As little as 8 weeks of mouth care can significantly improve oral hygiene outcomes. Given the consequences of poor oral hygiene, greater attention to mouth care education and provision are merited. The dedicated worker model is controversial, and future work should assess whether other models of care are equally beneficial.

Background/Objectives The poor oral hygiene of nursing home (NH) residents is a matter of increasing concern, especially due to its relationship to pneumonia and other health events. Because details and related risk factors in this area are scant, and providers need to be able to easily identify those residents at most risk, this study comprehensively examined the plaque, gingival, and denture status of NH residents, as well as readily available correlates of those indicators of oral hygiene, including items from the Minimum Data Set (MDS). Design An oral hygiene assessment and chart abstract conducted on a cross-section of NH residents Setting Fourteen NHs in North Carolina Participants 506 NH residents Measurements Descriptive data from the MDS and assessments using three standardized measures: the Plaque Index for Long-Term Care (PI-LTC), the Gingival Index for Long-Term Care (GI-LTC), and the Denture Plaque Index (DPI) Results Oral hygiene scores averaged 1.7 (of 3) for the PI-LTC, 1.5 (of 4) for the GI-LTC, and 2.2 (of 4) for the DPI. Factors most strongly associated with poor oral hygiene scores included having dementia, being on hospice care, and longer length of stay. MDS ratings of gingivitis differed significantly from oral hygiene assessments. Conclusions Findings identify resident subgroups that are at especially high risk of poor oral health who can be targeted in quality improvement efforts related to oral hygiene; they also indicate need to improve the accuracy of how MDS items are completed.

Objective: A two-year cluster randomized trial of Mouth Care Without a Battle © (MCWB) was conducted in nursing homes (NHs) to determine if recommended mouth care practices provided by NH staff could improve residents' oral hygiene and denture outcomes.Design: Cluster randomized trial of NHs.Setting and Participants: Seven MCWB NHs and six control NHs. A total of 219 NH residents completed baseline and 24-month oral exams and if applicable, denture assessments (control=98, intervention=121). Intervention:The intervention consisted of training NH staff in the MCWB protocol, and providing support in its use for two years.Measures: Descriptive data from the Minimum Data Set and clinical oral health assessments: the Plaque Index for Long-Term Care (range 0-3; PI-LTC), the Gingival Index for Long-Term Care (range 0-4; GI-LTC), and the Denture Plaque Index (range 0-4, DPI), with lower scores indicating better oral health.Results: There were no significant demographic or health differences between groups at baseline. Residents' mean age (SD) was 77.6 (13.7), 71% were female, and 49% had cognitive impairment. At 24 months, there were significant improvements in oral and denture hygiene in the intervention group compared to control (all p < .05) with mean changes in indices that were 0.44 (PI-LTC), 0.55 (GI-LTC), and 0.67 (DPI) points lower in intervention NHs than control NHs.

We pilot tested a carepartner-assisted intervention to improve oral hygiene in persons with cognitive impairment (participants) and help carepartners become leaders who can adapt approaches that foster participants' ability to develop new skills for oral hygiene care. Following

Poor oral health has a significant effect on the overall health and well-being of older adults, and negatively influences functional ability, diet and nutrition. 1,2 Despite the fact that poor oral health is common among older adults, it is often an overlooked area of healthy aging. 3,4 Poor oral health is increasingly linked to adverse health outcomes, including chronic pain, aspiration pneumonia, diabetes and cardiovascular disease. 5 Poor oral health is especially pronounced among cognitively impaired older adults, including