Abstract
This study aimed to assess the influence of an oral hygiene intervention on oral health, depending on the degree of dementia. A clinical evaluation of oral health parameters (index of decayed, missing, and filled teeth (DMFT-index), periodontal screening index (PSI), oral hygiene index (OHI), and bleeding on probing (BOP)) was performed in 120 subjects assigned to five groups, based on the mini mental state examination (MMSE) at baseline and after 12 months. Each MMSE group (no dementia (noDem, MMSE 28–30), mild cognitive impairment (mCI, MMSE 25–27), mild dementia (mDem, MMSE 18–24), moderate dementia (modDem, MMSE 10–17), and severe dementia (sDem, MMSE ≤ 9)) was split into control (no intervention) and experimental groups (intervention on oral hygiene: increased frequency, daily usage of high-fluoride toothpaste). In total, 99 out of 120 subjects were included in the analysis. The dropout rate was high in subjects with modDem and sDem due to death. In subjects with noDem, mCI, and mDem, no changes in the DMFT were found, but improvements in the OHI, BOP, and PSI were observed. Subjects with modDem or sDem demonstrated a deterioration in DMFT; however, in these patients, OHI improved in all control and experimental groups, BOP improved in the experimental group only, and PSI did not improve at all. The scope of improving oral health parameters by increasing the recall frequency and by continuously using high fluoride toothpaste is at its limits in people with severe dementia. Multidimensional approaches should be sought to improve the oral health of vulnerable older patients.
Highlights
The number of people suffering from dementia is increasing worldwide
Oral functional capacity (OFC) and its parameters became worse with the increase in the degree of dementia in all subjects
DMFT and DFT values showed no significant differences between the control and experimental groups of all mini mental state examination (MMSE) groups at the end of the study
Summary
The number of people suffering from dementia is increasing worldwide. By 2050, the prevalence is predicted to have doubled or even tripled in most industrialized countries [1].the proportion of people in need of care is increasing with a steadily growing older population [2]. The number of people suffering from dementia is increasing worldwide. By 2050, the prevalence is predicted to have doubled or even tripled in most industrialized countries [1]. The proportion of people in need of care is increasing with a steadily growing older population [2]. Because of the prevention efforts of the last decades, old and very old people retain more of their teeth into old age today [3]. The decline in cognitive abilities, culminating in dementia, leads to an increase in the need for care. This trend is observed in the field of dentistry. At the same time, the reduced utilization of dental services can be observed [4]. Patients with advanced dementia are not able to take care of their oral and denture hygiene on their own
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