Is Cognitive Status Related to Oral Hygiene Level and Appropriate for Determining Need for Oral Hygiene Assistance?

Abstract

A high Shulman clock-drawing test score indicates the need for oral hygiene assistance, but it is not suitable as a single tool to assess this need. Patients with other disabilities might equally qualify for assistance. Dentures, however, can be cleaned quickly and efficiently independently of patient compliance; therefore, cleaning the patients' dentures should be part of nursing personnel's daily care routine for every patient.

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

“…Besides the distinct outcome and predictor variables considered, this difference may be attributable to the younger age and lesser impairment of the participants in the ARIC cohort. As noted in the Introduction, a recent study by Steinmassl et al found no relationship between the degree of cognitive impairment and oral hygiene indexes; however, comparison with the present results is hampered by their use of Schulman's Clock‐drawing test, which provides only a partial evaluation of cognitive impairment.…”

“…However, few data are available on caregiver‐related obstacles to oral hygiene in non‐institutionalized patients with dementia. Oral hygiene measures should be reinforced in both the institutionalized elderly and those living in the community . 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 .…”

“…Oral hygiene measures should be reinforced in both the institutionalized elderly and those living in the community. 15 The value of daily tooth-brushing with electric or manual toothbrushes for plaque control in the elderly is well-documented 25 and the use of fluorides (mainly in toothpaste) has been described as the most effective and efficient method to prevent caries. 26 There is currently no consensus on the protocols for assistance by third parties in geriatric centers or at home.…”

“…Thus, a study of middle‐aged adults by Naorungroj et al found that declines in two cognitive measures were modestly associated with lack of tooth brushing but not with other dental behaviors or with clinical gingivitis or periodontitis. Likewise, a study of the institutionalized elderly by Steinmassl et al concluded that tooth hygiene indices were not related to the degree of cognitive impairment as measured by the Shulman clock‐drawing test. Hence, further exploration is required on the manner in which the loss of functional or cognitive capacities affects the maintenance of acceptable oral health levels and on the factors associated with a possible decline in oral hygiene practices.…”

Dental treatment under general anesthesia in adults with special needs at the University Hospital of Dental Prosthetics and Restorative Dentistry of Innsbruck, Austria: a retrospective study of 12 years

“…One study in around 680 home residents (mean age over 85 years) found a mean DMFT score of 25.6 ± 4.2 and shortcomings of oral care and prosthodontic rehabilitation [19]. Two investigations assessed the extent of denture hygiene (in relation to cognitive status) and denture retention in residents of retirement homes (mean age over 80 years) and also identified a need for improvement of oral care and denture maintenance/fitting [20,21]. The individuals admitted to DGA at the Hospital of Innsbruck are considerably younger and usually suffer disablement not associated with age-related diseases.…”