The impact of having natural teeth on the QoL of frail dentulous older people. A qualitative study (original) (raw)
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Nederlands tijdschrift voor tandheelkunde, 2017
When older people become frail, they often give up making dental visits, while their oral health care and oral health deteriorate. Open interviews and questionnaires were used to explore why frail older people change their oral health care behaviour and which (frailty-related) factors contribute to this change. These are mainly motivation-related factors. There seems to be a turning point where frail older people discontinue their oral health care routines and stop caring whether or not they loose teeth, because the perceived efforts no longer outweigh the perceived benefits of making dental visits and upkeep of oral hygiene. The use of standard questionnaires such as the validated Geriatric Oral Health Assessment Index-NL to measure oral health-related quality of life is limited, because they do not provide personal context required to interpret the outcomes. From a pre-frail stage (oral) care providers should monitor specific factors that might negatively affect oral health and or...
Dental care of frail older people and those caring for them: Dental care of frail older people
Journal of Clinical Nursing, 2010
Aims and objectives. To describe oral health utilisation patterns of frail older people and contrast these with attitudes and utilisation patterns of nursing staff who are caring for them.Background. In view of widespread poor oral health of frail older people in long-term care, staff attitudes have been identified as an area of interest. In addition to data on attitudes, the current study contributes a description of aspects of oral health related behaviour of staff and clients.Design. Cross-sectional study.Methods. Structured interviews of a random selection of long-term care staff (n = 320) and frail older people (n = 172), within the two groups of home-care services (HCS) and long-term care facilities (LTCF).Results. Of staff members, 55·3% attach the same importance to their own oral health compared to that of clients and 35·7% regard their own oral health as more important; 98·4% of staff attended two or more dental examinations per year; 3·4% of HCS and 37·1% of LTCF routinely arranged oral examinations. In 81·4% HCS and in 34·4% of LTCF, there was no routine dental service available. Patterns of oral health service attendance greatly differ between staff and clients.Conclusion. The oral health awareness of the majority of long-term care staff did not translate into adequate oral health care for clients. A gap exists between attitudes supportive of oral health, adequate and prevention driven own oral health related behaviour of staff and actual oral health care delivered to clients.Relevance to clinical practice. To bridge the gap identified, a concept is suggested for nursing educators and managers of LTCF targeting educational measures while taking into account individual attitudes.
Oral Health and Self-Perception in the Elderly
Health, 2014
Background: Investigating self-perception of oral health among the elderly may contribute towards changing public health and assistance policies in the area. Methods: The present study assessed the oral health status (tooth decay, need for treatment, periodontal status, use of and need for dental prosthesis, soft tissue alterations and self-perception of oral health) of 102 elderly people from two community groups in Fortaleza, Ceará State, Brazil. Results: Mean age was 69.9 years and 82.4% were female. Mean DMFT was 30.17 with a predominant missing component; 63.7% were edentulous. Regarding prosthesis, 29.4% and 67.6% of elderly patients did not use upper and lower dentures respectively, while 66.7% and 78.4% required some type of upper and lower prosthesis respectively. Among valid sextants, 44.3% presented dental calculus and 34.3% presented loss of attachment from 6 to 8 mm. Soft tissue alterations were found in 58.8%. Despite of precarious clinical conditions and dental treatment needs, good oral health perception was found (49%), as well as satisfaction with the appearance of teeth and gums (60.8%). Conclusion: Subjects displayed unsatisfactory oral health conditions, accumulated over time and resulting from the lack of policies favoring this age group. There is a need for oral rehabilitation that enables the recovery of function and esthetics among the elderly, restoring their self-esteem and improving social interaction. W. V. B. Moura et al.
Dental care of frail older people and those caring for them
Journal of Clinical Nursing, 2010
Aims and objectives. To describe oral health utilisation patterns of frail older people and contrast these with attitudes and utilisation patterns of nursing staff who are caring for them. Background. In view of widespread poor oral health of frail older people in long-term care, staff attitudes have been identified as an area of interest. In addition to data on attitudes, the current study contributes a description of aspects of oral health related behaviour of staff and clients. Design. Cross-sectional study. Methods. Structured interviews of a random selection of long-term care staff (n = 320) and frail older people (n = 172), within the two groups of home-care services (HCS) and long-term care facilities (LTCF). Results. Of staff members, 55AE3% attach the same importance to their own oral health compared to that of clients and 35AE7% regard their own oral health as more important; 98AE4% of staff attended two or more dental examinations per year; 3AE4% of HCS and 37AE1% of LTCF routinely arranged oral examinations. In 81AE4% HCS and in 34AE4% of LTCF, there was no routine dental service available. Patterns of oral health service attendance greatly differ between staff and clients. Conclusion. The oral health awareness of the majority of long-term care staff did not translate into adequate oral health care for clients. A gap exists between attitudes supportive of oral health, adequate and prevention driven own oral health related behaviour of staff and actual oral health care delivered to clients. Relevance to clinical practice. To bridge the gap identified, a concept is suggested for nursing educators and managers of LTCF targeting educational measures while taking into account individual attitudes.
