Impact of care level, setting and accommodation costs on a newly developed oral care nursing plan format for elderly patients with care needs – Results from a cross‐sectional study

Abstract

Objectives: A new oral care nursing plan format for improved communication among dentists, nursing staff and caregivers has been developed in Germany. We aimed to (1) describe this plan, (2) investigate the prevalence of oral health problems among elderly patients with care needs documented by the plan, outline the recommendations in the plans and (3) investigate whether the accommodation costs or care needs of patients influenced oral care quality or the need for oral hygiene support documented within the plan. Methods: In this cross-sectional trial, oral care nursing plans were collected from outpatient and inpatient care clinics. Items on the oral care nursing plan were divided into three areas (oral health, oral hygiene needs, and coordination needs and dental therapy) and were correlated with the care level and accommodation costs. Results: Oral care nursing plans were collected from seven dentists (N = 747; 94.5% from inpatient and 5.5% from outpatient care). The plans enabled documentation of well-known oral health and hygiene problems among elderly patients. In their current form, the plans provided recommendations for obvious oral hygiene tasks such as toothbrushing or fluoridating, rather than specialized tasks such as nutritional advice or dry mouth asymptomatic therapeutic approaches. Although accommodation costs were associated with the need for oral hygiene support (not with oral care condition), the care level influenced both measures. Conclusions: The oral care nursing plan can facilitate documentation of oral health and hygiene among elderly individuals with care needs. Further clarification of the plan would help promote careful documentation by dentists. Keywords: ageing; home care services; housing for the elderly; oral diagnosis; oral hygiene.

Oral health assessment in institutionalized elderly: a scoping review

“…Oral health status, oral care status, oral status 3 [87,92,97] -Oral health status scored as poor/medium/good, based on several clinical aspects (dental visits/oral mucosa condition/presence of teeth) [97] -Oral care status of teeth, mucous membranes and dentures scored as good/fair/poor [92] -Presence of oral status problems: gingivitis, caries, tooth fracture [87] Table 1 (continued)…”

“…Oral health index 1 [71] Oral health index was created: ranging from 0-9, the sum of all parameters. OHI score of less than -Volpe-Manhold Index [39,86] -Calculus index; ranging 0-3 [43] -Presence/absence calculus [45] -Average calculus score [94] Gingivitis/periodontitis assessment 1 [95] Pocket depth > 5.5 mm, bleeding, suppuration and / or tooth mobility class III -Approximal plaque index determined in percentages [55] Bleeding index 7 [32,35,45,55,86,93,98] -Modified sulcus bleeding index, grades 0-3 [93] -Papilla bleeding index [86] -Gingival bleeding index [32,35,98] -Presence of bleeding after probing [45] -Sulcus bleeding index [55] Gingival/gingivitis index -Food debris after rinsing, 6-point scale [86] -Debris index, ranging 0-3 [40,43,83,90] Tongue coating index 2 [76,99] -Tongue coating coverage, grades 0-4 [99] -Using the classification by Miyazaki [76] Oral hygiene assessment based on dependency 1 [92] The extent to which the patient can independently practice oral hygiene Independence of oral care 1 [76] The ability to independently perform oral selfcare Twenty chewing cycles with two-color chewing gum. After flattening, the gum was scanned and colorimetric assessment was performed [38,59] or a score was given, grades 1-5 [27] Clinical dental functionality (CDF) score 1 [96] CDF score is based on the even distribution of functional contacts in the upper and lower ...…”

“…Some studies assessed dental status by the presence of decay only, by either reporting a root caries index [39,50,74,86,93] or counting the number of teeth with root and/or coronal caries [35, 51, 56, 72, 75, 76, 83-85, 90, 94, 95]. Another method for assessment of dental status was dental treatment need [27,29,46,56,84,92]. The method differed for every study:…”

“…it could be simply grading 0 (no treatment needed) or 1 (treatment needed) [27] specified which type of treatment was required [29,46,56,92] and if this was simple or complex treatment [84]. One study used the dental risk assessment: a method to assess individual dental risk based on general and technical risk factors and dental caries and periodontitis risk [63].…”

Vitamin C fortification: need and recent trends in encapsulation technologies

“…Encapsulation technologies are being used to improve the matrix compatibility, stability, and bioavailability of vitamins in fortified foods ( 15 , 17 , 171 ). A wide range of these technologies are available [ Table 7 and Figure 8 ; ( 9 , 11 , 245 , 246 ). At present, however, a universal encapsulation technology has not been developed that is applicable to all food products.…”