0.01). The Cronbach's alpha for the 24-item scale was 0.94. CONCLUSION The ACORN scale is a valid and reliable tool that can be used to assess differences in attitude and confidence of students following oral health education. Further research is recommended to test the utility of this scale using other educational interventions with different groups of healthcare providers.
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Affiliation(s)
- Jacqueline Rojo
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia.
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia; Faculty of Medicine and Health, School of Dentistry, The University of Sydney, NSW 2006, Australia; University of Wollongong, School of Nursing, Wollongong, NSW, Australia
| | - Lucie Ramjan
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia; University of Wollongong, School of Nursing, Wollongong, NSW, Australia
| | - Leanne Hunt
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia; University of Wollongong, School of Nursing, Wollongong, NSW, Australia
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Sakai A, Matsuo K, Sekimoto Y, Hidaka R, Yoshihara A. Changes in oral health status with dental intervention during the acute to subacute stages of stroke. Gerodontology 2023. [PMID: 37496302 DOI: 10.1111/ger.12706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES To investigate the changes in oral health status with dental intervention during the acute and subacute stages of stroke and their associations with oral intake status. BACKGROUND Oral health may deteriorate easily in patients following a stroke. However, data are scarce on the changes in oral health with dental intervention throughout the acute and subacute stages of stroke recovery. MATERIAL AND METHODS We prospectively recruited 98 stroke patients who were admitted to an acute hospital and referred to a dental team and then could be followed at a subacute rehabilitation unit in the same hospital. Provided dental intervention, including oral health care and other general dental treatments, was recorded. Oral health was assessed with Oral Health Assessment Tool (OHAT), and the changes in OHAT score during the acute and subacute stages were statistically tested. Oral feeding status was examined using Functional Oral Intake Scale (FOIS). The cohort was divided into the non-oral feeding, dysphagia and regular diet groups based on FOIS score. Differences in OHAT among the oral intake groups were statistically tested. RESULTS Gross OHAT score did not differ among the oral intake groups at the time of admission (mean ± standard deviation score: 6.5 ± 2.8 for non-oral diet, 5.6 ± 2.4 for dysphagia diet and 5.3 ± 2.1 for regular diet), but improved more in the regular diet group (2.4 ± 1.5) than in the other groups (5.8 ± 3.0 for non-oral diet and 4.0 ± 2.1 for dysphagia diet) at the last evaluation. Oral hygiene scores improved significantly in the acute stage, while scores for dentures and natural teeth ameliorated significantly in the subacute stage. CONCLUSION Our findings suggest that appropriate dental intervention in the acute and subacute stages of stroke may contribute to improved oral health and oral food intake.
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Affiliation(s)
- Ayu Sakai
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital, Aichi, Japan
- Doctorate Course for Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Sekimoto
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Niigata University, Niigata City, Japan
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Wu C, Huang H, Xu W, Li J, Chen M, Zhao Q. Influencing factors associated with oral health among older hospitalized patients with ischemic stroke: A cross-sectional survey. Int J Nurs Sci 2023; 10:302-308. [PMID: 37545772 PMCID: PMC10401348 DOI: 10.1016/j.ijnss.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To investigate the oral health status of older patients with ischemic stroke and analyze the influencing factors, providing valuable insights for developing effective oral health management strategies tailored for this population. Methods A cross-sectional survey was conducted from January to June 2022, selecting 350 older patients with ischemic stroke from two tertiary hospitals in Chongqing. The Barthel Index (BI), Eating Assessment Tool (EAT-10), and Oral Health Assessment Tool (OHAT) were used to assess patients' self-care ability, swallowing function, and oral health status, respectively. A self-designed questionnaire was used to collect demographic information, disease-related information, and oral health behaviors of the patients. Binary logistic regression analysis was performed to analyze related influencing factors. Results A total of 346 older patients with ischemic stroke were included, with 199 males and 147 females. The median total score of OHAT was 5 (total score range 0-16). Dental decay (91.7%, 278/303) and poor oral hygiene (92.2%, 319/346) were the main oral health problems in this population. Binary logistic regression analysis showed that sex, hyperlipidemia, stroke severity, stroke events, oral health behaviors, and care dependency were influencing factors for the oral health of this population (P < 0.05). Conclusion The study revealed that healthcare professionals should strengthen the oral health assessment of older patients with ischemic stroke and implement individualized health education and management measures based on the characteristics of high-risk groups to promote their oral health.
