Oral Health Care Intervention Research Articles

Impact of oral care intervention on quality of life of patients with oral cancer undergoing radiotherapy in Sri Lanka: A quasi-experimental study.

Radiotherapy is used to treat oral cancer, yet it negatively affects patients' health-related quality of life (HRQOL). The aim was to evaluate the impact of an oral healthcare intervention on HRQOL of patients with oral cancer who receive radiotherapy with or without chemotherapy. An oral healthcare intervention was provided to 41 patients with oral cancer before radiotherapy (fluoride varnish application, scaling, permanent restorations, adjustment of sharp teeth, and extraction of teeth with questionable prognosis, oral hygiene instructions), during, and 3 months after radiotherapy (baking soda mouthwash, artificial saliva spray). EORTC QLQ-H&N35 was used to compare the HRQOL of the intervention and control groups, with the latter having received routine oral healthcare. The intervention group showed lesser values for HRQOL domains and items indicating fewer side effects during the last week of radiotherapy and 3 months after, compared to the control group. Most of the changes in HRQOL were significantly less in the intervention group compared to the control group (p < 0.01). The oral healthcare intervention effectively reduced the effect of radiotherapy and positively impacted on HRQOL of patients with oral cancer.

Prevalence and Patterns of Oral Mucosal Lesions Among Geriatric Patients in India: A Retrospective Study

ABSTRACT Introduction: Geriatric dentistry plays a pivotal role in addressing the oral health needs of the elderly population, who are prone to various age-related disorders affecting the oral mucosa. This study aims to investigate the prevalence of oral mucosal lesions among geriatric patients in India, considering factors, such as age, gender, and systemic diseases. Methodology: A hospital-based retrospective study was conducted, analyzing medical and clinical examination records of 354 geriatric patients attending a dental college/hospital between 2022 and 2023. Data on demographics, systemic diseases, oral habits, and denture usage were collected, and oral mucosal lesions were classified according to the World Health Organization (WHO) criteria. Results: Among the 354 subjects examined, oral mucosal lesions were observed in 54.66% of cases. Leukoplakia (19.49%) and lichen planus (17.80%) were the most prevalent lesions, followed by malignancy (12.99%) and denture stomatitis (9.04%). The prevalence varied across age-groups, with higher rates observed in individuals aged 60–70 years. Conclusion: The study highlights the significant burden of oral mucosal lesions among geriatric patients in India, underscoring the need for targeted preventive strategies and comprehensive oral healthcare interventions tailored to the specific needs of elderly individuals.

Oral health care intervention protocol for older adults at home in dental hygienists: a narrative literature review

Objectives: This study aims to propose a standard protocol for oral health care intervention activities by dental hygienists. Methods: A narrative literature review of home visit oral health care intervention activities reported in Cheonan, South Korea was conducted to enable the proposal of a standard home visit protocol for dental hygienists in the context of community care. Results: Oral health management intervention activities contributed to improving the quality of life, as well as the oral health, of older adults living at home. This was a result of applying a protocol consisting of oral observation, oral massage, expert oral hygiene management, oral muscle function training, and final stages. Conclusions: The visiting oral health intervention protocol was effective in resolving oral health problems of older adults. In the future, customized programs and reimbursement systems should be developed to promote oral health care for older adults that can be provided at home.

Awareness and attitudes regarding oral care intervention program based on community care for older adults at home: focusing on the grounded theory

Objectives: This study is based on a visiting oral health care intervention program in the community care. This qualitative study was conducted through in-depth interviews to identify awareness and attitudes regarding intervention program among older adults. Methods: The research team visited the homes of the target older adults and conducted in-depth interviews for approximately an hour using a semi-structured questionnaire. The collected voice recordings were transcribed using Clova Note, and AI program by Naver. Using the ‘Word Cloud Generator 3.7’ program, words of high importance and interest from interview answers were extracted, visualized, and analyzed. Results: Participating older adults acknowledged that their quality of life related to oral health could be improved by increasing the level of oral health awareness and oral health knowledge through the intervention program. In addition, the older adults indicated that their oral hygiene management ability improved compared to before the intervention through expert oral hygiene management and oral health education. Further, as the level of oral health knowledge increased, so too did satisfaction with the intervention program increase. Conclusions: The intervention program for visiting oral health care showed a positive effect on the awareness and attitude of older adults. Thus, it is suggested that education for continuous competency enhancement of dental hygienists and multidisciplinary education for the improvement of general health and quality of life of older adults should be promoted.

