Abstract
BackgroundThere is limited information available about the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments.AimsThe purpose of this study was to identify factors influencing the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments.MethodsThe study was performed in nine nursing-homes in Germany. Sociodemographic and general data were collected for all participants (n = 150). The Clinical Dementia Rating (CDR) was used to identify the presence of dementia, and the Apraxia Screening Test (AST) was used to identify motor impairment. A comprehensive dental examination was also performed. This included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMFT). In addition, dental and denture hygiene were assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI). Univariate and multivariate regression models were used to analyse possible factors affecting the dependent target variables.ResultsIn multivariate regression analysis, the factors that most strongly influenced greater PI were a lower number of medications taken (p = 0.018), poorer general health (p = 0.013) and the presence of dementia (p < 0.010). A more advanced age (p = 0.036) and longer nursing-home stay (p = 0.048) had a negative effect on the DHI. Furthermore, gender (p = 0.037, in favour of women), poorer general health (p = 0.003), presence of dementia (p = 0.003), and the absence of natural teeth (p = 0.028) influenced poorer oral health. The factors most strongly influenced greater number of missing teeth were a more advanced age (p = 0.021) and longer nursing-home stay (p = 0.015). In terms of fewer filled teeth, a shorter nursing-home stay (p = 0.002) was the factor most strongly influenced this.ConclusionsPoorer general health and the presence of apraxia and cognitive impairment are the main determinants for poorer oral hygiene and oral health among nursing-home residents. A longer nursing-home stay also seems to be relevant for oral health and denture hygiene.
Highlights
Ageing is a substantial risk factor for the development of general health problems, including cognitive impairment and dementia
The oral health of self-reliant older people has improved in the last decade, and their number of remaining natural teeth has increased in parallel [5, 6]
12–50% of nursing-home residents are edentulous, and many have no dental prosthesis at all [4, 8, 10, 12]. Such oral-health problems can be exacerbated by motor and cognitive impairments, because many older people with dementia refuse oral hygiene as part of their daily care routine
Summary
Ageing is a substantial risk factor for the development of general health problems, including cognitive impairment and dementia. Aging Clinical and Experimental Research oral-health problems such as caries, gingivitis, periodontal disease, and edentulism is still high, and inadequate oral hygiene is a major concern in long-term care [4, 7,8,9,10] In this context, the mean number of remaining teeth among nursing-home residents is 9–12 [4, 8], and many residents urgently need dental treatment for an ulcer, infection, broken tooth or untreated caries [4, 11]. 12–50% of nursing-home residents are edentulous, and many have no dental prosthesis at all [4, 8, 10, 12] Such oral-health problems can be exacerbated by motor and cognitive impairments, because many older people with dementia refuse oral hygiene as part of their daily care routine. A longer nursing-home stay seems to be relevant for oral health and denture hygiene
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