Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?

Abstract

Background There is limited information available about the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments. Aims The purpose of this study was to identify factors influencing the oral and denture hygiene and oral health of nursinghome residents with cognitive and motor impairments. Methods The study was performed in nine nursing-homes in Germany. Sociodemographic and general data were collected for all participants (n = 150). The Clinical Dementia Rating (CDR) was used to identify the presence of dementia, and the Apraxia Screening Test (AST) was used to identify motor impairment. A comprehensive dental examination was also performed. This included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMFT). In addition, dental and denture hygiene were assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI). Univariate and multivariate regression models were used to analyse possible factors affecting the dependent target variables. Results In multivariate regression analysis, the factors that most strongly influenced greater PI were a lower number of medications taken (p = 0.018), poorer general health (p = 0.013) and the presence of dementia (p < 0.010). A more advanced age (p = 0.036) and longer nursing-home stay (p = 0.048) had a negative effect on the DHI. Furthermore, gender (p = 0.037, in favour of women), poorer general health (p = 0.003), presence of dementia (p = 0.003), and the absence of natural teeth (p = 0.028) influenced poorer oral health. The factors most strongly influenced greater number of missing teeth were a more advanced age (p = 0.021) and longer nursing-home stay (p = 0.015). In terms of fewer filled teeth, a shorter nursing-home stay (p = 0.002) was the factor most strongly influenced this. Conclusions Poorer general health and the presence of apraxia and cognitive impairment are the main determinants for poorer oral hygiene and oral health among nursing-home residents. A longer nursing-home stay also seems to be relevant for oral health and denture hygiene.

Oral disease burden of dentate older adults living in long-term care facilities: FINORAL study

“…In our study, needing assistance in eating, unclear speech, and poor ability to make contact were associated with ODB severity. However, contrary to previous studies, ODB was not associated with mobility [ 35 , 36 ]. Furthermore, in line with prior studies, ODB was associated with cognitive decline [ 37 , 38 ] according to MMSE.…”

Improving oral hygiene for better cognitive health: Interrelationships of oral hygiene habits, oral health status, and cognitive function in older adults

“…cognitive impairment, dementia, long-term care, older adults, Oral Health, Oral hygiene, periodontitis, toothbrushing services (Kang et al, 2020), sweet preference, having acidic saliva pH (Manchery et al, 2022), hyposalivation (Sorensen et al, 2018), medications (Villa et al, 2015) and apraxia (Klotz et al, 2021). We, therefore, hypothesize that adequate toothbrushing has an indirect effect on cognitive function via periodontal status only in older adults without cognitive impairment (Figure S1).…”

“…A recent large sample survey suggests that adequate toothbrushing (thrice or more per day) and proximal cleaning are associated with a lower prevalence of periodontitis (Lee et al, 2018). A more likely pathway for the interrelationships between oral hygiene habits, oral health status, and cognitive function in older adults is that inadequate oral hygiene behaviours (such as brushing teeth less than twice a day) might contribute to cognitive decline due to poor periodontal status, while cognitive impairment leads to severe oral health problem because of much more complex factors, such as the impaired capacity of oral self‐care (Chen et al, 2015; Naorungroj, Slade, et al, 2013; Yoon et al, 2020), limited access to dental services (Kang et al, 2020), sweet preference, having acidic saliva pH (Manchery et al, 2022), hyposalivation (Sorensen et al, 2018), medications (Villa et al, 2015) and apraxia (Klotz et al, 2021). We, therefore, hypothesize that adequate toothbrushing has an indirect effect on cognitive function via periodontal status only in older adults without cognitive impairment (Figure S1).…”