Corporate Practice/Dental Service Organization.

Overcoming Oral Hygiene Challenges in the Nursing Home

Attitudes among dentists and dental hygienists towards extended scope and independent practice of dental hygienists

Gap in Dental Care Can Lead to Diabetes, Other Disease Conditions

The Present Status of Dental Journalism: The Rôle of Editorial and Advertising Policies, in the Campaign for Reform of Proprietary Dental Advertising

BackgroundThe link between oral bacteria and respiratory infections is well documented. Dental plaque has the potential to be colonized by respiratory pathogens and this, together with microaspiration of oral bacteria, can lead to pneumonia particularly in the elderly and critically ill. The provision of adequate oral care is therefore essential for the maintenance of good oral health and the prevention of respiratory complications.Main bodyNumerous oral care practices are utilised for intubated patients, with a clear lack of consensus on the best approach for oral care. This narrative review aims to explore the oral-lung connection and discuss in detail current oral care practices to identify shortcomings and offer suggestions for future research. The importance of adequate oral care has been recognised in guideline interventions for the prevention of pneumonia, but practices differ and controversy exists particularly regarding the use of chlorhexidine. The oral health assessment is also an important but often overlooked element of oral care that needs to be considered. Oral care plans should ideally be implemented on the basis of an individual oral health assessment. An oral health assessment prior to provision of oral care should identify patient needs and facilitate targeted oral care interventions.ConclusionOral health is an important consideration in the management of the critically ill. Studies have suggested benefit in the reduction of respiratory complication such as Ventilator Associated Pneumonia associated with effective oral health care practices. However, at present there is no consensus as to the best way of providing optimal oral health care in the critically ill. Further research is needed to standardise oral health assessment and care practices to enable development of evidenced based personalised oral care for the critically ill.

The importance of oral hygiene for patients on mechanical ventilation.

ObjectiveThe total years lived with disability among older people, and the concomitant burden of tooth loss in ageing societies have increased. This study is an overview of the burden of oral diseases and access to oral care in an ageing society. MethodsWe selected key issues related to the burden of oral diseases and access to oral care and reviewed the relevant literature. ResultsThe rising number of older people with teeth increases their oral health care needs. To improve access to oral care, affordability of care is a great concern with respect to universal health coverage. In addition, accessibility is a crucial issue, particularly for vulnerable older adults. To improve oral care access, attempts to integrate oral health care into general care are being made in ageing countries. For this purpose, provision of professional oral care at home through domiciliary visits and provision of daily oral health care by non-dental professional caregivers are important. Oral health care for older people reduces general diseases such as pneumonia and malnutrition, which in turn could reduce further healthcare costs. ConclusionsTo address the growing burden of oral care in ageing societies, special provision of oral health care to vulnerable older people, and integration of oral care with primary care will be required.

Nutritional Disorders in the Elderly

Objective To understand the real experience of oral hygiene care of perioperative oral cancer patients. Methods Qualitative descriptive research was adopted. Semi-structure in depth interviews were conducted among 17 postoperative oral cancer patients. NVivo 11 was used to manage and sort out the original data, data was analyzed with the content analysis of Colaizzi. Results Six themes regarding oral hygiene care was extracted, including the diversity of methods of oral hygiene and the care provider, patients have limited knowledge about oral hygiene care and the relative education is lacking, the change of function, structure and the degree of comfort of mouth impact the oral hygiene care, patients′ feedback on oral hygiene care is complicated, patients′ oral care related emotional experience is rich, oral hygiene care experience of elderly and non-elderly patients with oral cancer has few difference. Conclusions The oral hygiene care of perioperative oral cancer patients needs to be further standardized, the instruction of patients′ oral hygiene care needs to be enhanced, more attention should be paid to the popularization of disease knowledge, so as to optimize patients care and do a good job in disease prevention. Key words: Oral neoplasm; Perioperative period; Oral care; Qualitative study

Oral care of intensive care unit (ICU) bound individuals is essential for overall health outcomes and to prevent complications. Nurses, who are the primary caregivers, should possess adequate knowledge, attitude, and practice (KAP) in this regard to provide optimal care to these patients. There are no standardized guidelines existing at present in this regard, making the practice of oral care more challenging.There is a diversified representation of nurses who practice in this region of the world and have not been analyzed in the past. This study would like to address this paucity of data. Hence, the aim of the present study was to evaluate the knowledge, attitude, and practice of nurses regarding oral health care in ICU patients along with analyzing any existing hospital-based policies related to oral care. A cross-sectional study was conducted among 230 nurses practicing at ICU of the National Guard Health Affairs (NGHAs) Hospital, King Abdulaziz Medical City, in Riyadh City, Saudi Arabia. Nurses responded to 22 closed-ended questionnaires, which were adopted after content validation and reliability assessment. Descriptive statistics, chi-square analysis, and multinomial logistic regression were carried out using the Statistical Package for the Social Sciences (SPSS, Version 20, 2011; IBM Corp., Armonk, USA). A total of 230 (51.1%) nurses responded. The mean working experience of 12.6 (±7.5) years and ICU experience of 10.6 (±6.7) years were observed. Seventy-four (32.2%) nurses mentioned they received oral care training for ICU patients as part of their degree. A significant variation (p=0.03) in response was observed based on qualification concerning the knowledge of nurses if improper oral care among ICU patients could cause systemic complications. Nurses with less than five years' experience were more likely to provide oral care only once per day compared to nurses with higher experience (>10 years) (OR: 2.97, p=0.00, 95% CI: 2.40-12.2). There were certain knowledge, attitude, and practice-based questions that elicited significant differences in responses based on the qualifications and experience of the nurses. Overall, the nurses did possess fair knowledge and favorable attitudes towards oral care in these patients.

