Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients

Salmi, Riikka; Tolvanen, Mimmi; Suhonen, Riitta; Lahti, Satu; Närhi, Timo

doi:10.1111/scs.12579

Cited by 12 publications

(19 citation statements)

References 25 publications

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“…There are still many barriers that compromise the oral health of frail elderly people, such as means of transportation, underestimation of dental health problems and attitudes of caregivers towards oral care 41. Recent studies have shown that even if caregivers feel comfortable with regard to their oral health background and daily practices, they have expressed a need for additional training in several areas 41,42,43,44. Salmi et al found that over 50% of home care nurses had a need for further education about oral home care.…”

Section: Discussionmentioning

confidence: 99%

The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients

Tuuliainen

Nihtilä

Komulainen

et al. 2019

Scandinavian Caring Sciences

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The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients Background: Increasing numbers of frail elderly people living at home but dependent on supportive care will face complex oral health challenges. Objectives: To investigate the associations of frailty status with oral cleaning habits and oral hygiene taking into account the effects of preventive oral health intervention among home care clients aged 75 or over. Methods: Data were gathered by interviews and clinical oral examinations at baseline and after a 6-month follow-up. Frailty status was evaluated at baseline using the abbreviated comprehensive geriatric assessment (aCGA) scale, which consists of 15 questions from three different domains: cognitive status, functional status and depression. A total of 231 home care clients completed the aCGA at baseline and the interview and clinical oral examination both at baseline and after the follow-up. Results: Using the aCGA classification with at least one score in the ≥2 domain, 62% of clients were classified as frail at baseline. They had poorer oral cleaning habits and hygiene, and they had lost more teeth than nonfrail participants. Multivariate analysis showed that being frail at baseline was statistically significantly associated with a lower frequency of toothbrushing and denture cleaning (OR = 0.4, 95% CI = 0.1-0.9 and OR = 0.3, 95% CI = 0.1-0.8) at baseline, but not after the follow-up. Membership in the intervention group was associated with better oral cleaning at the follow-up. However, among the frail participants, toothbrushing frequency was still significantly lower and oral hygiene poorer than among the nonfrail group. Conclusions: Oral cleaning habits of frail elderly people were slightly improved as a result of external support, which had a positive effect on oral hygiene. Individual preventive actions in the context of oral health and hygiene should be integrated into the daily care plan of home care clients with the first signs of frailty.

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Section: Discussionmentioning

confidence: 99%

The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients

Tuuliainen

Nihtilä

Komulainen

et al. 2019

Scandinavian Caring Sciences

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“…Although the participating individuals already had relatively good oral hygiene as reflected by gingival inflammation with bleeding on probing approaching 27–28%, this was reduced by more than half after only two weeks of dietary change. In addition to conventional care, that include oral bacteria control [ 40 ], in office ultrasonic instrumentation [ 41 ] and home care protocols [ 42 ] also diet has to be considered a crucial factor for the maintenance of healthy oral conditions. Since periodontitis is an inflammatory condition associated with insulin resistance the fast and vast impact on dental health by the OBND ® this kind of intervention should be regarded as an important facet in the treatment regimen of T2D.…”

Section: Discussionmentioning

confidence: 99%

Improved General and Oral Health in Diabetic Patients by an Okinawan-Based Nordic Diet: A Pilot Study

Holmer

Widén

Bengtsson

et al. 2018

IJMS

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Periodontal disease, periodontitis as well as the preceding gingivitis, has been associated with both obesity and diabetes. Studies have shown that diet changes can lead to a lower incidence of such inflammation. The aim of the present case series over four weeks was to study the effects on medical and dental conditions in patients with type 2 diabetes of the consumption of the Okinawan-based Nordic Diet (OBND®). Medical and dental examinations were performed to estimate the general health and gingivitis/periodontitis. Serum cytokine levels were assessed using Luminex technology. Eight of ten study participants completed the study. All participants lost weight (p = 0.012). Six out of seven that were treated with insulin could reduce their insulin intake after two weeks with OBND®. The reduction was about 16 units which corresponds to a 34% relative reduction compared to the starting point (range 15–63%). Fasting blood glucose values fell (p = 0.035). Hemoglobin A1c (HbA1c) (p = 0.01), triglycerides (p = 0.05), and low-density lipoprotein (LDL) (p = 0.05) were also reduced. Bleeding on probing changed from ~28% before any dietary changes to ~13% after two weeks with OBND® (p = 0.01). The reduction in gingival bleeding was as substantial as might be expected from one session of professional tooth cleaning. Markers of inflammation were also reduced. The OBND® thus showed significant promise in alleviating the impact of diabetes on dental as well as general health.

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“…Samson et al (2009) 46 showed that improved knowledge among nursing staff contributed to improved oral hygiene among the care-dependent elderly and Coker et al (2014) 47 addressed the importance of further studies about improving nurses’ ability to perform oral hygiene care in elderly patients. However, the participation of nursing staff in questionnaire-based studies is challenging due to low response rates, 48 , 49 which was also experienced in the present study. The reasons for dropouts could be changes in workplace, lack of interest and lack of time.…”

Section: Discussionmentioning

confidence: 90%

<p>Effects of Domiciliary Professional Oral Care for Care-Dependent Elderly in Nursing Homes – Oral Hygiene, Gingival Bleeding, Root Caries and Nursing Staff’s Oral Health Knowledge and Attitudes</p>

Croonquist¹,

Dalum²,

Skott³

et al. 2020

CIA

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Purpose The primary aim was to describe the effects for nursing home residents of monthly professional cleaning and individual oral hygiene instruction provided by registered dental hygienists (RDHs), in comparison with daily oral care as usual. The secondary aim was to study the knowledge and attitudes among nursing staff regarding oral health care and needs. Patients and Methods In this randomised controlled trial (RCT), 146 residents were recruited from nine nursing homes in Regions of Stockholm and Sörmland and were randomly assigned (on nursing home level) to either intervention group (I; n=72) or control group (C; n=74). Group I received monthly professional cleaning, individual oral hygiene instructions and information given by an RDH. Group C proceeded with daily oral care as usual (self-performed or nursing staff-assisted). Oral health-related data was registered with the mucosal-plaque score index (MPS), the modified sulcus bleeding index (MSB), and root caries. The nursing staff’s attitudes and knowledge were analysed at baseline and at six-month follow-up. Statistical analysis was performed by Fisher’s exact test and two-way variance analysis (ANOVA). Results Improvements were seen in both Group I and Group C concerning MPS, MSB and active root caries. The nursing staff working with participants in Group I showed significant improvements regarding the Nursing Dental Coping Beliefs Scale (DCBS) in two of four dimensions, oral health care beliefs (p=0.0331) and external locus of control (p=0.0017) compared with those working with Group C. The knowledge-based questionnaire showed improvement ( p =0.05) in Group I compared with Group C. Conclusion Monthly professional oral care, combined with individual oral health care instructions, seems to improve oral hygiene and may reduce root caries among nursing home residents. This may also contribute to a more positive attitude regarding oral hygiene measures among nursing home staff, as compared with daily oral care as usual.

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Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients

Abstract: 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.

Cited by 12 publications

References 25 publications

The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients

The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients

Improved General and Oral Health in Diabetic Patients by an Okinawan-Based Nordic Diet: A Pilot Study

<p>Effects of Domiciliary Professional Oral Care for Care-Dependent Elderly in Nursing Homes – Oral Hygiene, Gingival Bleeding, Root Caries and Nursing Staff’s Oral Health Knowledge and Attitudes</p>

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