Abstract
ObjectivesThe oral health of nursing home residents is poor for various reasons. Many require help for oral hygiene. Regular professional brushing by a dental nurse should improve oral hygiene. This study aimed to determine the efficacy of regular tooth brushing by a dental nurse on the oral health of nursing home residents.MethodsThis controlled trial randomized participants (n = 50; mean age 83 ± 8 years) to brushing by a dental nurse every 2 weeks for 3 months (n = 25; test group) or oral hygiene procedures performed/controlled by nursing home staff (n = 25; control group). Personal, general and oral health, as well as various oral hygiene parameters—plaque index (PI), gingivitis index (GI), papilla bleeding index (PBI), oral hygiene index (OHI) and Volpe‐Manhold Index (VMI)—were evaluated at baseline, after initial professional dental cleaning and before last brushing.ResultsAt baseline, oral health was impaired according to investigated indices in both groups. After professional brushing for 3 months, there were improvements in PI, GI and PBI, with significant increases compared with the control group in OHI and VMI (P = 0.017 and P < 0.001, respectively). Among the control group, the number of teeth decreased while the root caries index increased (P = 0.002 between groups).ConclusionsRegular professional brushing every 2 weeks by a dental nurse can be recommended for nursing homes residents to improve oral health parameters and to help reduce root caries incidence as a basis to preserve the number of teeth. Such oral hygiene procedures will maintain and improve the oral health of nursing home residents.
Highlights
The number of people that depend on care in nursing homes will increase dramatically over the few decades
Zenthöfer et al[1] investigated a mixture of professional cleaning and remotivation of different groups among nursing home residents with low care levels and showed that professional teeth cleaning combined with individual instruction can improve oral hygiene, independent of whether remotivation was performed by a dentist or staff educated in dental hygiene and even when no remotivation was performed
There was improvement in oral hygiene parameters in the control group, and there is a question whether the success in oral hygiene parameters might be due to the Hawthorne effect[28] or at least be influenced in both groups: that is knowing they are involved in a study might lead to better brushing/supervising by staff and by residents during the TA B L E 3 Number of teeth, number of lost teeth and root caries index at baseline, before first brushing and before the last brushing session
Summary
The number of people that depend on care in nursing homes will increase dramatically over the few decades. The oral health of nursing home residents has been well documented and is poorer than that of older community‐dwelling people. Oral care in nursing homes is inadequate, aggravated by the lack of awareness of good. Nursing home residents often suffer from dementia and immobility, which may hinder them and the caring staff from performing good oral hygiene procedures.[11,12]. It has been suggested that oral hygiene performed in nursing homes is insufficient for the maintenance of good oral health.[4]. The fact that somebody requires external help for oral hygiene manoeuvres may itself represent an increased risk of impaired oral health. New and realistic strategies must be developed to improve the oral health of this special population
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