Objective: To explore the oral health care situation of dependent older people in Tambon Tha Pla Duk, Amphur Mae Tha, Lamphun Province in the north of Thailand from the perspectives of older health care stakeholders. Material and Method: Data were collected through focus group discussion with key stakeholders in older peoples’ health care. Supplementary data were collected through a triangulation of in-depth interviews, selfadministered questionnaires, and participant observations with field notes. Data analysis was carried out by using qualitative approaches. The data from all processes were coded, grouped, interpreted, and thematically analyzed for emerging themes. Results: The oral health care situation of dependent older people identified by the stakeholders were categorized into four issues: 1) Stakeholders’ perceptions about the importance of oral care for dependent older people, 2) The current oral health services and access to oral health services for dependent older people, 3) The problems identified by the stakeholders regarding oral care, and 4) The needs of the stakeholders regarding oral care. There were three main issues needing urgent consideration to improve the oral health care of the dependent older people in this sub-district: 1) No specific oral health care and services were available for the dependent older people. 2) There would have to be an improvement of the stakeholders’ knowledge, skills, and positive attitudes regarding older peoples’ oral care. 3) Increased awareness of older peoples’ oral health care in the community was necessary. Conclusion: The oral health care situation of dependent older people identified by the stakeholders should be considered important in order to develop an effective geriatric oral health program in this sub-district.

Firmly establishing oral health care professionals’ roles as vaccinators within the health care system

The purpose of this study was to explore how nurses provide bedtime oral hygiene care, how they decide on interventions provided, and what factors influence their ability to provide oral care. Current evidence links poor oral hygiene to systemic and infectious diseases such as pneumonia. Hospitalised patients, who now retain their teeth into older adulthood, often rely on nurses to provide oral hygiene care. Nurses have the potential to impact oral health outcomes and quality of life by controlling plaque. However, oral hygiene care practices of nurses in postacute hospital settings are relatively unknown. A qualitative, exploratory multiple-case study was conducted with 25 nurses working on five inpatient units at different hospitals. Nurses were accompanied on their evening rounds to observe oral care practices, the physical environment and workflow. Thematic analysis was used to analyse the case study data including transcripts of guided conversations, field notes and documents. Within-case analysis was followed by cross-case analysis. Findings indicate that (i) nurses often convey oral hygiene care to their patients as being optional; (ii) nurses are inclined to preserve patient autonomy in oral hygiene care; (iii) oral hygiene care is often spontaneous and variable, and may not be informed by evidence; and (iv) oral hygiene care is not embedded into bedtime care routines. Oral hygiene care is discretionary and often missed care. Nurses need knowledge of the health benefits of oral care, and skills related to assessment and approaches to oral care. Availability of effective products and supplies facilitates provision of oral care. The evidence for oral hygiene care practices, outcomes of nurse-administered oral care and nursing's role in influencing the oral health literacy of patients require further study.

Global health threats are also oral health threats

Objective: To verify user satisfaction with oral public health services in different treatment dimensions and relate them to demographic conditions. Material and Methods: This study using pilot pathfinder design, conducted in Bantaeng Regency in January 2018. Patient was obtained for 114 people. Data were collected using structured questionnaires, which have been designed according to this survey which has eighteen questions corresponding to the object, with response patterns: satisfied, more or less and dissatisfied. Satisfaction was analyzed by using chi-square test. Questions about satisfaction with services are grouped into five domains - 'physical structure', 'relationships and communication', 'information and support', 'health care' and 'service organization'. Results: The results showed that in dental and oral health centers in Bantaeng District the physical structure dimension showed the highest level of satisfaction, while the dimensions of dental and oral health care showed the lowest satisfaction. Conclusion: Communities in Bantaeng and Pa'jukukang Sub-districts of Bantaeng Regency are mostly satisfied with dental and oral health services based on health service dimensions. On the physical structure dimension shows the highest level of satisfaction, whereas the dimension of dental and oral health care shows the lowest satisfaction.