Iowa nursing facility oral hygiene (INFOH) intervention: A clinical and microbiological pilot randomized trial

Abstract

Recruitment and retention posed a significant challenge to this trial, even with a relatively short observation period. Results from this pilot study did not encourage further investigation of this customized oral hygiene protocol.

Oral health care for patients with Alzheimer's disease: An update

“…Regarding social support, such as being dependent on a caregiver has been reported as an important barrier to receiving proper oral hygiene care; also being institutionalized, as many reports have shown that nursing home residents receive inadequate oral hygiene and oral health care . Both dependency and institutionalization are common among patients with Alzheimer's disease, and educating caregivers to provide appropriate oral health care has been an enduring challenge, with no clear resolution in sight . Finances and other socioeconomic factors were also reported as barriers for older adults to access appropriate oral health care .…”

“…At a societal level, the lack of adequate reimbursement for dentists and dental hygienists to provide domiciliary oral health care has been cited as an important barrier . Lack of enforcement of appropriate regulations regarding oral hygiene routines in long‐term care institutions has been cited as another barrier, as well as lack of caregiver education, caregiver overload, and high turnover among nursing home caregivers . More research dollars are also needed to establish evidence‐based protocols for oral health care of patients with Alzheimer's disease …”

“…Oral health care in long‐term care institutions is usually poor, and seeking answers for how to fix it has stimulated much research and debate, but no resolution has been achieved . A recent study suggested that an effective training program for caregivers to provide oral hygiene for residents should include more than a couple hours of lectures, and needs the training of oral health “champions”—caregivers who would be responsible for training their peers and supervising oral hygiene in a nursing home. It is important to have more administrative support to enforce oral hygiene protocols, meaning that oral health outcomes should be part of the overall therapeutic goal for each resident.…”

“…16,51,52 Both dependency and institutionalization are common among patients with Alzheimer's disease, and educating caregivers to provide appropriate oral health care has been an enduring challenge, with no clear resolution in sight. 16,53 Finances and other socioeconomic factors were also reported as barriers for older adults to access appropriate oral health care. 54 Among older adults with Alzheimer's disease, financial burden can be even more intense, as they have more out-of-pocket health expenses when compared to older adults with no dementia.…”

“…15 Lack of enforcement of appropriate regulations regarding oral hygiene routines in long-term care institutions has been cited as another barrier, as well as lack of caregiver education, caregiver overload, and high turnover among nursing home caregivers. 16 More research dollars are also needed to establish evidence-based protocols for oral health care of patients with Alzheimer's disease. 58 At the dental professional level, although 92.8% of U.S. dental schools teach geriatric dentistry as a compulsory course, and 84.9% of those teach the topic "Restorative management of persons with Alzheimer's disease and other dementias," 59 only 57.1% had some compulsory clinical education in geriatric dentistry 60 and it is unsure how much of this clinical training involves patients with dementia.…”