[Oral health care guidelines for elderly people in long-term care facilities. Effectiveness and implementation in The Netherlands and Flanders],[Oral health care guidelines for elderly people in long-term care facilities. Effectiveness and implementation in The Netherlands and Flanders]

Contains fulltext : 79768.pdf (publisher's version ) (Open Access)Oral health care includes self-care, volunteer care, and professional care for maintaining or advancing appropriate oral health. It has been demonstrated that the oral health care in long-term care facilities for elderly people in The Netherlands and Flanders (Belgium) is not adequate. Daily oral hygiene care, carers' knowledge and skills providing adequate oral health care, (co)morbidity, and drug usage are points of special interest in realizing an improvement of oral health care and oral health. The Dutch Association of Nursing Home Physicians has formulated oral health care guidelines for elderly people in long-term care facilities. A research project on the effectiveness and implementation will be carried out, determining the guidelines'quality. The aim of the project is improving the quality of oral health care for and the quality of oral health and life of elderly people in long-term care facilities in The Netherlands and Flanders

The impact of undergraduate geriatric dental education on the attitudes of recently graduated dentists towards institutionalised elderly people.

Contains fulltext : 81243.pdf (publisher's version ) (Closed access)OBJECTIVE: The aim of the study was to assess the impact of undergraduate geriatric dentistry education on knowledge of ageing and on attitudes towards institutionalised elderly people, as perceived by recently graduated dentists. METHODS: A validated questionnaire was sent by mail to all dentists of the study group (n = 357). The questionnaire collected socio-demographic data, motives for pursuing a dental career, knowledge of ageing, attitude towards institutionalised elderly people using the Aging Semantic Differential (ASD), and aspects of geriatric dentistry education. RESULTS: Great variability between the six dental schools involved was observed in respect of the undergraduate education received in geriatric dentistry. Dentists' knowledge of ageing was also low. The mean value of ASD-total indicated that in this study there was a negative attitude towards the institutionalised elderly. The covariate 'financial motive for pursuing a dental career' was the only item that seemed to have any significant influence on the ASD. Age was the only significant variable for knowledge. All other covariates were found not to have any influence. CONCLUSIONS: From this study it would appear that the attitude of recently graduated dentists in Belgium towards the institutionalised elderly is rather negative and their knowledge of ageing is poor. The actual level of geriatric dentistry education in the undergraduate curriculum did not appear to influence this attitude, but Belgian dental schools are challenged to reorientate their provision of geriatric dentistry education to include activities that help to develop positive perceptions towards the elderly, with an empathic positive and caring attitude

Association of some specific nutrient deficiencies with periodontal disease in elderly people: A systematic literature review.

Contains fulltext : 80266.pdf (publisher's version ) (Closed access)OBJECTIVE: Deficiency of vitamin B complex, vitamin C, vitamin D, calcium, and magnesium has been associated with periodontal disease. This article systematically reviews the currently available literature on the feasible association of vitamin B complex, vitamin C, vitamin D, calcium, and magnesium deficiencies with periodontal disease in elderly people. METHODS: We performed a systematic review of relevant English- and Dutch-language medical literature published from January 1990 to May 2007, with critical appraisal of those studies evaluating the association of vitamin B complex, vitamin C, vitamin D, calcium, and magnesium deficiencies with periodontal disease in elderly people. RESULTS: None of the studies meeting the selection criteria included institutionalized elderly people. In the studies on non-institutionalized elderly people, no significant or consistent association was found between vitamin B complex, vitamin C, vitamin D, calcium, and magnesium dietary intakes and serum levels and periodontal disease. Although in those studies decreased dietary vitamin C intake was found to be associated with increased risk of periodontal disease, no conclusive evidence could be demonstrated. CONCLUSION: There is no evidence of an association of vitamin B complex, vitamin C, vitamin D, calcium, and magnesium deficiencies with periodontal disease in non-institutionalized elderly people. To produce conclusive evidence on the subject of this systematic literature review, longitudinal cohort studies and follow-up randomized controlled trials are needed

Oral health care and aspiration pneumonia in frail older people: a systematic literature review

Item does not contain fulltextOBJECTIVE: To systematically review the literature on oral health care interventions in frail older people and the effect on the incidence of aspiration pneumonia. BACKGROUND: Oral health care seems to play an important role in the prevention of aspiration pneumonia in frail older people. METHODS: Pubmed, Web of Science, Cochrane Library, EMBASE and CINAHL were searched for eligible intervention studies. Only publications with regard to hospitalized or institutionalized older people, who were not dependent on mechanical ventilation were eligible. Two authors independently assessed the publications for their methodological quality. RESULTS: Five publications were included and reviewed. Two studies showed that improvement of oral health care diminished the risk of developing aspiration pneumonia and the risk of dying from aspiration pneumonia directly. The three studies remaining showed that adequate oral health care decreased the amount of potential respiratory pathogens and suggested a reduction in the risk of aspiration pneumonia by improving the swallowing reflex and cough reflex sensitivity. CONCLUSIONS: According to the results of the current systematic literature review oral health care, consisting of tooth brushing after each meal, cleaning dentures once a day, and professional oral health care once a week, seems the best intervention to reduce the incidence of aspiration pneumonia

[The guideline Oral Health Care for dependent residents in long term care facilities, 2007: dire necessity!]