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Affiliation(s)
- Chengfei Wu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenxin Xu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinghong Li
- Department of Rehabilitation Medicine, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Mei Chen
- Department of Nursing, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Balwanth S, Singh S. Oral healthcare provision at long-term care facilities in eThekwini: Perspectives of coordinators. Afr J Prim Health Care Fam Med 2023; 15:e1-e10. [PMID: 37403681 DOI: 10.4102/phcfm.v15i1.3884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The prevalence and impact of oral disease among long-term institutionalised residents highlight the need for a scale-up of preventive and promotional oral health services that include oral health education and training for caregiving staff. However, opportunities to improve oral healthcare services are met with challenges. AIM This study was undertaken to establish coordinator perspectives on oral health provision. SETTING Seven long-term care facilities in the eThekwini district, South Africa. METHODS An in-depth exploratory study was conducted with 14 purposively selected coordinators (managers and nurses). Semi-structured interviews were conducted and focused on coordinators' experience and perspectives on oral healthcare. Data were analysed using thematic analysis. RESULTS The following themes emerged from the study: A lack of comprehensive oral health care practices, inadequate support from the dental sector, insufficient oral health prioritisation, limited funding for oral health, and challenges associated with coronavirus disease (COVID-19). All respondents reported that no oral health initiatives existed. Plans for oral health training workshops presented with coordination and funding challenges. Oral health screening initiatives have ceased since COVID-19. CONCLUSION The study findings indicated that prioritisation of oral health services was inadequate. There is a need for continual oral health in-service training for caregivers and support from coordinators in guiding the implementation of oral health training programmes.Contribution: It is envisaged that the findings of this study will bring about greater coordinator involvement and collaboration with the public and private dental sectors to improve oral healthcare at long-term care facilities.
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Affiliation(s)
- Sonam Balwanth
- Discipline of Dentistry, School of Health Sciences, University of KwaZulu-Natal, Durban.
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Liu S, Guo Y, Hu Z, Zhou F, Li S, Xu H. Association of oral status with frailty among older adults in nursing homes: a cross-sectional study. BMC Oral Health 2023; 23:368. [PMID: 37287021 PMCID: PMC10249201 DOI: 10.1186/s12903-023-03009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The oral status of an individual is a vital aspect of their overall health. However, older adults in nursing homes have a higher prevalence of frailty and poor oral health, particularly in the context of global aging. The objective of this study is to explore the association between oral status and frailty among older adults residing in nursing homes. METHODS The study involved 1280 individuals aged 60 and above from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used to evaluate physical frailty, while the Oral Health Assessment Tool was used to assess oral status. The frequency of tooth brushing was classified as never, once a day, and twice or more a day. The traditional multinomial logistic regression model was used to analyze the association between oral status and frailty. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated while controlling for other confounding factors. RESULTS The study found that the prevalence of frailty among older adults living in nursing homes was 53.6%, while the prevalence of pre-frailty was 36.3%. After controlling for all potential confounding factors, mouth changes requiring monitoring (OR = 2.10, 95% CI = 1.34-3.31, P = 0.001) and unhealthy mouth (OR = 2.55, 95% CI = 1.61-4.06, P < 0.001) were significantly associated with increased odds of frailty among older adults in nursing homes. Similarly, both mouth changes requiring monitoring (OR = 1.91, 95% CI = 1.20-3.06, P = 0.007) and unhealthy mouth (OR = 2.24, 95% CI = 1.39-3.63, P = 0.001) were significantly associated with a higher prevalence of pre-frailty. Moreover, brushing teeth twice or more times a day was found to be significantly associated with a lower prevalence of both pre-frailty (OR = 0.55, 95% CI = 0.34-0.88, P = 0.013) and frailty (OR = 0.50, 95% CI = 0.32-0.78, P = 0.002). Conversely, never brushing teeth was significantly associated with higher odds of pre-frailty (OR = 1.82, 95% CI = 1.09-3.05, P = 0.022) and frailty (OR = 1.74, 95% CI = 1.06-2.88, P = 0.030). CONCLUSIONS Mouth changes that require monitoring and unhealthy mouth increase the likelihood of frailty among older adults in nursing homes. On the other hand, those who brush their teeth frequently have a lower prevalence of frailty. However, further research is needed to determine whether improving the oral status of older adults can change their level of frailty.
