Effectiveness of Individual Oral Health Care Training in Hospitalized Inpatients in Geriatric Wards

Abstract

Objective: To investigate the effectiveness of individual oral health care training (IndOHCT) on dental plaque removal and denture cleaning in hospitalized geriatric inpatients. Background: The literature reveals neglect of hygiene and oral care in people aged over 65 years, especially in persons in need of care. Hospitalized geriatric inpatients have poorer dental health than those non-hospitalized. Furthermore, the existing literature reporting on oral healthcare training interventions for hospitalized geriatric inpatients is scarce. Materials and Methods: This pre-post-controlled intervention study dichotomized 90 hospitalized geriatric inpatients into an intervention group (IG) and a control group (CG). Inpatients in the IG received IndOHCT. Oral hygiene was assessed using the Turesky modified Quigley–Hein index (TmQHI) and the denture hygiene index (DHI), at baseline (T0), at a second examination (T1a), and after supervised autonomous tooth brushing and denture cleaning (T1b). The influence of the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Barthel Index (BI) scores on oral hygiene was examined. Results: There was no significant plaque reduction on teeth or dentures between T0 and T1a in either group. Between T1a and T1b, plaque reduction on the teeth was more effective in the IG than in the CG (p < 0.001). Inpatients with 1–9 remaining teeth removed significantly more dental plaque than inpatients with 10 or more remaining teeth. Inpatients with lower MMSE scores (p = 0.021) and higher age (p = 0.044) reached higher plaque reduction on dentures. Conclusions: IndOHCT improved oral and denture hygiene in geriatric inpatients by enabling them to clean their teeth and dentures more effectively.

Exploring the integration of dentistry within a multidisciplinary palliative care team: does bedside dental care improve quality of life and symptom burden in inpatient palliative care patients?

“…The implementation of effective oral healthcare in clinical palliative care is a multidisciplinary challenge that extends beyond routine consultation with a dentist. A key strategy to improve the oral health of palliative care patients is the targeted training of caregivers, as suggested by Viebranz et al [ 27 ]. This study emphasises the positive effects of individualised oral hygiene training on oral and denture hygiene in geriatric patients, highlighting the need to educate caregivers in the recognition and treatment of oral disease.…”

Oral health assessment in institutionalized elderly: a scoping review

“…Eleven studies used other periodontal measures: measurements according to the National Institute of Dental Research Criteria [53], the Periodontal Screening Index [44,58,59], Dutch Periodontal Screening Index [71], Extent and Severity Index [52] and The Miller Index score [45,76]; -National Institute of Dental Research Criteria; examination of 6 teeth on 6 sides and assessing presence or absence of dental plaque, gingival bleeding, supraand subgingival calculus, as well as probing pocket depth [53]. -Periodontal Screening Index [26]: screening 6 points per tooth and per sextant ranging from 0-4 based on probing depth, bleeding on probing and calculus.…”

“…The (modified) plaque index, using grades 0-3, distinguished no plaque to visible layers of plaque [39,41,50,60,71,80,86,88,94,99,101]. A more detailed index was the Quigley-Hein plaque index, which includes all teeth except third molars [58,86]. Each surface was scored between 0 (no plaque) and 5 (two-thirds of the surface).…”

“…Another instrument used was the Missisippi OHI, which used plaque disclosing agent, and divided each tooth in 5 sections, which were all scored [47]. In case of edentulous elderly a specific denture hygiene index could be used [32,40,41,55,58,81,83,98], using either grades or a percentage to express cleanliness. A different method for determining oral hygiene was scoring food debris [86] or using the debris index [40,43,83,90].…”