Comment on: Referral criteria to specialist palliative care for patients with dementia: A systematic review

Tan, Li Feng; Fen, Sara Ho Wei

doi:10.1111/jgs.17197

Cited by 3 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, treatment of oral frailty should be concentrated on preventing any further exacerbation of dental disease. An interesting case of a 90 year old man with dementia was described by Tan et al [58]. In this case, the man had "10 missing teeth, 9 dental caries, an abscess in a lower molar, and 3 teeth broken at gum level" and was receiving ONS to help with his malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Dental and oral implications of prescribed Oral Nutritional Supplements for disease related malnutrition- A systematic review

Coffey

Leary

Roberts

et al. 2023

Nutrition and Healthy Aging

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: The use of Oral Nutritional Supplements (ONS) is widespread among patients with long- and short-term medical conditions. Although ONS serve an important purpose in the management of malnutrition, their effect on the oral hard and soft tissues is not well understood. The aim of this article is to conduct an analysis of the available literature relating to ONS and their impact on the oral environment. METHODS: This study was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines adapted by Liberati. The PICO question is as follows: Population: Individuals (both children and adults) Intervention: Use of Oral Nutritional Supplements Comparison: Individuals not taking Oral Nutritional Supplements Outcome: Increased risk of oral disease (specifically dental caries, periodontal disease or candida) The research question was “Are people who take ONS at higher risk of oral diseases than the general population?” Eligibility criteria The results obtained from the literature search were filtered, according to these inclusion and exclusion criteria: Inclusion criteria • Individuals were prescribed Oral Nutritional Supplements • All studies were included, including, case– control, cohort, cross-sectional or case studies. • Studies were included if they directly compared the association between ONS and oral health i.e. Effect of ONS on the oral environment had to be one of the aims of the study • Studies on human subjects or in vitro experiments • Published in English language • Studies from 1960 to the present day Exclusion criteria • Studies not in English • Review articles and case series were excluded • Studies including the use of other nutritional supplements such as vitamin or herbal supplements were not included. • Other supplemental feeding methods such as enteral or parenteral feeding were not examined 4 databases were searched: Medline (via Ebsco), Embase, Web of Science Core Collection, Google Scholar. Risk of bias was assessed using the ROBINS-I tool. RESULTS: A total of 58 records were identified through databases and searching bibliographies. 50 publications were excluded from the review, based on study title and abstract. The full text of eight articles were assessed for eligibility. No article answered the primary aim of the systematic review. Three articles discussed the secondary aim of the systematic review and these were included in the qualitative systematic review. The main outcome of the first study showed that the ONS had higher cariogenic potential than milk due to it’s higher acidogenicity. However, there was no statistical difference in dentine demineralisation and no significant difference in viable micro-organisms present. The main outcome of the second study showed that Escherichia coli, Staphylococcus aureus and C. albicans all grew at room temperature in the dairy-based ONS collected, and that C. albicans also grew in the juice which was milk protein-free and lipid-free. The third study showed that ONS were “potentially cariogenic” on enamel. DISCUSSION: Two studies were deemed as being at “low” of bias, however another study was deemed to be at “serious” level of bias. All studies stressed the possibility of dental disease caused by oral nutritional supplements, however there is not enough research available to imply causation. Due to the high sugar content of these supplements, and the known dental implications of this, it would be beneficial to carry out more research into this area.

show abstract

Section: Discussionmentioning

confidence: 99%

Dental and oral implications of prescribed Oral Nutritional Supplements for disease related malnutrition- A systematic review

Coffey

Leary

Roberts

et al. 2023

Nutrition and Healthy Aging

View full text Add to dashboard Cite

show abstract

“…1 As they correctly indicated, "The article described a novel approach [, Adaptive Care Planning (AdaptCP),] to iteratively develop advance care planning (ACP) conversations with patients and their families." 2 Tan and colleagues raise several interesting points worth addressing.…”

mentioning

confidence: 99%

“…6,7 Fourthly, Tan and colleagues voice additional concerns "that premature ACP decisions made thinking they are flexible, transient, and adaptable as clinical conditions progress may be disadvantageous as patients may be too sick to change their ACP decisions later on." 2 We share the belief that conversations regarding goals, values, and care preferences before acute crisis are of great importance. These ongoing conversations outside of acute crisis are indeed critically important to promote coping and prognostic awareness.…”

mentioning

confidence: 99%

Reply to: Comment on: Adaptive care planning: A paradigm shift

Moody,

Bell,

Lindenberger

et al. 2024

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…To the Editor : We appreciate the opportunity to further discuss the role of specialist palliative care for patients with dementia. There are three points we would like to highlight in response to the letter by Tan and Ho 1 …”

mentioning

confidence: 99%

Reply to comment on: Referral criteria to specialist palliative care for patients with dementia—A systematic review

Hui

2021

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

Comment on: Referral criteria to specialist palliative care for patients with dementia: A systematic review

Abstract: See the Reply by https://doi.org/10.1111/jgs.17199.

Cited by 3 publications

References 10 publications

Dental and oral implications of prescribed Oral Nutritional Supplements for disease related malnutrition- A systematic review

Dental and oral implications of prescribed Oral Nutritional Supplements for disease related malnutrition- A systematic review

Reply to: Comment on: Adaptive care planning: A paradigm shift

Reply to comment on: Referral criteria to specialist palliative care for patients with dementia—A systematic review

Contact Info

Product

Resources

About