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Affiliation(s)
- Siyue Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Yicong Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Shaojie Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
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Boukeng LBK, Minkandi CA, Dapi LN. Oral pathology and overweight among pupils in government primary schools in Cameroon: a cross-sectional study. BMC Oral Health 2023; 23:282. [PMID: 37173666 PMCID: PMC10176739 DOI: 10.1186/s12903-023-02941-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Tooth decay and periodontal diseases are the main oral pathologies in the world. The prevalence of overweight in children has increased worldwide. Overweight children have alterations in the composition of saliva and excessive consumption of saturated fatty acids tend to slow the metabolism of carbohydrates in the oral cavity leading to tooth decay, periodontal disease and others oral disorders. The aim of this study was to assess the relationship between oral pathologies and overweight in pupils of primary schools of Cameroon. METHODS A cross-sectional study was carried out from June to August 2020 in four government primary schools selected through cluster sampling in Yaounde. 650 pupils aged between 6 and 11 years were enrolled. Data collected included anthropometric, oral pathologies, quality of oral hygiene and feeding habits. Data were analysed with the SPSS 26.0 statistical software and binary logistic regression was used to determine the risks of oral pathologies in overweight pupils. P-value of 0.05 was considered statistically significant. RESULTS The prevalence of overweight was 27% (95% CI: 23.5-30.5). The main oral pathologies was tooth decay (60.3%). Binary logistic regression revealed that overweight pupils were significantly 1.5 times more likely to develop tooth decay than non-overweight pupils (95% CI: 1.1-2.4). CONCLUSION Overweight, tooth decay are prevalent among pupils. Overweight pupils have a higher risk of developing tooth decay compared to non-obese pupils. An integrated package of oral and nutritional health promotion activities is necessary in primary schools in Cameroon.
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Affiliation(s)
- Lionel Berthold Keubou Boukeng
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, P.O. Box 1364, Yaoundé, Cameroon
| | - Claude Axel Minkandi
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, P.O. Box 1364, Yaoundé, Cameroon
| | - Leonie Nzefa Dapi
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, P.O. Box 1364, Yaoundé, Cameroon.
- Department of Medicine and Optometry, Inst of Health and Life Sciences, Linnaeus University, P.O. Box 39182, Kalmar, Sweden.
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Tian F, Li J, Wu B, Xiao R, Liu J, Yu J, Liu L, Zhu R. Differences in the oral health status in hospitalised stroke patients according to swallowing function: A cross-sectional study. J Clin Nurs 2023; 32:1140-1147. [PMID: 35253288 DOI: 10.1111/jocn.16254] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/29/2021] [Accepted: 01/24/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Dysphagia is one of the common complications caused by stroke, leading to poor oral health. Oral health is often neglected after stroke by clinical care providers and the patients. Identifying the status of oral health in hospitalised stroke patients with swallowing disorders will facilitate the attention of clinical care providers. AIM To investigate the differences in the oral health status between hospitalised post-stroke patients with dysphagia and non-dysphagia. DESIGN A cross-sectional study. METHODS A purposive sampling method was used to recruit participants. Participants included hospitalised post-stroke patients with dysphagia and without dysphagia. Stroke patients were recruited from the Department of Neurology, Guizhou Provincial People's Hospital in China. A total of 120 stroke patients completed the survey. The data collected included their demographics, the scores on the Oral Health Assessment Tool (OHAT), Geriatric Oral Health Assessment Index (GOHAI), and the Eating Assessment Tool-10 (EAT-10). The study was compliant with the STROBE checklist. RESULTS The average age of the dysphagia group was 67 (64~76) vs the participants without dysphagia group 67 (65~76), (p = .610). The mean standard deviation (SD) OHAT score of participants with dysphagia was 5.28 (2.33) compared to participants without dysphagia 8.89 (3.07), (p < .05). This result indicates post-stroke dysphagia (PSD) patients had worse oral health than stroke patients without dysphagia. Binary logistic regression analysis showed that oral health status was the independent influencing factor of swallowing function (p < .01). CONCLUSION The participants with dysphagia had worse oral health status compared to those without dysphagia, illustrating the critical importance of improving attention to oral health management in patients with post-stroke swallowing disorders. RELEVANCE TO CLINICAL PRACTICE Oral health was often omitted when comparing to other functional impairments resulting from stroke. Health caregivers of post-stroke patients with dysphagia should be aware of the importance of evaluating patient's oral condition and implementing oral care.
