Oral status, oral hygiene habits and caries risk factors in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living

Strömberg, Ella; Hagman-Gustafsson, Marie-Louise; Holmén, Anette; Wårdh, Inger; Gabre, Pia

doi:10.1111/j.1600-0528.2011.00653.x

Cited by 57 publications

(88 citation statements)

References 24 publications

(30 reference statements)

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“…The same holds true for the participants; there is no placebo treatment available and therefore, participants in the control group receive ´care as usual´. This ´care as usual´ for dependent elderly could, and one might even argue, should, include oral health care, but it has been shown that this is often unfortunately not the case (e.g., [26,28,57-60]). In contrast to the nursing staff and the participants, the trained examiners are blinded for the participants’ allocation in either the intervention or control group.…”

Section: Discussionmentioning

confidence: 99%

Increased masticatory activity and quality of life in elderly persons with dementia-a longitudinal matched cluster randomized single-blind multicenter intervention study

et al. 2013

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BackgroundWorldwide, millions of people are suffering from dementia and this number is rising. An index of quality of life (QoL) can describe the impact a disease or treatment has on a person’s wellbeing. QoL comprises many variables, including physical health and function, and mental health and function. QoL is related to masticatory ability and physical activity. Animal studies show that disruption of mastication due to loss of teeth or a soft diet leads to memory loss and learning problems. Since these are common complaints in dementia, it is hypothesized that improvement of masticatory function and normalization of diet consistency can increase QoL in elderly persons suffering from dementia. Therefore, the goal of the present study is to examine whether an increase in masticatory activity, achieved by increased food consistency and enhancement of masticatory function through improved oral health care has a positive effect on QoL, including cognition, mood, activities of daily living (ADL), and circadian rhythm in elderly persons with dementia.Methods and designThe described study is a prospective longitudinal matched cluster randomized single-blind multicenter study. Participants are elderly persons living in the Netherlands, suffering from dementia and receiving psychogeriatric care. An intervention group will receive improved oral health care and a diet of increased consistency. A control group receives care as usual. Participants will be assessed four times; outcome variables besides QoL are cognition, mood, independence, rest-activity rhythm, blood pressure, and masticatory function.DiscussionThis research protocol investigates the effect of an intervention executed by daily caregivers. The intervention will increase masticatory activity, which is achieved by three different actions, (providing oral health care, increasing food consistency, or a combination of both). There is a certain amount of variety in the nature of the interventions due to local differences in nursing homes. This might be a scientific weakness in the study design; however, a practical implementation of any findings will be subject to the same factors, making this study design clinically relevant.Trial registrationNTR1561

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Section: Discussionmentioning

confidence: 99%

Increased masticatory activity and quality of life in elderly persons with dementia-a longitudinal matched cluster randomized single-blind multicenter intervention study

et al. 2013

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“…This strategy allowed us to identify common patterns in responses across people with maximum variation in variables that are known to influence the oral health behavior of the target group: age [22,26-28], gender [26,27], dental status [15,22,28,29], institutionalization [13,14] and type and intensity of care they receive as a measure for frailty [15,16,20,21,30,31]. …”

Section: Methodsmentioning

confidence: 99%

“…However, despite extensive research on barriers to dental service-use [7,12-17] and oral hygiene-related behavior [18-21] in which barriers have been associated with impaired mobility, impaired activities of daily living, low energy, depression, and lack of social support, it remains unclear how frailty in its many forms influences the oral care of older people. For example, it is not clear whether service-use and toothbrushing are disturbed more by impaired mobility, dexterity, or low morale, or, as some [22,23] suggest, by a lack of time and energy caused by more pressing general health problems.…”

Section: Introductionmentioning

confidence: 99%

The impact of frailty on oral care behavior of older people: a qualitative study

2013

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BackgroundFrailty has been demonstrated to negatively influence dental service-use and oral self-care behavior of older people. The aim of this study was to explore how the type and level of frailty affect the dental service-use and oral self-care behavior of frail older people.MethodsWe conducted a qualitative study through 51 open interviews with elders of varying frailty in the East-Netherlands, and used a thematic analysis to code transcripts, discussions and reviews of the attributes and meaning of the themes to the point of consensus among the researchers.ResultsThree major themes and five sub-themes emerged from our analyses. The major themes indicate that frail elders: A) favor long-established oral hygiene routines to sustain a sense of self-worth; B) discontinue oral hygiene routines when burdened by severe health complaints, in particular chronic pain, low morale and low energy; and C) experience psychological and social barriers to oral health care when institutionalized. The subthemes associated with the discontinuation of oral care suggest that the elders accept more oral pain or discomfort because they: B1) lack belief in the results of dental visits and tooth cleaning; B2) trivialize oral health and oral care in the general context of their impaired health and old age; and B3) consciously use their sparse energy for priorities other than oral healthcare. Institutionalized elderly often discontinue oral care because of C1) disorientation and C2) inconveniencing social supports.ConclusionThe level and type of frailty influences people’s perspectives on oral health and related behaviors. Frail elders associate oral hygiene with self-worth, but readily abandon visits to a dentist unless they feel that a dentist can relieve specific problems. When interpreted according to the Motivational Theory of Life Span Development, discontinuation of oral care by frail elderly could be viewed as a manifestation of adaptive development. Simple measures aimed at recognizing indicators for poor oral care behavior, and providing appropriate information and support, are discussed.

