Improving oral health of institutionalized older people with diagnosed dementia

Zenthöfer, Andreas; Cabrera, Tomas; Rammelsberg, Peter; Hassel, Alexander J.

doi:10.1080/13607863.2015.1008986

Cited by 30 publications

(42 citation statements)

References 33 publications

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“…26 There is currently no consensus on the protocols for assistance by third parties in geriatric centers or at home. [27][28][29] In contrast to other studies, 14 the education variable was not a confounder. Schooling level was associated with both tooth/prosthesis-brushing and the plaque index but not with higher or lower cognitive impairment.…”

Section: Discussionmentioning

confidence: 62%

“…The value of daily tooth‐brushing with electric or manual toothbrushes for plaque control in the elderly is well‐documented and the use of fluorides (mainly in toothpaste) has been described as the most effective and efficient method to prevent caries . There is currently no consensus on the protocols for assistance by third parties in geriatric centers or at home …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Oral Hygiene in the Elderly with Different Degrees of Cognitive Impairment and Dementia

Gil-Montoya

Sánchez-Lara

Carnero-Pardo

et al. 2016

J American Geriatrics Society

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The control of bacterial dental plaque through daily oral hygiene is essential to prevent oral diseases such as caries or periodontal disease, especially in at-risk populations, including the elderly with mild cognitive impairment and dementia. The aim of this study was to determine the association between different levels of cognitive impairment and dementia in an elderly population and their capacity to maintain adequate oral hygiene. A case-control study (elderly with versus without mild cognitive impairment or dementia) was performed in Granada, Spain. Outcome variables were tooth/prosthesis-brushing frequency/day, bacterial plaque index, and gingival bleeding index. Statistical models were adjusted by age, sex, educational level, and tobacco and alcohol habits. The study included 240 cases and 324 controls. The final model, adjusted by age, sex, educational level, and tobacco and alcohol consumption, showed a significant association between degree of cognitive impairment and daily oral hygiene, accumulation of bacterial plaque, and gingival bleeding. In summary, deficient daily oral hygiene, evidenced by greater bacterial dental plaque accumulation and gingival inflammation, is independently associated with cognitive impairment, even at its earliest stage.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Oral Hygiene in the Elderly with Different Degrees of Cognitive Impairment and Dementia

Gil-Montoya

Sánchez-Lara

Carnero-Pardo

et al. 2016

J American Geriatrics Society

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“…From our point of view, use of PDC as a first step can provide the basis for implementation of other longterm strategies. 16,[20][21][22][23]35 We have shown that the necessary time frames to provide dental care neither differ between demented and nondemented residents nor between mobile and immobile residents. This finding might provide optimism that oral hygiene procedures can be implemented for all nursing home residents, and the knowledge might reduce restraints when healthcare professionals consider implementing such methods.…”

Section: Discussionmentioning

confidence: 92%

“…According to daily experience, the successful provision of PDC by a dental nurse under the supervision of a cooperating dentist in nursing homes depends on the organization, and often the goodwill, of nursing home personnel and management. From our point of view, use of PDC as a first step can provide the basis for implementation of other long‐term strategies . We have shown that the necessary time frames to provide dental care neither differ between demented and nondemented residents nor between mobile and immobile residents.…”

Section: Discussionmentioning

confidence: 98%

“…Professional dental cleaning (PDC) as a first step may count as a pretreatment method for all sustainable preventive programs to achieve and maintain good oral hygiene. It may be combined with or followed by other long‐term strategies such as implementation of healthcare worker training, oral healthcare programs including mobile dental teams, the implementation of ultrasonic baths, Gerodent, or MOUTh programs . We have recently shown that the use of PDC is well accepted and improves oral health in both demented and nondemented nursing home residents .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of time and resources required for professional dental cleaning in nursing home residents

Barbe

Kottmann

Müller

et al. 2019

Special Care in Dentistry

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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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Effectiveness of a Mouth Care Program Provided by Nursing Home Staff vs Standard Care on Reducing Pneumonia Incidence

et al. 2020

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IMPORTANCE Pneumonia affects more than 250 000 nursing home (NH) residents annually. A strategy to reduce pneumonia is to provide daily mouth care, especially to residents with dementia. OBJECTIVE To evaluate the effectiveness of Mouth Care Without a Battle, a program that increases staff knowledge and attitudes regarding oral hygiene, changes mouth care, and improves oral hygiene, in reducing the incidence of pneumonia among NH residents. DESIGN, SETTING, AND PARTICIPANTS This pragmatic cluster randomized trial observing 2152 NH residents for up to 2 years was conducted from September 2014 to May 2017. Data collectors were masked to study group. The study included 14 NHs from regions of North Carolina that evidenced proportionately high rehospitalization rates for pneumonia and long-term care residents. Nursing homes were pair matched and randomly assigned to intervention or control groups. INTERVENTION Mouth Care Without a Battle is a standardized program that teaches that mouth care is health care, provides instruction on individualized techniques and products for mouth care, and trains caregivers to provide care to residents who are resistant and in special situations. The control condition was standard mouth care. MAIN OUTCOMES AND MEASURES Pneumonia incidence (primary) and hospitalization and mortality (secondary), obtained from medical records. RESULTS Overall, the study enrolled 2152 residents (mean [SD] age, 79.4 [12.4] years; 1281 [66.2%] women; 1180 [62.2%] white residents). Participants included 1219 residents (56.6%) in 7 intervention NHs and 933 residents (43.4%) in 7 control NHs. During the 2-year study period, the incidence rate of pneumonia per 1000 resident-days was 0.67 and 0.72 in the intervention and control NHs, respectively. Neither the primary (unadjusted) nor secondary (covariate-adjusted) analyses found a significant reduction in pneumonia due to Mouth Care Without a Battle during 2 years (unadjusted incidence rate ratio, 0.90; upper bound of 1-sided 95% CI, 1.24; P = .27; adjusted incidence rate ratio, 0.92; upper bound of 1-sided 95% CI, 1.27; P = .30). In the second year, the rate of pneumonia was nonsignificantly higher in intervention NHs. Adjusted post hoc analyses limited to the first year found a significant reduction in pneumonia incidence in intervention NHs (IRR, 0.69; upper bound of 1-sided 95% CI, 0.94; P = .03). CONCLUSIONS AND RELEVANCE This matched-pairs cluster randomized trial of a mouth care program compared with standard care was not effective in reducing pneumonia incidence at 2 years, although reduction was found during the first year. The lack of significant results in the second year (continued) Key Points Question Can nursing home staff reduce pneumonia by providing mouth care to residents? Findings In this pragmatic cluster randomized trial including 2152 residents from 14 paired nursing homes during 2 years, there was no statistically significant difference in the primary outcome of pneumonia incidence during 2 years. Adjusted post hoc analyses indicated a stat...

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Improving oral health of institutionalized older people with diagnosed dementia

Cited by 30 publications

References 33 publications

Oral Hygiene in the Elderly with Different Degrees of Cognitive Impairment and Dementia

Oral Hygiene in the Elderly with Different Degrees of Cognitive Impairment and Dementia

Evaluation of time and resources required for professional dental cleaning in nursing home residents

Effectiveness of a Mouth Care Program Provided by Nursing Home Staff vs Standard Care on Reducing Pneumonia Incidence

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