Testing the ability for autonomous oral hygiene in hospitalized geriatric patients—clinical validation study

Abstract

Objectives This study aimed to evaluate if the Timed Test for Money Counting (TTMC) complemented with testing the range of shoulder motion by griping the backside of the neck (NG) predicts the ability of geriatric inpatients to perform effective plaque reduction by autonomously conducted oral hygiene. Material and methods This clinical validation study involved 74 hospitalized geriatric inpatients, 48 (64.9%) females, aged between 66 and 98 years (mean age 84.1 years). Oral health status was examined. Dental plaque was assessed with the Turesky modified Quigley-Hein Index (TI) on teeth and the Denture Hygiene Index (DHI) on removable dentures. The performance and duration of TTMC and NG were recorded. After autonomous tooth brushing and denture cleaning by the patient, dental plaque was scored again with the TI and DHI. Geriatric assessment data were collected from medical records. Results Forty-nine (66.2%) geriatric inpatients completed the TTMC&NG successfully. Passing the TTMC&NG was significantly associated with better plaque removal on teeth and dentures by autonomously conducted oral hygiene. The sensitivity of the TTMC&NG for above average plaque reduction was 86.4% on teeth and 77.8% on dentures. The test revealed a negative predictive value of 75.0% to detect below average plaque reduction on teeth and 72.7% on dentures. Conclusions The TTMC&NG served as a suitable predictor for the ability of geriatric inpatients to perform autonomously effective tooth brushing and denture cleaning. Clinical relevance This simple and short test might help the medical staff to identify geriatric inpatients unable to perform effective oral hygiene by themselves.

Association between risk of dysphagia and signs suggestive of sarcopenia, nutritional status and frequency of oral hygiene in hospitalized elderly

“…Such a low frequency of oral hygiene among the hospitalized elderly can be explained by the reports indicating that most of the time there is a lack of attendants or caretakers, which could have encouraged or helped the patients with their hygiene. A research study (32) addressed the issue of how many frail and medically compromised older individuals are still able to perform oral and prosthesis hygiene by themselves, and how many of them need help to perform this activity. Oral hygiene and cleaning of dentures require a certain level of manual dexterity, visual acuity, procedural and cognitive skills, along with a sufficient mobility of the shoulder as well as elbow joints.…”

Associação entre risco de disfagia e sinais sugestivos de sarcopenia, estado nutricional e frequência de higiene oral em idosos hospitalizados

“…Essa baixa frequência de higiene oral em idosos hospitalizados, apresentada no estudo, pode ser explicada pelos relatos que na maior parte do tempo eles não tinham acompanhantes ou cuidadores que poderiam incentivar ou ajudar na higienização. Uma pesquisa (32) relatou que em idosos frágeis e medicamente comprometidos, coloca-se a questão de quais destes ainda são capazes de realizar uma higiene bucal e da prótese suficiente sozinhos ou que precisam de assistência para essa atividade, pois a higienização oral e a limpeza das próteses necessitam de um certo nível de destreza manual, acuidade visual, habilidades processuais, cognitivas e mobilidade suficiente das articulações do ombro e cotovelo.…”

Prosthetic rehabilitation of geriatric patients: A case report

“…Patients with reduced cognitive abilities and dementia are more difficult for treatment, however, they should not be excluded from prosthodontic therapeutic procedures. Attention should also be paid to neurological patients in whom it is more difficult to perform certain conventional work phases of making complete dentures (8,9).…”