Are oral health education for carers effective in the oral hygiene management of elderly with dementia? A systematic review

Manchery, Nithin; Subbiah, Gireesh Kumar; Nagappan, Nagappan; Premnath, Parvathy

doi:10.4103/1735-3327.276232

Cited by 26 publications

(26 citation statements)

References 41 publications

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“…Effective intervention plans will also require training carers with a goal of promoting not just the oral health of vulnerable groups, but also the overall general health and wellbeing of those that they care for. 56 , 57 This may be significant for those living in their own homes and communities while being looked after by informal caregivers, mostly spouses and children, who need additional professional support and advice on how to direct timely care across dental care pathways. 57 …”

Section: Discussionmentioning

confidence: 99%

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Perspectives of community-dwelling older adults with dementia and their carers regarding their oral health practices and care: rapid review

Aulakh

Curtis

et al. 2021

BDJ Open

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Aim To review evidence on oral health practices, beliefs/views and experiences of community-dwelling older adults living with dementia, including their carers. Materials and methods A search of key terms across six databases including Pubmed, Web of Science and OVID (Embase, MEDLINE [R] and PsycINFO) and Google Scholar was conducted, supplemented by reference screening. The Mixed Methods Appraisal Tool (MMAT) 2018 was used to assess the methodological quality. Results Eighteen studies reported across 19 papers were included in the review. Papers largely focused on normative needs (n = 13), whilst also reporting oral health-related experiences (n = 2), practices (n = 7), and beliefs/views (n = 9), of community dwellers with dementia. Generally, people living with dementia presented with poor oral and dental health, the exception being one study where dental care was integrated with memory clinic services. Maintenance of oral health focused only on toothbrushing. Overall, people living with dementia have reduced capacity for self-performed oral hygiene and high reliance on caregivers. There was a paucity of evidence on their perceptions of oral health and quality of life, the findings of which were equivocal, with weak evidence suggesting possible difficulty in identifying and communicating their needs. Experiences of accessing dental care, when explored, appear to be system dependent. Conclusion There was limited research evidence on oral health-related practices, beliefs/views and experiences of people with dementia. Recommendations for future research are presented.

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Section: Discussionmentioning

confidence: 99%

“… 56 , 57 This may be significant for those living in their own homes and communities while being looked after by informal caregivers, mostly spouses and children, who need additional professional support and advice on how to direct timely care across dental care pathways. 57 …”

Section: Discussionmentioning

confidence: 99%

Perspectives of community-dwelling older adults with dementia and their carers regarding their oral health practices and care: rapid review

Aulakh

Curtis

et al. 2021

BDJ Open

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“…We also searched the Cochrane Library. We identified a range of systematic reviews relevant to this topic area (Albrecht et al, 2016; Hoben et al, 2017; Manchery et al, 2020; Weening‐Verbree et al, 2013). Examples of the diverse interventions reported in the reviews included managing resistance to mouth care; oral care in the prevention of pneumonia; denture disinfection; influencing staff or resident behaviours; and educational interventions.…”

Section: Methods and Resultsmentioning

confidence: 99%

Maintaining and improving mouth care for care home residents: A participatory research project

Griffiths

Devi

Cheetham

et al. 2021

Int J Older People Nursing

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Background Many people residing in nursing or residential care homes (also called long‐term care facilities) live with physical or cognitive difficulties. Staff working in these environments often help residents (particularly those with more advanced dementia) with their personal care needs, including maintaining mouth care and health. Poor oral health is associated with many difficulties, including increased risk of respiratory problems, pain and discomfort. Yet, concerns have been raised that staff may not have the knowledge and skills to effectively support residents with oral care and health. There is therefore an important gap between what is known about the importance of maintaining oral health (scientific evidence) and daily practice in long‐term care environments. Objectives To work with care home staff: (1) to create a learning culture to address how to promote mouth care for residents, particularly when a resident resists support with this aspect of care; and (2) to effect mouth care practice changes (if required) using participatory and inclusive research cycles. Methods and results We conducted a participatory research project to address this important area of care. Four participatory research ‘cycles’ were conducted. Cycle one explored existing literature to develop accessible guidance on strategies that staff could use to support residents to maintain and improve oral care, particularly when a resident may resist such care. Cycle two built on this review to determine knowledge levels within the care team. This highlighted deficiencies in staff knowledge, skills and competence for providing mouth care and their need for training to address this. Cycle three identified evidence‐based strategies to develop staff understanding and knowledge. Cycle four brought together experts from nursing, dentistry, behaviour change, systematic reviews and care homes research to develop a grant application to progress this work further. Conclusion This paper provides an example of the processes undertaken in a participatory research project, bringing together science and practice to improve an essential area of care. Implications for practice Using participatory research approaches in this setting can allow the effective translation of uncertainties in care and practice into questions that can be addressed by research, leading to meaningful outcomes for those living and working in care homes.

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“…Thus, it is quite clear that oral health status in these patients may be improved by educating the healthcare providers with the knowledge pertaining to such subjects. [ 7 ]…”

Section: Introductionmentioning

confidence: 99%

Oral Health Status and Treatment Need in Geriatric Patients with Different Degrees of Cognitive Impairment and Dementia

Kumar

Jha

Negi

et al. 2021

Journal of Family Medicine and Primary Care

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Background: Health can be defined as more than an absence or lack of disease. It is generally related to personal, physical, social, along with spiritual wellness. However, the importance of good health is comparable with a progressive physical and cognitive limitations due to aging and hence, its clear definition is not possible. Hence, most of the important aims or goals in aging are unrelated to finding a cure but rather toward achieving an optimal function. Thus, a healthy aging process that encompasses physical, mental, psychological, and spiritual well-being is always much desired. Aim and Objectives: The aim and objective of this study is to assess the oral health status and degree of cognitive impairment along with dementia, if present. Materials and Methods: This is a prospective and cross-sectional analysis comprising of 300 study participants of which 150 are males while 150 are females. Cognitive ability is assessed using the Standardized Mini-Mental State Examination (SMMSE) scoring test. A score value lesser than or equal to 23 is considered as low, whereas a score of 24 and above represents normal cognitive abilities. Subjects with low score are selected for the study. Oral health status is assessed by examining a) total numbers of teeth present; b) presence or absence of denture use; and c) capacity for masticatory or chewing ability (recorded as yes or no). Demographic variables parameters include age, gender, and presence of smoking habit. Clinical parameters or variables are analyzed by employing the independent t -test and Chi-square test. Pearson's correlation analysis is used to test a correlation between impairment of cognitive capacity, oral health status, masticatory capability, and use of dentures, if present. Two-tailed t -test is used to derive a P value for significance. Results: The total numbers of teeth present are significantly correlated with a lower SMMSE score (R = + 0.56; P = 0.03) while a significant association is noted between ability for mastication and lower SMMSE score ( P = 0.05). Conclusion: This study concluded that loss of cognition or dementia is closely related to a poor oral health status.

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Are oral health education for carers effective in the oral hygiene management of elderly with dementia? A systematic review

Cited by 26 publications

References 41 publications

Perspectives of community-dwelling older adults with dementia and their carers regarding their oral health practices and care: rapid review

Perspectives of community-dwelling older adults with dementia and their carers regarding their oral health practices and care: rapid review

Maintaining and improving mouth care for care home residents: A participatory research project

Oral Health Status and Treatment Need in Geriatric Patients with Different Degrees of Cognitive Impairment and Dementia

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