ObjectivesThe oral health of nursing home residents is poor for various reasons. Many require help for oral hygiene. Regular professional brushing by a dental nurse should improve oral hygiene. This study aimed to determine the efficacy of regular tooth brushing by a dental nurse on the oral health of nursing home residents.MethodsThis controlled trial randomized participants (n = 50; mean age 83 ± 8 years) to brushing by a dental nurse every 2 weeks for 3 months (n = 25; test group) or oral hygiene procedures performed/controlled by nursing home staff (n = 25; control group). Personal, general and oral health, as well as various oral hygiene parameters—plaque index (PI), gingivitis index (GI), papilla bleeding index (PBI), oral hygiene index (OHI) and Volpe‐Manhold Index (VMI)—were evaluated at baseline, after initial professional dental cleaning and before last brushing.ResultsAt baseline, oral health was impaired according to investigated indices in both groups. After professional brushing for 3 months, there were improvements in PI, GI and PBI, with significant increases compared with the control group in OHI and VMI (P = 0.017 and P < 0.001, respectively). Among the control group, the number of teeth decreased while the root caries index increased (P = 0.002 between groups).ConclusionsRegular professional brushing every 2 weeks by a dental nurse can be recommended for nursing homes residents to improve oral health parameters and to help reduce root caries incidence as a basis to preserve the number of teeth. Such oral hygiene procedures will maintain and improve the oral health of nursing home residents.
Candida albicans secretes phospholipases, which are considered to be one of the mediators of cell penetration. It is known that other phospholipases from mammalian cells can be inhibited by lipophilic beta-blocking structures. As the result of a synthesis programme of several years' duration, structures deriving from beta-hydroxyethylamines were introduced. In vitro and in vivo results with these compounds are presented in comparison with standard antimycotics. In combination with fluconazole, several of the compounds can prevent death in mice infected with lethal inocula of C. albicans. Histological examinations confirm the inhibitory effect of the beta-blocker-like structures on tissue penetration. The structures therefore constitute new antimycotics that are endowed with extensive in vitro effectiveness against fungi and also definite in vivo effects in the animal model.
Professional dental cleaning is an efficacious and accepted method as a first step in line with strategies to improve oral health and should be considered in nursing home residents.
ObjectivesOlder people are at increased risk of intraoral yeast colonization. In this observational case series, we assessed Candida colonization among nine nursing home residents to investigate possible correlations with their individual characteristics, general health parameters, and oral care. We also described the effect of professional dental cleaning (PDC) including prosthesis cleaning on colonization cases.Materials and methodsGeneral clinical and oral health was assessed in nine residents, and samples were taken from six oral mucosa sites or prosthetic surfaces. PDC was performed to achieve macroscopically clean results, and residents were re‐examined 2 weeks later.ResultsWe found that six residents were intraorally colonized with Candida albicans; four also had Candida glabrata. Prostheses were particularly infected. Dementia, multimorbidity, and presence of prostheses reduced oral hygiene ability; requiring assistance for oral hygiene care was a risk indicator for Candida colonization. PDC reduced C. albicans (at the expense of increased C. glabrata) but was not optimal for maintaining Candida reduction.ConclusionIn this pilot study, Candida colonization is prevalent among nursing home residents, especially those with cognitive impairment, multimorbidity, or reduced oral hygiene capacity. Potential negative effects on general health necessitate diagnostic and therapeutic guidelines. PDC alone did not maintain the reduction in Candida colonization; additional methods for daily oral care are necessary.
Aim We aimed to describe time requirements and costs associated with professional dental cleaning (PDC) performed by a dental nurse in one German nursing home, and to reveal potential differences in required time for demented versus nondemented and mobile versus immobile residents. Methods and results We performed a retrospective, cross‐sectional analysis of treatment time and costs, including a transparent, easily adaptable path of action that allows implementation of PDC in nursing homes. Total mean (±SD) treatment time for one session per resident was documented, including differences in demented and immobile residents, and projected treatment costs (€/$) per resident. We found no differences in required time for one PDC (37 ± 11 minutes) in residents with or without dementia (P = 0.803) or, immobile versus mobile residents (P = 0.396). Mean projected treatment costs of PDC were €14.98/$17.07 per resident per cleaning session, resulting in total costs of €13.5 million ($15.4 million). Conclusion Cognitive status and mobility does not affect the mean time required to perform PDC by a dental nurse in nursing home residents. Main cost factor is working time of dental staff; consumable supplies have less impact. Our data may stimulate to include PDC as initial step toward implementation of long‐term oral hygiene strategies.
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