Oral health and apraxia among institutionalized elderly people—A pilot study

Zenthöfer, Andreas; Navratil, Sabrina Dominique; Rammelsberg, Peter; Cabrera, Tomas; Gorenc, Lina; Urbanowitsch, Nadja; Wetzel, Petra; Schröder, Johannes; Hassel, Alexander J.

doi:10.3109/00016357.2014.961956

Cited by 14 publications

(37 citation statements)

References 25 publications

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“…In contrast, it does seem to be a risk factor for decayed teeth. These results are in agreement with those of Zenthöfer et al [27]. One reason apraxia might not be a risk factor for denture hygiene is because dentures, which are cleaned outside the mouth, are more easily cleaned than natural teeth.…”

Section: Discussionsupporting

confidence: 93%

“…One reason apraxia might not be a risk factor for denture hygiene is because dentures, which are cleaned outside the mouth, are more easily cleaned than natural teeth. It might also be because a very high proportion of dentures had high plaque levels [27]. Moreover, the stepwise variable selection algorithm stops if only one variable is left in the model which would explain why apraxia (not significant, see Table 3) is in the final multivariate model.…”

Section: Discussionmentioning

confidence: 99%

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Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?

et al. 2020

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Background There is limited information available about the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments. Aims The purpose of this study was to identify factors influencing the oral and denture hygiene and oral health of nursinghome residents with cognitive and motor impairments. Methods The study was performed in nine nursing-homes in Germany. Sociodemographic and general data were collected for all participants (n = 150). The Clinical Dementia Rating (CDR) was used to identify the presence of dementia, and the Apraxia Screening Test (AST) was used to identify motor impairment. A comprehensive dental examination was also performed. This included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMFT). In addition, dental and denture hygiene were assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI). Univariate and multivariate regression models were used to analyse possible factors affecting the dependent target variables. Results In multivariate regression analysis, the factors that most strongly influenced greater PI were a lower number of medications taken (p = 0.018), poorer general health (p = 0.013) and the presence of dementia (p < 0.010). A more advanced age (p = 0.036) and longer nursing-home stay (p = 0.048) had a negative effect on the DHI. Furthermore, gender (p = 0.037, in favour of women), poorer general health (p = 0.003), presence of dementia (p = 0.003), and the absence of natural teeth (p = 0.028) influenced poorer oral health. The factors most strongly influenced greater number of missing teeth were a more advanced age (p = 0.021) and longer nursing-home stay (p = 0.015). In terms of fewer filled teeth, a shorter nursing-home stay (p = 0.002) was the factor most strongly influenced this. Conclusions Poorer general health and the presence of apraxia and cognitive impairment are the main determinants for poorer oral hygiene and oral health among nursing-home residents. A longer nursing-home stay also seems to be relevant for oral health and denture hygiene.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?

et al. 2020

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“…Gingival bleeding was absent in 0.0 to 9.4% of the participants with dementia [ 41 , 64 ]. Consequently, most of the participants had gingival bleeding or inflammation [ 40 , 42 , 60 ]. More specifically, gingivitis was present in 13.6 to 38.9% [ 45 , 46 , 55 ], moderate periodontitis in 6.9 to 36.0%, and severe periodontitis in 11.9 to 24.5% of the participants with dementia [ 41 , 46 , 55 , 75 ].…”

Section: Resultsmentioning

confidence: 99%

“…Consequently, most of the participants had gingival bleeding or inflammation [ 40 , 42 , 60 ]. More specifically, gingivitis was present in 13.6 to 38.9% [ 45 , 46 , 55 ], moderate periodontitis in 6.9 to 36.0%, and severe periodontitis in 11.9 to 24.5% of the participants with dementia [ 41 , 46 , 55 , 75 ]. The mean percentage of the Gingival Bleeding Index was 46.0% in a study by De Souza Rolim [ 46 ] and 43.8–53.8% in the publications by Zenthöfer [ 68 , 70 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues

et al. 2017

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BackgroundThe number of older people with dementia and a natural dentition is growing. Recently, a systematic review concerning the oral health of older people with dementia with the focus on diseases of oral hard tissues was published.ObjectiveTo provide a comprehensive literature overview following a systematic approach of the level of oral hygiene and oral health status in older people with dementia with focus on oral soft tissues.MethodsA literature search was conducted in the databases PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. A critical appraisal of the included studies was performed with the Newcastle-Ottawa scale (NOS) and Delphi list.ResultsThe searches yielded 549 unique articles, of which 36 were included for critical appraisal and data extraction. The included studies suggest that older people with dementia had high scores for gingival bleeding, periodontitis, plaque, and assistance for oral care. In addition, candidiasis, stomatitis, and reduced salivary flow were frequently present in older people with dementia.ConclusionsThe studies included in the current systematic review suggest that older people with dementia have high levels of plaque and many oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, stomatitis, mucosal lesions, and reduced salivary flow.Scientific rationale for studyWith the aging of the population, a higher prevalence of dementia and an increase in oral health problems can be expected. It is of interest to have an overview of the prevalence of oral problems in people with dementia.Principal findingsOlder people with dementia have multiple oral health problems related to oral soft tissues, such as gingival bleeding, periodontal pockets, mucosal lesions, and reduced salivary flow.Practical implicationsThe oral health and hygiene of older people with dementia is not sufficient and could be improved with oral care education of formal and informal caregivers and regular professional dental care to people with dementia.Electronic supplementary materialThe online version of this article (10.1007/s00784-017-2264-2) contains supplementary material, which is available to authorized users.

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“…On the other side, poor oral health is associated with worse nutritional status and higher long term mortality . There is also some evidence suggesting that more specific cognitive deficits such as apraxia (ie, the inability to perform skilled and purposed tasks, such as doing simple handiwork, drawing or teeth washing) are associated with poor oral health . Because apraxia can be easily addressed (eg, with proper device counseling and caregiver education), we focused on a simple screening tool that identifies apraxic subjects.…”

Section: Introductionmentioning

confidence: 99%

Constructional apraxia screening and oral health among hospitalized older adults: A cross‐sectional study

Bevilacqua

Severin

Russi

et al. 2019

Special Care in Dentistry

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Aims: Apraxia may hinder oral self-care and is associated with poor oral hygiene.Intersecting Pentagons Test (IPT) is a simple screening tool for constructional apraxia (CA) that tests the ability to copy a bidimensional figure. In this study we investigated whether IPT is useful to identify subjects that need interventions to support oral health in a cohort of geriatric inpatients. Methods and results:We assessed oral health through the decayed, missing or filled teeth index, plaque index, and periodontal screening and recording tool. We inquired about autonomy in oral hygiene activities through a standardized questionnaire. Among subjects with CA (273 out of 478 hospitalized subjects aged > 65 years) we found a higher prevalence of edentulism (P = 0.04), periodontal disease (PD) (P = 0.03), and dependence in oral hygiene activities (P < 0.001). Only 34.8% of nonautonomous apraxic patients had a caregiver that supplied oral care. In an age and sex-adjusted generalized linear model, IPT proved to be an independent predictor of dependence in oral care, reaching 61.5% sensitivity in identifying dependent patients.

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Oral health and apraxia among institutionalized elderly people—A pilot study

Abstract: Although this pilot investigation has limitations, the results suggest the presence of apraxia should be considered when planning oral healthcare strategies. Further research with larger samples is encouraged to confirm these relationships.

Cited by 14 publications

References 25 publications

Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?

Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?

Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues

Constructional apraxia screening and oral health among hospitalized older adults: A cross‐sectional study

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