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“…Kwetsbaarheid heeft een negatieve invloed op zowel tandartsbezoek als op mondverzorgingsgedrag (MacEntee, 2011). Onderzoek heeft aangetoond dat verminderde mobiliteit, verminderde fysieke functies, weinig energie, depressie en gebrek aan sociale steun hiermee zijn geassocieerd (Dolan et al, 1998; Kiyak en Reichmuth, 2005;Borreani et al, 2008;Stromberg et al, 2012). Niet bekend is op welke manier kwetsbaarheid en verschillende kwetsbaarheidsfactoren van invloed zijn op de mondverzorging en tandartsbezoek van ouderen.…”

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De invloed van kwetsbaarheid op mondzorggedrag en tandartsbezoek van ouderen

Niesten¹,

Sanden²,

Gerritsen³

2015

NTvT

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Om meer inzicht te krijgen in de manier waarop tandartsbezoek en mondverzorging wordt beïnvloed door de mate van kwetsbaarheid en verschillende kwetsbaarheidfactoren werden 51 kwetsbare ouderen geïnterviewd. Aanvullende informatie werd verzameld over leeftijd, geslacht, woonsituatie, aanwezigheid en gebruik van gebitsprothesen, zelfgerapporteerde mondgezondheid en gezondheid, chronische aandoeningen en zorgzwaarte. Uit de thematische kwalitatieve analyse van de verzamelde gegevens blijkt dat kwetsbare ouderen zolang mogelijk vasthouden aan vertrouwde mondverzorgingsroutines om een gevoel van eigenwaarde te ondersteunen. Bij ernstige gezondheidsklachten geven ze eerst het tandartsbezoek op en uiteindelijk ook de mondverzorgingsroutines. Daarbij spelen gebrek aan vertrouwen in het resultaat van het tandartsbezoek, het bagatelliseren van klachten en het devalueren van de mondgezondheid een rol. Ook ervaren kwetsbare ouderen psychische en sociale belemmeringen voor mondzorg en tandartsbezoek wanneer ze in verzorgingshuizen terechtkomen. Wat weten we?Kwetsbaarheid heeft vaak tot gevolg dat mensen minder vaak naar de tandarts gaan en hun mond minder goed verzorgen. De mondgezondheid van kwetsbare en zorgafhankelijke ouderen is slechter dan die van niet-kwetsbare ouderen. Wat is nieuw?Het onderzoek biedt nieuwe inzichten in de manier waarop kwetsbaarheid het mondverzorgingsgedrag en tandartsbezoek beïnvloedt en hoe en in hoeverre mentale, fysieke en sociale beperkingen hierbij een rol spelen. Praktijktoepassing InleidingAl meer dan 35 jaar vinden onderzoekers een discrepantie tussen klinische (door de tandarts vastgestelde) behandelnoodzaak en subjectieve (door de patiënt ervaren) behandelnoodzaak en tussen subjectieve behandelnoodzaak en tandartsbezoek (Grabowski en Bertram, 1975;Gerritsen et al, 2011). Van de 100 ouderen bij wie een klinische behandelnoodzaak is vastgesteld, ervaart minder dan de helft de noodzaak voor behandeling, en slechts ruwweg een kwart neemt daadwerkelijk initiatief om een tandarts te bezoeken (Ferro et al, 2008;Gerritsen et al, 2011).Gobbens et al (2010) definiëren kwetsbaarheid als "een dynamische toestand die wordt gekenmerkt door verliezen in één of meerdere domeinen van het menselijk functioneren (fysiek, psychologisch, sociaal), die veroorzaakt worden door een scala aan factoren en die het risico op negatieve gezondheidsuitkomsten vergroten". Deze toestand draagt waarschijnlijk bij aan de discrepantie tussen klinische en subjectieve behandelnoodzaak, en tussen subjectieve noodzaak en tandartsbezoek. Kwetsbaarheid heeft een negatieve invloed op zowel tandartsbezoek als op mondverzorgingsgedrag (MacEntee, 2011). Onderzoek heeft aangetoond dat verminderde mobiliteit, verminderde fysieke functies, weinig energie, depressie en gebrek aan sociale steun hiermee zijn geassocieerd (Dolan et al, 1998; Kiyak en Reichmuth, 2005;Borreani et al, 2008;Stromberg et al, 2012). Niet bekend is op welke manier kwetsbaarheid en verschillende kwetsbaarheidsfactoren van invloed zijn op de mondverzorging en t...

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Oral status, oral hygiene habits and caries risk factors in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living

Cited by 57 publications

References 24 publications

Increased masticatory activity and quality of life in elderly persons with dementia-a longitudinal matched cluster randomized single-blind multicenter intervention study

Increased masticatory activity and quality of life in elderly persons with dementia-a longitudinal matched cluster randomized single-blind multicenter intervention study

The impact of frailty on oral care behavior of older people: a qualitative study

De invloed van kwetsbaarheid op mondzorggedrag en tandartsbezoek van ouderen

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