Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults

Kossioni, Anastassia; Hajto‐Bryk, Justyna; Janssens, Barbara; Maggi, Stefania; Marchini, Leonardo; McKenna, Gerald; Müller, Frauke; Petrovic, Mirko; Roller‐Wirnsberger, Regina; Schimmel, Martín; Putten, Gert-Jan van der; Vanobbergen, Jacques; Zarzecka, Joanna

doi:10.1016/j.jamda.2018.10.007

Cited by 62 publications

(51 citation statements)

References 60 publications

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“…Although patients with CKD have been reported to have lower rates of dental visits than the general population [50], regular dental visits and habitual monitoring of oral function, such as the ability to chew, swallow, and eat, are recommended to help prevent severe frailty. Regular check-ups by multidisciplinary medical staff and the establishment of seamless consultations with a dental professional are required [51]. Healthcare providers must perform comprehensive patient management across disciplines and individual specialties.…”

Section: Discussionmentioning

confidence: 99%

Association among kidney function, frailty, and oral function in patients with chronic kidney disease: a cross-sectional study

et al. 2020

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Background: Chronic kidney disease (CKD) involves many factors that can cause frailty and oral hypofunction. We aimed to investigate the prevalence of frailty and oral hypofunction and to examine the associations among kidney function, frailty, and oral function in adults with CKD in Japan. Methods: This cross-sectional study was conducted at two institutions. The participants included 109 patients with CKD stages 3-5 who visited outpatient clinics or were admitted for inpatient treatment. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study frailty criteria. Oral function was evaluated by assessing oral motor skills [oral diadochokinesis (ODK) rate], masticatory ability, and the repetitive saliva swallowing test. The estimated glomerular filtration rate (eGFR) was used to indicate kidney function. We examined the associations among kidney function, frailty, and oral function using binomial logistic regression analysis. Results: In total, 31 participants (28.4%) were classified as being frail. Univariate analysis showed that age, body mass index, eGFR, and haemoglobin level were significantly associated with frailty. ODK and swallowing function were significantly associated with frailty. Multivariate analysis revealed that frailty was significantly associated with eGFR [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92-1.00, p = 0.048] and ODK rate (OR 0.68, CI 0.47-0.98, p = 0.038). However, no significant association was found between CKD severity and masticatory or swallowing function. Conclusion: We found a high prevalence of frailty in patients with CKD and a significant association between frailty and oral motor skills, affecting the swallowing function of patients with nondialysis CKD. The high prevalence of frailty among patients with CKD suggests that routine assessment of frailty is necessary to prevent the development of severe complications. In addition, oral and kidney function should be carefully evaluated, and oral health education and interventions should be performed for patients with CKD.

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Section: Discussionmentioning

confidence: 99%

Association among kidney function, frailty, and oral function in patients with chronic kidney disease: a cross-sectional study

et al. 2020

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“…A motivated family will seek the resources to provide the best possible care for its loved ones, and there are a lot of good resources as illustrated in the Supporting Information. However, as mentioned above, the physician who diagnosis dementia and the dentist have a very important role in stimulating the patient's families interest in domiciliary oral hygiene care and educating the families about how to provide appropriate daily oral hygiene care . Clinical experience has shown that motivated and educated families can provide excellent care for their loved ones with Alzheimer's disease.…”

Section: Promoting Oral Health Care For Patients With Alzheimermentioning

confidence: 99%

“…However, as mentioned above, the physician who diagnosis dementia and the dentist have a very important role in stimulating the patient's families interest in domiciliary oral hygiene care and educating the families about how to provide appropriate daily oral hygiene care. 64 Clinical experience has shown that motivated and educated families can provide excellent care for their loved ones with Alzheimer's disease. However, there is a moment, usually in the moderate stage of dementia, 36 that behavioral problems become overwhelming for the caregivers and the patients are then referred to a long-term care institution.…”

Section: Establishing and Maintaining Oral Hygiene Routines: Domicilimentioning

confidence: 99%

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

Marchini

Ettinger

Caprio

et al. 2019

Special Care in Dentistry

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Alzheimer's disease and related disorders (ADRD) are among the age‐associated chronic conditions that are most challenging to health care systems around the globe, as patients with dementia require full‐time, intensive care for multiple years. Oral health care is negatively impacted by cognitive decline, and consequently poor oral health is common among people with ADRD. Poor oral health status is linked with many undesirable consequences for the well‐being of people with ADRD, from excruciating local pain to life‐threatening conditions, as aspiration pneumonia. In this paper, the authors provide an update on the most current concepts about Alzheimer's disease epidemiology, etiology, and management, current oral health care for patients with Alzheimer's disease, oral health promotion strategies for this population, as well as current research and future direction for improving oral health care for patients with Alzheimer's disease. It concludes that oral health care should be included in the patient's routine health care as early as possible in the progression of Alzheimer's disease for preventing rapid oral health deterioration. Establishing oral hygiene routines and providing dental treatment that is customized to the patients’ individual needs and disease stage are important to achieve good oral health outcomes and prevent quality of life decline.

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“…The assessment for removable dentures and teeth in the OHAT are divided into two categories, although those are a same assessment category in the OAG [7,9]. Practical guidelines for physicians describe denture hygiene and maintenance as important for promotion of oral health in frail older adults [27]. That being the case, knowledge of OHAT usage may contribute to the promotion of dental referrals for dentures and oral health for frail inpatients with dentures.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with nurses’ performance of oral assessments and dental referrals for hospital inpatients

Haresaku¹,

Uchida²,

Aoki³

et al. 2020

BMC Oral Health

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Background: Nurses' oral assessment and dental referral performance for inpatients are important to provide appropriate oral care services in hospitals. The purpose of this study was to investigate the knowledge, attitudes, and performance of oral assessments and dental referrals for their inpatients among nurses and to identify factors associated with that performance to promote oral health care in hospitals. Methods: All nurses (n = 919) who worked at five hospitals in Japan were recruited as responders. A questionnaire regarding their performance of oral assessments and dental referrals was distributed to the subjects in each hospital. The data were collected from August 2018 to September 2018. Results: A total of 757 (82.4%) nurses (82 males and 675 females) responded to the questionnaire. With respect to each of the 8 oral assessment categories, 16.2-41.2% of the nurses performed oral assessments for more than 50% of their inpatients, and 20.3-29.9% had encouraged more than one inpatient to see a dentist within the previous 3 months. Significant differences were found by ward and hospital in their performance of oral assessments for inpatients. Additionally, their oral assessment performance, knowledge of the usage of oral assessment tools, wards, and hospitals were significantly associated with their dental referral performance. Conclusions: The performance of oral assessment and dental referral was not developed sufficiently in the hospitals. Thus, oral health professionals should support oral assessment education for nurses, including usage of assessment tools, to promote dental referral by nurses. These results may contribute to promotion of dental referral performance by nurses and provision of oral health care by oral health professionals for hospital inpatients.

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Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults

Cited by 62 publications

References 60 publications

Association among kidney function, frailty, and oral function in patients with chronic kidney disease: a cross-sectional study

Association among kidney function, frailty, and oral function in patients with chronic kidney disease: a cross-sectional study

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

Factors associated with nurses’ performance of oral assessments and dental referrals for hospital inpatients

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