A registry study of oral health problems and preventive interventions among older persons receiving municipal healthcare – PROSENIOR

Abstract

Oral health is known to impact on the quality of life in older persons (Lindmark et al., 2020;McGrath & Bedi, 1991;van de Rijt et al., 2021), and oral health is experienced as central for the sense of self-esteem and thus is perceived as a priority by older persons (McKenzie-Green et al., 2009). Importantly, poor oral health is associated with malnutrition (Lindroos et al., 2019;van Lancker et al., 2012) and is a risk factor for aspiration pneumonia among older persons (van der Maarel-Wierink et al., 2011), which in turn increases the risk for death (Welte et al., 2012). However, a recent review (Manger et al., 2017) shows strong evidence that the incidence of pneumonia can be reduced by regular oral hygiene interventions, that is through the use of chlorhexidine in mouthwash or gel among older persons.Another review (van der Maarel-Wierink et al., 2013) concludes that tooth brushing after each meal, cleaning dentures once a day and professional oral health care once a week reduce the incidence of aspiration pneumonia among frail older persons.

The STAIR OF KNOWLEDGE – Prevention of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes Development and evaluation of the feasibility of an educational intervention

“…However, the preventive work as outlined by SA was not straightforward (48,52,59,(71)(72)(73)(74)(75)(76). For instance, it required committed leadership (71); it was necessary for managers to prioritize SA (71) and support the team (74).…”

“…For instance, healthcare professionals experienced that the risk assessments and their clinical estimation differed, since most of the older persons were considered at risk according to the risk assessment instruments, but not according to their clinical estimation (73). Furthermore, studies show that not all older persons at risk of malnutrition and falls had planned care action (48,59,75), that more care-dependent older persons had poorer oral health (52), and that planned care action did not always match the specific problems related to poor oral health and falls (48,59,76). Moreover, only a quarter of planned preventive care action related to poor oral health was carried out (76) and less than half of the planned care action for falls was performed (48).…”

“…Furthermore, studies show that not all older persons at risk of malnutrition and falls had planned care action (48,59,75), that more care-dependent older persons had poorer oral health (52), and that planned care action did not always match the specific problems related to poor oral health and falls (48,59,76). Moreover, only a quarter of planned preventive care action related to poor oral health was carried out (76) and less than half of the planned care action for falls was performed (48). This indicate that the evidence, as suggested by SA, is not fully integrated into practice, and that there is a lack of knowledge among healthcare professionals regarding prevention of the health risks.…”