Contains fulltext : 69227.pdf (publisher's version ) (Closed access)The oral health status of residents in Dutch nursing homes is rather poor, especially of those depending on caregivers for their oral health care. Moreover, when care dependency is rising, the provision of good oral health care becomes more difficult. With more elderly people still having (parts of) their natural teeth, the need for good oral health care is increasing even more. Therefore a specific guideline was developed. The ultimate aim of the guideline "Oral health care for dependent residents in long term care facilities" is to improve the oral health of nursing home residents. Oral health care needs to be incorporated in daily nursing home care routine and in the integral care plan of every resident. Attention is given to the importance of an adequate implementation of this guideline as well as to the necessity of research evaluating the effects of it's implementation

Risk factors for aspiration pneumonia in frail older people: a systematic literature review

Item does not contain fulltextOBJECTIVE: To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors. DESIGN: Systematic literature review. SETTING: PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published in English in the period January 2000 to April 2009. PARTICIPANTS: Frail older people. MEASUREMENTS: Only publications with regard to hospitalized, institutionalized, or frail home-dwelling people of 60 years and older were eligible. Two authors independently assessed the publications for their methodological quality. Unadjusted and adjusted odds ratios and their corresponding 95% confidence intervals for respective risk factors related to aspiration pneumonia were extracted. The results were evaluated according to the levels of evidence of the Oxford Centre for Evidence-based Medicine. RESULTS: A total of 21 publications fulfilled the quality criteria. Evidence level 2a (systematic review with homogeneity of cohort studies) was found for a positive relationship between aspiration pneumonia and age, male gender, lung diseases, dysphagia, and diabetes mellitus; 2b (individual cohort study) for severe dementia, angiotensin I-converting enzyme deletion/deletion genotype, and bad oral health; 3a (systematic review with homogeneity of case-control studies) for malnutrition; 3b (individual case-control study) for Parkinson's disease and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health among the risk factors seems limited. CONCLUSION: Thirteen significant risk factors were identified: age, male gender, lung diseases, dysphagia, diabetes mellitus, severe dementia, angiotensin I-converting enzyme deletion/deletion genotype, bad oral health, malnutrition, Parkinson's disease, and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health seems limited

An oral health care guideline for institutionalised older people

Item does not contain fulltextdoi: 10.1111/j.1741-2358.2010.00406.x An oral health care guideline for institutionalised older people Institutionalized older people are prone to oral health problems and their negative impact due to frailty, disabilities, multi-morbidity, and multiple medication use. Until recently, no evidence-based oral health care guideline for institutionalized older people has been available. For that reason, the Dutch Association of Nursing Home Physicians developed the Oral health care Guideline for Older people in Long-term care Institutions (OGOLI), meeting the requirements of the AGREE instrument for assessing a guideline's quality. This short report presents the keynotes and the content of the Oral health care Guideline. Most recommendations are based on expert opinions. Only 4 recommendations (education, pneumonia, use of an electric toothbrush, and fluoride rinsing in case of a sudden increase of oral plaque amount) are based on evidence level A2 conclusions. This emphasizes the need for further research on oral health of institutionalized older people

Effectiveness of supervised implementation of an oral health care guideline in care homes; a single-blinded cluster randomized controlled trial

Item does not contain fulltextOBJECTIVES: The objective of this study was to assess the effectiveness of a supervised implementation of the "Oral health care Guideline for Older people in Long-term care Institutions" (OGOLI) in The Netherlands. MATERIALS AND METHODS: A sample of 12 care homes in the Netherlands was allocated randomly to an intervention or control group. While the residents in the control group received oral health care as before, the intervention consisted of a supervised implementation of the OGOLI. RESULTS: At baseline, the overall random sample comprised 342 residents, 52 % in the intervention group and 48 % in the control group. At 6 months, significant differences were observed between the intervention and the control group for mean dental as well as denture plaque, with a beneficial effect for the intervention group. The multilevel mixed-model analyses conducted with the plaque scores at 6 months as outcome variables showed that the reduction by the intervention was only significant for denture plaque. CONCLUSIONS: Supervised implementation of the OGOLI was more effective than non-supervised implementation in terms of reducing mean plaque scores at 6 months. However, the multilevel mixed-model analysis could not exclusively explain the reduction of mean dental plaque scores by the intervention. CLINICAL RELEVANCE: A supervised implementation of an oral health care guideline improves oral health of care home residents