Oral health-related quality of life and prosthetic status of nursing home residents with or without dementia

Anna-Luisa Klotz,1 Alexander Jochen Hassel,1 Johannes Schröder,2,3 Peter Rammelsberg,1 Andreas Zenthöfer1 1Department of Prosthodontics, Dental School, 2Institute of Gerontology, 3Section of Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany Purpose: The objective of this cross-sectional study was to evaluate the effect of prosthetic status on the oral health-related quality of life (OHRQoL) of nursing home residents with or without dementia.Methods: The study was performed in 14 nursing homes across the federal state of Baden-Württemberg, Germany. All eligible participants were included, and general and medical information and information about their dental and prosthetic statuses were collected. The Geriatric Oral Health Assessment Index (GOHAI) was administered to evaluate OHRQoL. The Mini-Mental State Examination (MMSE) served to classify participants into living or not living with dementia according to the established cutoff value for dementia (MMSE <24). Parametric bivariate statistics and logistic regression models were used to analyze data at P<0.05.Results: A total of 169 participants were included in this study. The mean age of the participants was 82.9 years. A total of some 70% of the sample was living with dementia. The mean GOHAI score along the sample was 49.1 (8.3), and 41% of the sample reported substantially compromised OHRQoL (GOHAI <50). OHRQoL was statistically similar for people with or without dementia (P=0.234); objective oral health was also similar in both groups (P>0.05). The number of teeth (odds ratio [OR]: 2.0), the type of prosthetic status (OR: 6.5), and denture-related treatment needs (OR: 2.4) were the major factors significantly affecting OHRQoL (P<0.05).Conclusion: The OHRQoL of elderly nursing home residents is substantially compromised. Several prosthetic treatment needs for residents living with or without dementia were identified. Edentulism without tooth replacement and having <5 teeth resulted in an increased risk of substantially compromised OHRQoL. Further studies should be conducted to determine whether improvements in prosthetic status can increase OHRQoL. Keywords: nursing home, dementia, oral health-related quality of life, prosthetic conditio

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

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, longitudina