PurposeThe objective of this cross-sectional study was to evaluate the effect of prosthetic status on the oral health-related quality of life (OHRQoL) of nursing home residents with or without dementia.MethodsThe study was performed in 14 nursing homes across the federal state of Baden-Württemberg, Germany. All eligible participants were included, and general and medical information and information about their dental and prosthetic statuses were collected. The Geriatric Oral Health Assessment Index (GOHAI) was administered to evaluate OHRQoL. The Mini-Mental State Examination (MMSE) served to classify participants into living or not living with dementia according to the established cutoff value for dementia (MMSE <24). Parametric bivariate statistics and logistic regression models were used to analyze data at P<0.05.ResultsA total of 169 participants were included in this study. The mean age of the participants was 82.9 years. A total of some 70% of the sample was living with dementia. The mean GOHAI score along the sample was 49.1 (8.3), and 41% of the sample reported substantially compromised OHRQoL (GOHAI <50). OHRQoL was statistically similar for people with or without dementia (P=0.234); objective oral health was also similar in both groups (P>0.05). The number of teeth (odds ratio [OR]: 2.0), the type of prosthetic status (OR: 6.5), and denture-related treatment needs (OR: 2.4) were the major factors significantly affecting OHRQoL (P<0.05).ConclusionThe OHRQoL of elderly nursing home residents is substantially compromised. Several prosthetic treatment needs for residents living with or without dementia were identified. Edentulism without tooth replacement and having <5 teeth resulted in an increased risk of substantially compromised OHRQoL. Further studies should be conducted to determine whether improvements in prosthetic status can increase OHRQoL.

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Background To evaluate early failure and possible risk factors for failure of dental implants placed under practice-based conditions. Methods To clarify the research question, anonymized data from 106 patients with 186 dental implants were analyzed. The presence of sucessful healing (yes/no) at the time of incorporation of the final prosthesis was assessed. Mixed models were compiled for each target variable to enable estimation of the effects of patient-related and implant-related conditions on the risk of early implant failure. Results Nine out of 186 implants (4.8%) placed in 106 participants failed before incorporation of the final prosthesis. The use of shorter implants (< 10 mm) and the need for augmentation procedures were associated with a greater risk of early implant failure. For shorter implants, the risk was 5.8 times greater than that for longer implants ( p = 0.0230). Use of augmentation procedures increased the risk by a factor of 5.5 ( p = 0.0174). Conclusions Implants placed in the dental practice with a specialization in implantology heal successfully. The use of augmentation procedures and of implants shorter than 10 mm seems to be associated with a greater risk of early implant failure.

Background:The oral health of seniors in nursing homes is compromised.Furthermore, reduced chewing efficiency is described to be associated with reduced cognition. However, studies investigating how prosthetic status affects the chewing efficiency of nursing home residents are not available.Objective: To evaluate associations between prosthetic status, dementia and chewing efficiency of seniors in nursing homes. Methods:This study was performed in nine nursing homes. In addition to assessing the general and medical data of the participants, a dental examination was assessed and the severity of dementia was evaluated by use of the Clinical Dementia Rating (CDR). Furthermore, chewing efficiency was assessed by use of a two-colour mixing ability test. Descriptive and bivariate statistics, as well as linear regression models with the dependent variable chewing efficiency and possible confounders, were used to analyse data at P < .05. Results:Complete target variables of 146 participants were analysed. The mean (SD) chewing efficiency of the study sample, as expressed by the variance of hue, was .590 (.250). The type of prosthesis used (P < .001), the number of occluding tooth pairs (P < .001) and the presence of dementia (P = .002) were the main variables significantly affecting chewing efficiency. The condition of removable dentures also had an effect (P = .016). Multivariate testing predominantly confirmed these associations. Conclusion:The chewing efficiency of seniors in nursing homes is somewhat compromised. Beyond dental aspects, suffering from dementia seems to reduce the chewing efficiency. Further interventional/longitudinal studies are, however, encouraged to verify this outcome. K E Y W O R D Sclinical dementia rating, chewing efficiency, dementia, dental prostheses, nursing home, twocolour chewing gum test

Objective: To evaluate the repeatability, interexaminer, and interdevice reliability of two clinically applicable spectrophotometers under laboratory and clinical conditions.Material and Methods: For the in vitro part of the study, measurements were performed by the use of Vita Easyshade Advance 4.0 (ES-A) and the Easyshade V (ES-V) at identical positions on different shade tabs (3D-Master; Vita Zahnfabrik, Bad Säckingen, Germany). To test repeatability, one shade tab was measured 50 times by one operator. To determine interrater and interdevice agreement, two operators used both devices to perform 10 measurements on five different shade tabs. Clinical interdevice and interexaminer reliability was checked with a positioning jig used (15 participants). Measurement accuracy of both devices was evaluated for the recommended color of shade tabs.Results: Repeatability of results from both Easyshades was excellent for all color components (maximum deviation between measurements was ≤0.1 units). Interrater agreement was also perfect (intraclass correlation, ICC = 1.000). Interdevice agreement was lower, but still good (ICC ≥ 0.834). In the clinical environment, interrater and interdevice agreements were similar (ICC > 0.964 and ICC > 0.873). Accuracy was satisfactory for both devices, with both observers in full agreement for nearly 80% of ratings.Conclusions: Both Easyshades produced reliable and accurate measurements and can therefore be recommended for clinical determination of tooth color.

Oral hygiene and oral health seem to affect the risk of mortality of nursing home residents. Dental intervention programs seem to reduce the risk of 1-year mortality among nursing home residents having remaining natural teeth. Further studies, with larger sample sizes and evaluation of the causes of death, are necessary to investigate the reasons for these associations.

The purpose of this study was to identify how changes to general health might affect the oral health of nursing-home residents over a six-month period. Materials and Methods: The study was conducted in nine nursing homes in Germany. Sociodemographic and general data were collected at baseline and after six months. Complete baseline and follow-up data were available for 114 participants. The Clinical Dementia Rating (CDR) and the Global Deterioration Scale (GDS) were used to identify the presence and, if applicable, severity of dementia among participants. The Apraxia Screen of TULIA (AST) was used to identify motor impairment. A comprehensive dental examination of each participant was also performed. The examination included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMF-T). In addition, dental and denture hygiene were quantitatively assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI), respectively. Global dental treatment needs were evaluated by use of the Oral Health Assessment Tool (OHAT). Univariate and multivariate linear regression models were compiled to analyse possible factors affecting the dependent target variables. Results: During the study period, denture hygiene among the study population worsened by an average of 15%. The regression models detected that a more advanced age (in years) was associated with a less pronounced deterioration of denture hygiene as measured by use of the DHI (−0.806 per additional year of age; p = 0.030). Furthermore, an increase in the level of care needed (coefficient (C): −1.948; p = 0.002) and a more poorly graded assessment of general health compared with the value at baseline (C: 1.054; p = 0.026) were both associated with a deterioration of oral health as evaluated by use of the OHAT. In addition to these results, an increase in care needs was also associated with a deterioration of dental health as evaluated by use of the DMF-T (C: 0.966; p = 0.013). Conclusion: In the short term, a deterioration of general health, including an increase in care needs, seems to be the predominant factor associated with a more pronounced deterioration of oral health among nursing-home residents.

OHRQoL seems to be a substantial predictor of subjective well-being in quinquagenarians and septuagenarians across the rather long observational period. Further studies with larger sample sizes are required to confirm this finding.