Abstract
Abstract Objective Due increased number of elders living in long-term care institutions, actions designs to improve their oral health are essential. Thus, the aim of this study was to evaluate the impact of an educational program for the caregivers through the assessment of the oral hygiene of institutionalized elders. Material and method The education program consisted in lectures to caregivers about oral health that were performed once a month. The subjects were 40 functionally dependent institutionalized elders and 14 caregivers. Hygiene habits, plaque index, and tongue coating/discoloration of the elders were measured before the educational program (baseline- T0) and after 6 (T1), 12 (T2), 18 (T3) and 24 months (T4). Caregivers answered questions about their knowledge, doubts and implementation of dental care (T0 to T4). Result After analyzing the data (Friedman, Chi-square and Spearman α = 0.05), a gradual improvement in the oral hygiene of the subjects was observed, with an increased frequency of brushing (p=0.0005), a change in the brush type (p=0.0065) and a reduction in the plaque index (p<0.05) and tongue coating (p<0.05). Caregivers showed a marked improvement in their dental care knowledge. Conclusion It was concluded that the educational program for caregivers had a positive impact in the oral health of institutionalized elderly observed by the increased in the effectiveness of oral hygiene parameters such as plaque index and tongue coating, contributing to the knowledge gain in hygiene by caregivers.
Highlights
The number of elders living in long-term care institutions (LTCI) has been increasing in many countries[1]
There is a failure between the high need for dental care and the limited services offered to the institutionalized elders[10]; there is a need to educate caregivers about oral health to be potential care educators
To perform the clinical evaluations, all authors participated in a training that consisted of theoretical classes in a period of three weeks (4 hours a week) about oral hygiene, factors related to plaque index and characteristics of the buccal mucosa, emphasizing the tongue coating and tongue discoloration
Summary
The number of elders living in long-term care institutions (LTCI) has been increasing in many countries[1]. Of dependence in daily activities and requiring a multidisciplinary treatment, with contributions from nurses, caregivers and other health professionals[4], associated to the impact in the financial system[5] Factors such as cognitive decline[6], sarcopenia[7] and lack of mobility in elders due to either physical disabilities or tissue and organ impairments resulting from aging or degenerative diseases contribute significantly to poor oral health[8]. There are some barriers[10,11,12] to achieving adequate oral health for the residents of LTCIs; these barriers include high costs, restricted mobility, a low level of awareness about the needs of elders, the perceived need for dental care among the institutionalized elders, the number of teeth, the functional and clinical status of the elders, financial restrictions, resistance to care and fear and lack of caregiver knowledge about oral health[10]; knowing that the health education of caregivers contributes to the improvement of the oral health of the elderly[6,13,14]. Thereby, the following hypotheses were tested: H0-The caregiver educational program will not affect the oral hygiene quality of dependents elderly; H1- The caregiver educational program will affect the oral hygiene quality of dependents elderly
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