The Dentist's Role in Preserving the Elderly Patients' Dignity
2013
Senescence is a biological process which is part of the normal vital cycle of the human individual and the understanding and evaluation of its specific aspects is of top importance. When not pathological and generating pathology, senescence is a biological step in human life which still makes it possible for diseases to take toll. That calls for an individualized approach of the elderly patient, in view of the numerous somatic, psychological and social changes that may occur. The elderly represent a significant, growing percentage of patients in a dental clinic and it is necessary to adequately approach each of them from a psychological point of view, paying attention to the assortment of specific ailments that affect them. Quite often, in the physician-patient relation, the dignity of the elderly gets tainted due to the lack of economic and medical solutions for these patients‟ extended problems. By maintaining or restoring these patients‟ functional and aesthetic oral-dental healt...
The importance of oral health in (frail) elderly people – a review
European geriatric medicine
Two important factors contribute to a higher chance of a deterioration of oral health status in frail and disabled elderly people. First, advances in oral health care and treatment have resulted in a reduced number of edentulous individuals and the proportion of adults who retain their teeth until late in life has increased substantially. Second, neglected self-care and/or professional care have led to reduced oral health care utilization. This review reports the consequences of having a poor oral health status and its impact on general health of frail elderly people and gives an overview of the important enabling and disabling factors regarding the provision of oral health care to frail older persons. Impaired cognitive and functional ability, medication-induced hyposalivation, reduced saliva buffer capacity and high saliva acidity, diabetes mellitus, the number of exposed root surfaces due to gingival recession, poor oral hygiene, high frequency of sugar consumption, and poor soci...
Gerodontology, 2006
Oral health care for frail elderly people: actual state and opinions of dentists towards a wellorganised community approach Objective: This study was undertaken to provide an analysis of the actual oral heath care for frail elderly people living in different settings and to explore opinions of dentists towards new concepts in developing a community approach. Method: Data were collected from a sample of 101 dentists (15%) in the county of Antwerp using a selfadministered 30-item questionnaire including questions about age, gender, education, organisational aspects of dental surgery, questions concerning dentists' own contribution to oral healthcare services for frail elderly people and statements concerning opinions and attitude toward the organisation of oral health care for frail elderly people. At the same time, qualitative data were collected from focus group sessions with all participating dentists. Non-parametric analysis was used to explore possible relationships between opinion and possible explanatory variables. Results: Half of the dentists offered dental services to residential or nursing homes (mean number of treatments a year: 5.4) and at home (mean number of treatments a year: 2.4). Prosthetic treatments such as relieving denture pressure points, repairing, rebasing and making new dentures were carried out in 77.4% and 76.7% of the cases in residential or nursing homes and at home respectively. Extractions were carried out in 16% and 18.6% of the cases in both living situations respectively. The main reasons for dentists refusing domiciliary oral health care were the absence of dental equipment (63%), lack of time (19%), with 11% convincing the patients to be treated in their dental surgery. Analysis showed different opinions of dentists depending on age, gender and university of education; however, statistically significant differences were only found by age. Conclusion: The older the dentist, the greater the tendency to refuse domiciliary oral healthcare services. The younger dentists were reluctant to cooperate in the provision of oral health care in a structured community approach.
Frailty and oral health: Findings from the Concord Health and Ageing in Men Project
Gerodontology, 2019
Objective: To examine whether frailty in older men is associated with poorer oral health and lower levels of dental service utilisation. Background: Poor oral health has been associated with some frailty components. Less is known about the link between frailty and oral health outcomes. Methods: a cross-sectional analysis. Data were collected from 601 older men with both frailty status and oral health information. Frailty was defined as meeting three or more of the Cardiovascular Health Study criteria: weight loss, weakness, exhaustion, slowness and low activity. Dental service utilisation [DSU] behavior was collected from self-response questionnaires and face-to-face interviews. Oral status (number of remaining and functional teeth, periodontal disease, active coronal decayed surface [ACDS], and self-rated oral health [SROH]) was recorded by two oral health therapists. The association between frailty and oral health behavior and risk markers was modelled using logistic regression. Results: Nineteen percent of the participants were identified as frail. There were significant associations between frailty and dentition status (odds ratio [OR]: 2.49, 95% confidence interval [CI]: (1.17-5.30), and frailty and ACDS (OR: 3.01, CI: 1.50-6.08) but only ACDS remained significant after adjusting for confounders (adjusted OR: 2.46, CI: 1.17-5.18). There was no association between frailty and DSU and frailty and SROH. Conclusion: Frailty was independently associated with presence of dental caries. However, dental service utilisation, self-rated oral health and other oral health markers were not significantly associated with frailty after adjusting for confounders. The prevalence of periodontal disease was high regardless of their frailty status.