There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly.

Objectives:The aim was to examine importance and consideration of oral healthrelated issues (OHRIs) during service planning by the case managers (CMs). Methods and results:The study was conducted in a major Finnish city. All 25 CMs, supervising over 450 domiciliary care employees who are caring for 4600 domiciliary care clients, received a multiple-choice questionnaire with additional open-ended questions. CMs were dichotomized by age and educational background. Differences were compared with the chi-square test and Fisher´s exact test. Response rate was 88%. All CMs considered OHRIs important. However, OHRIs were not routinely considered during service planning, especially by the CMs with a social service than health background (0% vs 30%, P < 0, 0.056). OHRIs were considered never or seldom by 73% of the CMs. OHRIs were mostly considered after evaluating the overall need for domiciliary care. A lack of guidelines was reported by 45% of the CMs. Of the CMs, 41% could use their knowledge for paying attention to OHRIs. All CMs wished for better routines for paying attention to OHRIs. Conclusion:OHRIs are not routinely considered in service planning. This study indicated a need for structured guidelines and further education for assess the need for oral home care assistance. K E Y W O R D S domiciliary care, older people, oral health assessment Spec Care Dentist. 2019;39:485-490. wileyonlinelibrary.com/journal/scd 485

Objectives The aim was to compare the perceived oral health and oral health behaviours of home‐dwelling older people with and without domiciliary care. Background Oral health is poor in long‐term care, but less is known about perceived oral health of home‐dwelling older people receiving domiciliary care. Materials and methods Data from the Health 2000 and Health 2011 surveys (BRIF8901) were used. Interview participants were at least 70 years old and living at home with or without domiciliary care (n = 1298 in 2000 and n = 1027 in 2011). Differences in perceived oral health (subjective oral health, pain, eating difficulties) and oral health behaviours (hygiene, use of services) were compared based on the use of domiciliary care and stratified by gender. Differences between groups were compared with the chi‐square test. Results In 2011, compared to non‐clients, domiciliary care clients more often had poor subjective oral health (40.3% vs. 28.9%, P = .045). In both surveys, they also used oral health services less recently (2000, 76.4% vs. 60.9%; and 2011, 61.1% vs. 46.6%) and more often had difficulties chewing hard food (2000, 50.6% vs. 34%, P < .001; and 2011, 38.4% vs. 20.7%, P < .001) than non‐clients. In 2000, clients had more difficulty eating dry food without drinking (39.5% vs. 21.6%, P < .001) and cleaning their teeth and mouth (14.3% vs. 1.1%, P < .001) than non‐clients. Women clients in 2011 brushed their teeth less often than non‐clients (43.5% vs. 23.7%, respectively, P = .001). Conclusion Domiciliary care clients have poorer perceived oral health, and greater difficulties with eating and oral hygiene maintenance than non‐clients.

ObjectivesThe aim was to compare oral health‐related quality of life (OHRQoL) between home‐dwelling older people with and without domiciliary care when adjusted for gender, education, use of dental services and removable dental prostheses.BackgroundOHRQoL of home‐dwelling older people with and without domiciliary care is a neglected area of research, with few studies having been conducted.Materials and MethodsA secondary analysis was conducted on the Finnish Health 2011 interview data. Home‐dwelling participants (age ≥ 70) with or without domiciliary care were included (n = 758). OHRQoL was measured with the Oral Health Impact Profile questionnaire (OHIP‐14) calculating three outcomes: prevalence of at least one impact reported: “occasionally,” “fairly often” or “very often” (OFoVo), severity as mean sum score and mean of the seven OHIP‐14 dimensions. These were evaluated by use of domiciliary care using logistic and negative binomial regression analyses.ResultsDomiciliary care clients tended to have poorer OHRQoL than non‐clients (severity mean 4.33 vs 4.11, P = .057), especially men (6.71 vs 4.15, P = .027), and reported more psychological discomfort than non‐clients (mean 1.10 vs 0.82, P = .039). The use of removable dental prostheses was the strongest predictor (OR 2.84, P < .001) of poor OHRQoL.ConclusionDomiciliary care clients tended to report poorer OHRQoL, especially with regard to psychological discomfort dimension than non‐clients. Thus, support of oral hygiene and regular utilisation of oral health services should be part of domiciliary care among older people to enhance OHRQoL.