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Affiliation(s)
- Fang Tian
- Guizhou University of Traditional Chinese Medicine, School of Nursing, Guiyang City, China.,Guizhou Provincial People's Hospital, Guiyang City, China
| | - Juan Li
- Guizhou Provincial People's Hospital, Guiyang City, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Rong Xiao
- University of Maryland School of Nursing (Shady Grove Campus), Rockville, Maryland, USA
| | - Jiru Liu
- Guizhou University of Traditional Chinese Medicine, School of Nursing, Guiyang City, China
| | - Jie Yu
- Guizhou University of Traditional Chinese Medicine, School of Nursing, Guiyang City, China
| | - Lin Liu
- Guizhou Provincial People's Hospital, Guiyang City, China
| | - Rong Zhu
- Guizhou Provincial People's Hospital, Guiyang City, China
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Shimizu A, Maki H, Ohno T, Nomoto A, Fujishima I, Kayashita J, Momosaki R, Nishioka S, Wakabayashi H. Association of poor oral health status and faecal incontinence in patients with dysphagia: A cross-sectional analysis from the Sarcopenic Dysphagia Database. J Oral Rehabil 2023; 50:286-292. [PMID: 36609695 DOI: 10.1111/joor.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/08/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Poor oral health status may alter oral and gut microbiota. Previous studies have shown that poor oral health can exacerbate gut inflammation. Therefore, poor oral health status may be related to faecal incontinence via changes in the gut. OBJECTIVE To investigate the association between poor oral health status and faecal incontinence in inpatients with dysphagia. METHODS This multicentre cross-sectional study included 423 patients (mean age 79.8 ± 11.5 years, 48.2% female) with dysphagia. Oral health status was assessed at each facility using the Oral Health Assessment Tool (OHAT) or the Revised Oral Assessment Guide (ROAG). Poor oral health status was defined as an OHAT score of ≥3 or a ROAG score of ≥13. A multivariate logistic model was used to analyse the association between poor oral health status and faecal incontinence. RESULTS A total of 351 (83.0%) patients had poor oral health and 97 (22.7%) had faecal incontinence. Patients with poor oral health status had a higher proportion of faecal incontinence than those with normal oral health status (25.4% vs. 11.1%, p = .009). A multivariate logistic model revealed an association between faecal incontinence and poor oral health status (adjusted odds ratio = 2.501, 95% confidence interval = 1.065-5.873, p = .035). CONCLUSIONS Poor oral health status assessed by OHAT or ROAG in inpatients with dysphagia may adversely affect faecal incontinence. Further studies are needed to determine the causal relationship between poor oral health status and faecal incontinence.
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Affiliation(s)
- Akio Shimizu
- Department of Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, Japan
| | - Hiroki Maki
- Department of Pharmacy, Kofu Municipal Hospital, Kofu, Yamanashi, Japan
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Akiko Nomoto
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Zimmermann T, Koenig A, Porzelt S, Schmage P, Konnopka C, Schellhammer S, Behrens-Potratz A, Ijeoma Okoro E, Henken E, Stratmeyer P, Beikler T, König HH, Scherer M, Konnopka A. Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP): an observational study at the sector boundary between dental and general practice care in Germany. BMJ Open 2023; 13:e063685. [PMID: 36914197 PMCID: PMC10016254 DOI: 10.1136/bmjopen-2022-063685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION Older people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing evidence that poor oral health and systemic diseases are closely associated, for example, in cardiological, metabolic or neurodegenerative conditions. Thus, Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) is investigating the need, provision and utilisation of oral healthcare, systemic morbidity and clinical status of the oral cavity in older people. METHODS AND ANALYSIS InSEMaP consists of four subprojects (SP), all involving the target population of older people in need of home care. In SP1 part a, a sample is surveyed using a self-report questionnaire. In SP1 part b, stakeholders (general practitioners, dentists, medical assistants, family and professional caregivers) are interviewed regarding barriers and facilitators using focus groups and personal interviews. In SP2, a retrospective cohort study, health insurance claims data are examined to investigate the utilisation of oral healthcare, its association with systemic morbidity and healthcare costs. In SP3, a clinical observational study will assess the oral health of participants by a dentist's visit at home. SP4 synthesises the results of SP1, SP2 and SP3 to develop integrated clinical pathways, identifying strategies to uphold oral healthcare in older people. In assessing and evaluating the process of oral healthcare, and its associated systemic morbidity, InSEMaP aims to improve general healthcare across the sector boundary of dental and general practitioner care. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Review Board of the Hamburg Medical Chamber (approval number: 2021-100715-BO-ff). The results of this study will be disseminated through conference presentations and publications in peer-reviewed journals. An expert advisory board to support the InSEMaP study group will be established. TRIAL REGISTRATION NUMBER German Clinical Trials Register: DRKS00027020.
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Affiliation(s)
- Thomas Zimmermann
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Alena Koenig
- Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany
| | - Sarah Porzelt
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Petra Schmage
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Center for Dental and Oral Medicine, Hamburg, Germany
| | - Claudia Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
| | - Stefanie Schellhammer
- Department of Health Care Research and Innovation, Deutsche Angestellten-Krankenkasse (DAK), Hamburg, Germany
| | - Anja Behrens-Potratz
- Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany
| | - Edelqueen Ijeoma Okoro
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Espen Henken
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
| | - Peter Stratmeyer
- Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Center for Dental and Oral Medicine, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Hamburg, Germany
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