The moderating effect of oral health on the association between exercise and frailty in patients with musculoskeletal disorders: Findings from the Korean Longitudinal Study of Aging

PurposeThis study aimed to examine the effects of exercise and oral health on frailty and to investigate the moderating effect of oral health on the relationship between exercise and frailty among patients with musculoskeletal disorders. MethodsThis descriptive, cross-sectional study used data from the seventh wave of the Korean Longitudinal Study of Aging. Frailty index based on 41 deficits across seven domains was used, and oral health was assessed using the Geriatric Oral Health Assessment Index. Hierarchical regression analysis was performed to confirm the moderating effect of oral health, and PROCESS macro model 1 by Hayes was applied to examine an inference test of the conditional effect of the moderator. ResultsData on 1,812 participants with musculoskeletal disorders (mean age 75.0 ± 8.6 years) was analyzed. Compared with no exercise, regular exercise (β= -2.39, 95% confidence interval [CI]= -3.42; -1.34) was significantly associated with lower frailty level. Good oral health (β= -0.38, 95% CI= -0.44, -0.32) was significantly associated with lower frailty level. A significant moderating effect of oral health on the relationship between regular exercise and frailty was detected (β= 0.18, 95% CI= 0.05, 0.30). ConclusionsThe beneficial effects of regular exercise on frailty were greater in participants with poor oral health than in those with good oral health. Healthcare providers should actively encourage older patients with musculoskeletal disorders and poor oral health to exercise regularly. Combined exercise and oral healthcare interventions may be the most effective strategy for managing frailty in older patients with musculoskeletal disorders.

Dental and nursing collaboration in oral healthcare research in palliative care inpatient settings.

Collaboration between palliative care nurses and oral health professionals has been frequently recommended to ensure optimal oral healthcare. However, the importance of this collaboration to the success of evidence-based protocols, involving oral healthcare interventions in the inpatient palliative care setting, is less discussed. Feasibility requires consideration during the planning, intervention and implementation phases of any clinical trial; all of which typically rely on good collaboration with nursing staff. Therefore, it is imperative that nursing staff appreciate the need for oral healthcare at the end of a person's life. Nursing and dental collaboration is critical to the feasibility of running research trials in this group and can help overcome some of the logistical and ethical challenges in this vulnerable population.

Using Codesign to Develop a Novel Oral Healthcare Educational Intervention for Undergraduate Nursing Students

To build a nursing workforce that is equipped to undertake oral health promotion and screening, an educational program was needed. With codesign being used in multiple settings, it was selected as the approach to use, with Mezirow's Transformative Learning theory as the underpinning framework. This study aimed to develop an oral healthcare educational intervention for nursing students. Using a six-step codesign framework, nursing students and faculty staff were invited to participate in two Zoom™ Video Communication workshops to codesign the learning activities to be used in the classroom. The codesign process was evaluated through focus groups and analysed using a hybrid content analysis approach. A multifaceted oral healthcare educational intervention was developed. Learning material was delivered using a range of different learning and teaching resources such as dental models, podcasts, and an oral health assessment across two subjects. Multiple approaches to recruitment, the inclusion of participants, and good facilitation of workshop discussions were critical to the codesign of the educational intervention. Evaluation revealed that preparing participants prior to the workshops acted as a catalyst for conversations, which facilitated the codesign process. Codesign was a useful approach to employ in the development of an oral healthcare intervention to address an area of need.

Oral Health Interventions in Natural Disasters: A Scoping Review.

This work aimed to identify, appraise, and summarize existing knowledge about oral health interventions in the context of natural disasters and verify the main research gaps. We searched in PubMed (National Library of Medicine, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and Epistemonikos (Epistemonikos Foundation, Santiago, Chile) until 2021 for primary studies and systematic reviews, assessing any oral health intervention in the context of natural disasters. The interventions were classified according to Cochrane Effective Practice and Organization of Care (EPOC) categories, and the type of natural disaster was defined according to the classification by the Centre for Research on the Epidemiology of Disasters (CRED). We assessed a total of 19 studies (majorly in Japan, n = 8), all performed in the context of an earthquake or mixed natural disasters (earthquake and tsunami). Regarding interventions, 12 studies reported a promotional/ preventive intervention, with oral examination being the most frequent. 7 studies reported therapeutic interventions, mainly related to emergency management of fractures and injuries. The evidence accessed in our study was limited, highlighting the need for further research to focus on different oral health care interventions and outcomes in the context of different natural disasters, thus enhancing the formulation and implementation of recommendations and protocols worldwide.

Changes in the oral health status of older adults with visual and hearing impairments through home oral health care intervention: a case report

Changes in the oral health status of older adults with visual and hearing impairments through home oral health care intervention: a case report

Oral health care services for community-dwelling older people with dementia: A scoping review.

To assess whether, and if so, which oral health care services for community-dwelling older people with dementia are available. Oral health in people with dementia is poor compared with people without dementia. Although multiple oral health care interventions have previously been studied for older people living in nursing homes, little is known about interventions or services for community-dwelling older people with dementia. A literature search was performed in the databases Pubmed, Embase and CINAHL. The following search terms were used: "Dementia", "Oral health", "Dental health services" and "Older person". The term "dental health services" was intended to be an as broad as possible construct because limited search results were expected. The search generated 1624 unique references, of which seven studies were eligible for inclusion (four cohort studies, one cross-sectional study, and two qualitative studies). The included studies described two actual oral health care services: a telephone help line on oral health and dementia, and a mobile geriatric dental programme in adult day health centres. A need was found for services and strategies specific to community-dwelling older people with dementia. One identified solution was an intervention with individually tailored daily oral hygiene self-care supported by the informal caregiver. Furthermore, increasing accessibility of oral health care professionals with treatment at other locations than their own practices, better collaboration between health care professionals and preventive oral health care are highly necessary. There is limited evidence on the availability of oral health care services for community-dwelling older people with dementia, while a need was found for oral health care services that focus on good accessibility, oral hygiene self-care, preventive strategies and collaboration among health care professionals.

