Occurrence of oral health problems and planned measures in dependent older people in nursing care

Rantzow, Veronica; Andersson, Pia; Lindmark, Ulrika

doi:10.1111/jocn.14584

Cited by 17 publications

(23 citation statements)

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“…In studies using the same assessment tool as used in the current study, that is the ROAG, individuals with oral health problems varied between 11% and 30%. 15,53,54 The difference between the current study and previous studies could be explained by the difficulty in using the ROAG as a screening tool within nursing care or in different contexts of the study populations. 55 However, oral problems are very common in older people, especially frail older adults 4,5 and those with cognitive disorders.…”

Section: Discussioncontrasting

confidence: 61%

“…Most of the older people in current study were healthy, that is no risk of oral health problems. In studies using the same assessment tool as used in the current study, that is the ROAG, individuals with oral health problems varied between 11% and 30% 15,53,54 . The difference between the current study and previous studies could be explained by the difficulty in using the ROAG as a screening tool within nursing care or in different contexts of the study populations 55 .…”

Section: Discussionmentioning

confidence: 63%

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Oral health is essential for quality of life in older adults: A Swedish National Quality Register Study

et al. 2020

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Increased life expectancy for people aged 65 or older is a fact worldwide. [1][2][3] Oral diseases such as dental caries, periodontitis and dry mouth are highly prevalent in older adults, and the risk of tooth loss in old age is high. 4,5 Oral disease measured by dental professionals is only one perspective of oral health and does not include a person's experiences of oral health in relation to their context or situation. Furthermore, oral health problems may have social, economic and psychological consequences and thus also have an impact on quality

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 63%

Oral health is essential for quality of life in older adults: A Swedish National Quality Register Study

et al. 2020

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“…To collect the presented data, dentists used a standard dental mirror and a dental explorer. Caregivers did not apply any diagnostic instruments 1 In patients without teeth or implant-based retainers, gum tissue of the edentulous ridges was assessed 2 Registrations were not considered in the analysis if the outcome was absent 3 Arithmetic mean over all caregivers…”

Section: Discussionmentioning

confidence: 99%

“…International research consistently reports poor oral health in care-dependent older individuals [1][2][3][4]. This causes oral infection and tooth loss and finally results in compromised oral functioning [5] and reduced quality of life [6,7].…”

Section: Introductionmentioning

confidence: 99%

Assessment of oral health in older adults by non-dental professional caregivers—development and validation of a photograph-supported oral health–related section for the interRAI suite of instruments

et al. 2020

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Objectives An optimized oral health-related section and a video training were developed and validated for the interRAI suite of instruments. The latter is completed by professional non-dental caregivers and used in more than 40 countries to assess care needs of older adults. Methods The optimized oral health–related section (ohr-interRAI) consists of nine items and a video training that were developed in consecutive phases. To evaluate psychometric properties, a study was conducted in 260 long-term care residents. Each resident was assessed by a dentist and by four caregivers (two who received the video training, two who did not). Results Mean kappa values and percent agreement between caregivers and dentist ranged between κ = 0.60 (80.2%) for dry mouth and κ = 0.13 (54.0%) for oral hygiene. The highest inter-caregiver agreement was found for dry mouth with κ = 0.63 [95% CI: 0.56–0.70] (81.6%), while for the item palate/lips/cheeks only κ = 0.27 [95% CI: 0.18–0.36] (76.7%) was achieved. Intra-caregiver agreement ranged between κ = 0.93 [95% CI: 0.79–1.00] (96.4%) for dry mouth and κ = 0.45 [95% CI: 0.06-0.84] (82.8%) for gums. Logistic regression analysis showed only small differences between caregivers who watched the video training and those who did not. Conclusions Psychometric properties of the optimized ohr-interRAI section were improved compared to previous versions. Nevertheless, particularly the items based on inspection of the mouth require further refinement and caregiver training needs to be improved. Clinical Relevance Valid assessment of oral health by professional caregivers is essential due to the impaired accessibility of regular dental care for care-dependent older adults.

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“…Moreover, the chances of oral symptoms being omitted, under-rated, and exaggerated by the examiner in both direct inspection and interview approaches may create discrepancy leading to false conclusions [70]. The variation in cognitive level and behaviour problems among nursing home residents evolve complexity in oral health screening [71]. Moreover, challenges may arise due to the lack of communication, co-operation, and self-reporting [26].…”

Section: Nomentioning

confidence: 99%

The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review

2021

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Background Globally, oral health status of the geriatric population residing in nursing homes is poor. The integration of non-dental professionals is vital to monitor oral health, early identification and triaging of oral health problems, and timely referral to dental professionals. The aims of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of their psychometric properties. Methods This review was conducted as per the PRISMA guidelines. CINHAL (EBSCO), Medline (Ovid), and EMBASE (Ovid) were searched systematically. Two reviewers independently screened the title, abstract, and full text of the studies as per the eligibility criteria. Studies describing oral health assessment instruments used to assess oral health of nursing home residents by non-dental professionals were included. Using a methodological framework, each instrument was evaluated for purpose, content, and psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness. Additionally, the reporting quality assessment of each included study was performed according to the SURGE guidelines. Results Out of the 819 screened articles, 10 studies were included in this review. The 10 identified instruments integrated 2 to 12 categories to assess oral health, which was scored on a 2 to 5-point scale. However, the measurement content varied widely, and none were able to comprehensively measure all aspects of oral health. Three measurement approaches were identified: performance- based assessment, direct inspection of the oral health status, and interview measures. Only eight instruments provided quality assessment on the basis of validity, reliability, feasibility and generalisability, whereas three instruments- Brief Oral Health Status Examination, Dental Hygiene Registration, and Oral Health Assessment Tool reported good methodological quality on at least one assessment criteria. Conclusions None of the instruments identified in this review provided a comprehensive assessment of oral health, while three instruments appeared to be valid and reliable. Nonetheless, continuous development of instruments is essential to embrace the complete spectrum of oral health and address the psychometric gaps.

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Occurrence of oral health problems and planned measures in dependent older people in nursing care

Abstract: The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes.

Cited by 17 publications

References 30 publications

Oral health is essential for quality of life in older adults: A Swedish National Quality Register Study

Oral health is essential for quality of life in older adults: A Swedish National Quality Register Study

Assessment of oral health in older adults by non-dental professional caregivers—development and validation of a photograph-supported oral health–related section for the interRAI suite of instruments

The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review

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