Abstract
BackgroundGlobally, oral health status of the geriatric population residing in nursing homes is poor. The integration of non-dental professionals is vital to monitor oral health, early identification and triaging of oral health problems, and timely referral to dental professionals. The aims of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of their psychometric properties.MethodsThis review was conducted as per the PRISMA guidelines. CINHAL (EBSCO), Medline (Ovid), and EMBASE (Ovid) were searched systematically. Two reviewers independently screened the title, abstract, and full text of the studies as per the eligibility criteria. Studies describing oral health assessment instruments used to assess oral health of nursing home residents by non-dental professionals were included. Using a methodological framework, each instrument was evaluated for purpose, content, and psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness. Additionally, the reporting quality assessment of each included study was performed according to the SURGE guidelines.ResultsOut of the 819 screened articles, 10 studies were included in this review. The 10 identified instruments integrated 2 to 12 categories to assess oral health, which was scored on a 2 to 5-point scale. However, the measurement content varied widely, and none were able to comprehensively measure all aspects of oral health. Three measurement approaches were identified: performance- based assessment, direct inspection of the oral health status, and interview measures. Only eight instruments provided quality assessment on the basis of validity, reliability, feasibility and generalisability, whereas three instruments- Brief Oral Health Status Examination, Dental Hygiene Registration, and Oral Health Assessment Tool reported good methodological quality on at least one assessment criteria.ConclusionsNone of the instruments identified in this review provided a comprehensive assessment of oral health, while three instruments appeared to be valid and reliable. Nonetheless, continuous development of instruments is essential to embrace the complete spectrum of oral health and address the psychometric gaps.
Highlights
Oral health status of the geriatric population residing in nursing homes is poor
Three instruments- Brief Oral Health Status Examination (BOHSE) [34], Dental Hygiene Registration (DHR) [52], and Oral Health Assessment Tool (OHAT) [43] reported good methodological quality on at least one assessment criteria and appeared to be valid and reliable assessment tools for use by non-dental professionals to assess the oral health of nursing home residents
The objectives of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of the psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness of these instruments
Summary
Oral health status of the geriatric population residing in nursing homes is poor. Poor oral health outcomes such as dental caries (tooth decay) and periodontal (gum) diseases may further increase the risk of systemic diseases [4,5,6]. Several studies conducted globally suggest that about 1 in 5 older adults aged 65 and above have tooth loss [10,11,12], while more than half have periodontal diseases [11, 13]. This suggests that oral health problems are one of the major global health concerns with an increased prevalence of oral diseases among older people [14]
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