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Carers’ education improves oral health of older people suffering from dementia – results of an intervention study

Authors Zenthöfer A, Meyer-Kühling I, Hufeland AL, Schröder J, Cabrera T, Baumgart D, Rammelsberg P, Hassel AJ

Received 28 July 2016

Accepted for publication 15 September 2016

Published 30 November 2016 Volume 2016:11 Pages 1755—1762

DOI https://doi.org/10.2147/CIA.S118330

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker

Andreas Zenthöfer,1 Inga Meyer-Kühling,2,3 Anna-Luisa Hufeland,1 Johannes Schröder,2,3 Tomas Cabrera,1 Dominik Baumgart,1 Peter Rammelsberg,1 Alexander J Hassel1

1Department of Prosthetic Dentistry, University of Heidelberg, 2Institute of Gerontology, University of Heidelberg, 3Section of Geriatric Psychiatry, Center of Psychiatry, University of Heidelberg, Heidelberg, Germany

Aim:
The aim of this study was to evaluate the effectiveness of carers’ education on improvements in oral health and denture hygiene of care-dependent and cognitively impaired older people in nursing homes compared to those without intervention.
Methods: A total of 219 seniors living in 14 nursing homes in southwest Germany (intervention: n=144; control: n=75) were enrolled in this study. For each participant, Plaque Control Record (PCR), Gingival Bleeding Index (GBI), Denture Hygiene Index (DHI) and Community Periodontal Index of Treatment Needs (CPITN) were assessed at baseline and six months following the interventions. In addition, demographic parameters such as age, sex, chronic diseases, permanent medications, level of dependency and cognitive state were recorded. In the intervention homes, education for caregivers was provided and ultrasound baths for denture cleaning were implemented. Changes in the dental target variables PCR, GBI, CPITN and DHI during the six-month study period were compared between subjects in the intervention and the control groups as well as between subjects with and without dementia. Additionally, multivariate models were compiled for each dental index to evaluate possible confounders.
Results: In the intervention group, PCR and DHI significantly improved during the study period (P<0.001). Oral health and denture hygiene improved likewise in subjects with and without dementia. In the control group, no significant improvements were observed (P>0.05).
Conclusion: Carers’ education improves oral health of people in nursing homes over a clinically relevant period of time. Implementation of ultrasound baths is a simple and effective measure to improve denture hygiene of both institutionalized elderly people and seniors with dementia and in severe need of care. From a clinical standpoint, it is noteworthy that the respective interventions can be easily implemented in everyday care routine.

Keywords:
oral health, intervention, older people, nursing home, longitudinal

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Increasing dependency of older people in nursing homes is associated with need for dental treatments

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