the intervention had a positive effect on oral hygiene, however the number of teeth with plaque remained high, even after the intervention. Multiple approaches based on individual needs are required to improve the oral health of vulnerable older adults, including integrating dental preventive care into daily care plan carried out by home care nurses.

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.

Being overweight is a risk factor for many chronic diseases including oral diseases. Our aim was to study the associations between oral health behavior, lifestyle factors and being overweight among young European adults, 2011–2012. The subjects constituted a representative sample of adult population aged 18–35 years from eight European countries participating in the Escarcel study. The participants completed a self-administered questionnaire on dietary habits, oral health behavior, smoking, exercise, height, and weight. Overweight was defined as body mass index (BMI) ≥ 25 kg/m2 using the World Health Organization criteria. Mean BMI was 23.2 (SD 3.48) and 24.3% of the study population were overweight. Those who were overweight drank more soft drinks (p = 0.005) and energy drinks (p = 0.006) compared with those who were non-overweight. Brushing once a day (OR 1.6; 95% CI 1.3-2.0), emergency treatment as the reason for last dental visit (OR 1.6; 95% CI 1.3–1.9) and having seven or more eating or drinking occasions daily (OR 1.4; 95% CI 1.1–1.7) were statistically significantly associated with overweight. Associations were found between oral health behavior, lifestyle and overweight. A greater awareness of the detrimental lifestyle factors including inadequate oral health habits among overweight young adults is important for all healthcare providers, including oral health care professionals.

Objective To examine the effectiveness of tailored xerostomia and nutritional 6‐month interventions on xerostomia among home care clients aged 75 years or over who were malnourished or at risk of malnutrition. Background A subjective feeling of dry mouth (xerostomia) is common among older adults and affects their quality of life, nutrition and oral health. Medical conditions, polypharmacy, dehydration and malnutrition are often underlying causes of xerostomia. Materials and Methods The data are based on the NutOrMed study with a dietary intervention group of 119 patients and control group of 97 patients. In‐home interviews were carried out by home care nurses, nutritionists, dental hygienists and pharmacists and tailored interventions by nutritionist and dental hygienists. Xerostomia intervention included individual counselling on dry mouth care and was applied to all those suffering occasionally or continuously from xerostomia (57%, n = 66) in the intervention group. Nutritional intervention was applied to all participants in the intervention group, and it included instructions on increasing the number of meals, energy, protein intake and liquid intake. Results Among participants who received both interventions, xerostomia decreased by 30% and malnutrition or risk of malnutrition decreased by 61%. The interventions were highly significant (OR 0.1, 95% CI: 0.06; 0.2) in reducing xerostomia. Conclusions Home care clients suffering from xerostomia profited significantly from tailored xerostomia and dietary interventions. Evaluation and treatment of xerostomia are important among older persons who are malnourished or at risk of malnutrition as a part of a comprehensive health intervention to improve their nutrition and oral health.

BackgroundA reform to Dental Care legislation in 2002 abolished age limits restricting adults’ use of public dental services in Finland. In the Public Dental Service (PDS) unit of Espoo, the proportion of adult patients rose from 36% to 57%. The aim of this study was to investigate heavy use of dental services by adults and its determinants.MethodsA longitudinal cohort study was undertaken based on a PDS patient register. Of all adults who attended the PDS in Espoo in 2004, those who had six or more visits (n=3,173) were assigned to the heavy user group and a comparison group of low users (n=22,820) had three or fewer dental visits. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and type of visit, oral health status and treatment provided was collected from treatment records. Each group was followed-up for five years and information on the number and types of visit was recorded for each year from 2005 to 2009.ResultsMost heavy users (61.6%) became low users and only 11.2% remained chronic heavy users. Most low users (91.0%) remained low users. For heavy users, the mean number of dental visits per year (3.0) during the follow-up period was significantly lower than initially in 2004 (8.3) (p<0.001) but 74.8% of heavy users had had emergency visits compared with 21.6% of the low users (p<0.001).A third (33%) of the visitors in each group had no proper examination and treatment planning during the 5-year follow-up period and two or more examinations were provided to fewer than half of the heavy (46.1%) or low (46.5%) users.The mean number of treating dentists was 5.7 for heavy users and 3.8 for low users (p<0.001).ConclusionsFrequent emergency visits were characteristic of heavy users of dental services. Treatment planning was inadequate, probably partly due to the many dentists involved and too many patients requesting care. Better local management and continuous education are needed to ensure good quality adult dental care and to reduce heavy consumption.

Aims The purpose was to examine the prevalence and determinants of self‐reported eating problems in old home care clients, screened separately by a clinical nutritionist and a dental hygienist. Methods and Results The data came from the Nutrition, Oral Health and Medication (NutOrMed) study, the participants of which were ≥75‐year‐old home care clients living in Finland. The structured interviews were conducted at the participants' (n = 250) homes. Of the participants, 29% reported poor appetite, 20% had problems with chewing, and 14% had problems with swallowing when asked by a clinical nutritionist. Additionally, 18% reported oral health‐related eating problems when asked by a dental hygienist. Participants with continuous xerostomia (odds ratio [OR]: 3.0, 95% confidence interval [CI]: 1.0–9.0) or poor self‐reported oral health (OR: 4.3, 95% CI: 1.4–13.0) had a higher risk for problems with chewing when asked by a clinical nutritionist. Edentulous participants (OR: 3.5, 95% CI: 1.2–10.9) and participants with toothache or problems with dentures (OR: 10.3, 95% CI: 4.0–26.0) had a higher risk for oral health‐related eating problems when asked by a dental hygienist. Conclusion Eating problems are common in older adults, and interprofessional collaboration is required for their identification and alleviation.

No abstract