Reducing Dental Plaque Scores in Long-term Care Facilities Using a Checklist and Random Inspections: A Pilot Study

Abstract

The development and use of tailored interventions in overcoming barriers to optimum health in long-term care facility residents is of the highest importance. One successful approach to improving health outcomes is the use of a checklist by health care providers. Despite the evidence of the success of such checklists in nursing and medicine, there is little evidence on their use in improving dental outcomes. This study investigated whether an intervention comprising the daily use of a checklist for oral care by nursing staff supplemented by random inspections by a charge nurse resulted in lower dental plaque scores in patient participants at a long-term care facility (n=19) as compared with in those at another long-term care facility that did not receive the intervention (n=13). All participants received a dental cleaning at baseline. At a follow-up examination at 6 to 8 weeks post-baseline, significant differences were observed in the plaque scores between the participants at each location, with the median plaque scores in those undergoing the intervention being less than half of those in the patients that did not (20.8% vs. 52.8%, p<0.001). After adjusting for age in a linear regression model, this difference remained significant. The use of a daily checklist for oral care supplemented by random inspections by a charge nurse was associated with lower plaque scores (p<0.001). These results warrant further research, including prospective studies aimed at establishing how use of both clinical supervision and a checklist for oral health may influence plaque scores in geriatric patients in long-term care facilities over time.

Oral health and healthy ageing: a scoping review

“…Control group: those who did not practice tooth brushing 6 mos Dental nurses Improved oral health perception, lower plaque & gingival & inflammation scores & less clinical attachment loss Leon et al (2019) [ 91 ] Application of 5000 ppm NaF-dentifrice. Control group: 1450 ppm NaF-dentifrice 24 mos N/A 5000 ppm F-dentifrice more effective than conventional dentifrice in preventing & arresting RCLs Laurence et al (2019) [ 92 ] Educational sessions for nursing staff. Control group: those not receiving intervention 2 mos Dentist Improved plaque scores Saleem et al (2019) [ 93 ] Provided lip trainer device to one group, sonic toothbrush to other group & others as control 6 mos Clinician Dental hygienist Lip training device improved salivary flow rates & oral wettability.…”

“…Two studies focused on interventions for the caretakers of older residents that included educational sessions and demonstrations on oral hygiene and denture care [ 92 , 98 ]. Such intervention reduced the plaque and gingival indexes in the older residents and improved knowledge and attitudes on oral health among their caretakers.…”

Evaluation of the Empower model of care for partial denture clients in a public oral health care setting

“…Several researchers 13,[28][29][30] have indicated that individually tailored interventions, such as the one employed by the Empower model of care, can improve oral hygiene outcomes resulting in reduced plaque levels. These results indicate that after attending four education sessions (i.e.…”

“…12 There is broad evidence that oral health can be maintained successfully with effective oral selfcare. 5,13,14 Additionally, research shows varying degrees of success with oral hygiene programs among partial denture wearers. 15,16 However, it has also been reported that the methods of oral hygiene instruction are not as significant as the need for oral hygiene instruction to be followed up and repeated.…”

“…There is broad evidence that oral health can be maintained successfully with effective oral self‐care 5,13,14 . Additionally, research shows varying degrees of success with oral hygiene programs among partial denture wearers 15,16 .…”