Evaluation of an oral health service for nursing home residents

Abstract

The purpose of this study was to evaluate a comprehensive, on-site, oral health care program for nursing home residents. Before and after a 1-year evaluation period the elderly residents in the nursing home (NH-1) were interviewed and examined clinically. A comparable control group comprising the elderly residents in another nursing home (NH-2) were also interviewed and clinically examined before and after a 1-year period. The main objectives of the program were to increase the utilization of the dental care system, to meet the need for immediate attention, to improve oral hygiene, to reduce the prevalence of oral mucosal lesions, gingivitis, and untreated decay, and to meet the realistic prosthodontic treatment need. All the elderly residents accepted a yearly examination by a dentist, and 50% were treated in NH-1 during the evaluation period, compared with 16% in NH-2. The need for immediate attention was reduced by 56% in NH-1 and had increased by 20% in NH-2. Whether the activities in NH-2 qualify as an oral health program with on-site examinations and referral for treatment outside the institution is discussed. The annual cost per resident during the evaluation period was a little more in NH-2 than in NH-1. The conclusion is that oral health improved during the observation period in both nursing homes. The rate of participation and the improvement in oral health was most evident in NH-1.

Development and evaluation of two root caries controlling programmes for home‐based frail people older than 75 years

“…Reports from the 1980s and 1990s 3,4 indicate that the Danish Dental Health System was not designed to provide care for an increasing number of frail, dependent dentate elderly patients. Thus, in the mid 1990s the Danish Parliament put into force an Act (Act of 1993) which decreed that the Public Dental Health Service (PDHS) should offer dental services to functionally dependent, elderly persons, either at home or in nursing homes.…”

“…Similar oral health problems have been described from other industrialised countries, for example, in Australia 5 . Both here and in Denmark irrespective of their differences in social and cultural background and in the structure of the dental health care systems, root caries in elderly people seems to be a major problem [2][3][4][5] . Therefore the main aim of the present study was to evaluate two approaches to control root caries lesions in elderly persons living at home.…”

Effectiveness of health care worker training on the oral health of elderly residents of nursing homes

“…A lack of training about oral health and disease in both undergraduate and postgraduate nursing curriculae has been identified as a major barrier to providing adequate oral care (19, 23–25). Oral health education programmes offered to care staff can positively affect their ability to perform oral hygiene procedures (26–28). In addition to theoretical knowledge, practical training should also be included (11, 29–31).…”

“…Several published studies have evaluated the effectiveness of oral care training programmes delivered to the carers of dependent elderly persons but not all have demonstrated a positive effect on staff ability to perform oral hygiene procedures and on patients’ oral health (26–28, 32–35). Clearly, promoting change in practice is a complex issue, with factors such as personnel attitude to oral care having to be addressed (36).…”

Improving oral health in institutionalised elderly people by educating caregivers: a randomised controlled trial

“…Practical training for nurses and auxiliary care staff has frequently been recommended as a way of improving oral health care for functionally dependent clients (2,4,5,9,22). Among the few training programmes evaluated by reference to levels of oral health in clients, results have varied from having little impact (23,24) to achieving progressive improvement (25).…”