A systematic review of measurement instruments for oral health assessment of older adults in long-term care facilities by nondental professionals.

Abstract

Regular oral health assessment of older adults living in Long-term Care Facilities (LTCF) can improve their oral health. This study aimed to systematically review studies describing the development of instruments employed by nondental professionals to assess the oral health of older adults in LTCF and to evaluate their measurement properties. Electronic searches were conducted in the MEDLINE (PubMed), Embase, Web of Science, Scopus, and LILACS databases. Measurement properties of the identified instruments were evaluated using the Consensus-based Standards to select health Measurement Instruments (COSMIN) checklist. Studies assessing at least one measurement property (validity, reliability, or responsiveness) of instruments used to assess oral health of older adults living in LTCF by nondental professionals were considered. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) checklist was used to evaluate the quality of evidence. Fifteen studies reporting measurement properties of seven instruments were selected. The ohr-interRAI and the OHAT were considered to have sufficient content validity, with high and moderate evidence quality, respectively. OHAT, BOHSE, and DHI showed acceptable results on reliability but with very low quality of evidence. DHI and OHSTNP also showed acceptable results for criterion validity, but, with low quality of evidence, insufficient or unclear results were observed for the remaining measurement properties. Studies evaluating the validity criteria of BOHSE and hypotheses testing of ohr-MDS were considered to have high evidence quality. The ohr-interRAI can be provisionally recommended for use until further evidence is provided. Further methodologically rigorous studies are needed to assess the measurement properties of the existing instruments.