Pharmaceutical cost implications for oral healthcare interventions at a dental clinic in Windhoek, Namibia

Half of the world’s 7.9 billion population suffers from oral health conditions. Most are largely preventable and treatable but costs are often unaffordable especially in developing countries. The World Health Organization (WHO) resolved in 2021 to include oral healthcare interventions in universal healthcare coverage (UHC) programmes. Although the general expenditure on oral healthcare services has been reported by some countries, amounts spent on particularly pharmaceuticals have not been reported. This study aimed to report on the prevalence of different types of oral health diseases in patients attending a dental clinic in Windhoek (Namibia) and quantify the pharmaceutical expenditure incurred. Records for all patients who visited the dental clinic at KIRH during a six-month period (1 January 2021 to 30 June 2021) were reviewed. Costs associated with the respective pharmaceutical management options for the most common oral conditions were calculated based on the approximated cost for a single treatment course per patient.Pharmaceutical expenditure on oral diseases was approximately 0.4% of the hospital’s annual budget. From this, 94.6% was due to treatment of dental caries which had a 90.1% prevalence. Prevalence of dental caries among 13-19 years age group (9.5%) was lower than for 1-12 years (18.6%) and 20-64 years (68.2%). Cases for dental caries were fewer for the 65+ years age group (3.8% of total cases) but had the highest prevalence (95.2%) of dental caries then other age groups. The proportion of the pharmaceutical budget spent on treating oral diseases was 0.4%, of which 94.6% was due to dental caries. Promotion of oral healthcare among children may be instrumental in reducing the pharmaceutical costs associated with treatment of dental carries.

Oral Health Knowledge, Attitudes and Practices of People Living with Diabetes in South Asia: A Scoping Review.

Diabetes increases the risk of oral health complications. This review aimed to synthesise the current evidence on the oral health knowledge, attitudes and practices of people living with diabetes in South Asian countries and provide recommendations on possible strategies for addressing the gaps in oral health care in this population, including the role of non-dental professionals. Using a scoping review framework, six electronic databases (Ovid Medline, CINAHL, ProQuest Central, Scopus, Web of Science and Embase) were searched to identify the relevant literature published between January 2000 and December 2021. The data were extracted into three main categories based on the review's aims, and further refined into sub-categories. A total of 23 studies were included. The review identified that while people with diabetes living in South Asian countries had some level of awareness about oral health and limited care practices to maintain good oral health, there were gaps in knowledge, and there were areas where their oral health practices and attitudes could be improved. The findings suggest a need for developing targeted oral health policies as well as implementing integrated oral health care interventions involving non-dental professionals to improve the oral health outcomes of people with diabetes.

Effect of Non-surgical Periodontal Therapy on the Clinical Periodontal Inflammatory Parameters in \(\beta\)-Thalassemia Major (TM-\(\beta\)) Patients with Gingivitis

Background: Increased prevalence of gingival diseases in thalassemia patients has been consistently reported. In diseases with neutrophil dysfunctions, periodontal tissue is lost very rapidly. \(\beta\)-thalassemia major (TM- \(\beta\)) patients exhibit defective neutrophils and macrophages. Therefore, supplementary gingival inflammation is detrimental to periodontal tissues in these patients. This warrants attention to specialized oral health care intervention in these patients. This is the pioneer pre and post study that evaluates the effect of non-surgical periodontal therapy (NSPT) in \(\beta\)-thalassemia major (TM- \(\beta\)) patients with gingivitis. And also reports the prevalence and distribution of disease severity in TM- \(\beta\)patients.&#x0D; Methods: 31 patients (15 females, 16 males) fulfilling the inclusion criteria were provided with protocol guided NSPT including scaling, polishing and chemical mouthrinse (0.2% CHX). Gingival index (GI), plaque score, Papillary bleeding index (PI) and periodontal pocket depth (PPD) were recorded with a periodontal probe (UNC-15) at baseline and evaluated after 6 weeks of intervention. Paired T-test was applied for GI, PBI and plaque and Wilcoxon signed rank test for PPD at the P-value of &lt;0.05&#x0D; Results: 86% of the assessed individuals had gingivitis (6% -mild, 44%- moderate and 36% - severe). NSPT showed highly significant (P - &lt;0.000) improvement from baseline to 6 weeks after intervention for all the clinical parameters, GI, PBI, plaque score and PPD.&#x0D; Conclusion: Within the limitations of the study, the results show that with proper protocol, multidisciplinary approach and careful screening of the patient’s systemic status, TM-\(\beta\)patients with gingivitis respond positively to local measures of plaque control.

Association between oral health and atrial fibrillation: A systematic review

Background and objectivePoor oral health increases systemic inflammation, which has complex pathophysiologic links with atrial fibrillation (AF). The aim of this comprehensive systematic review was to investigate the association between oral health and AF in terms of new-onset AF and AF recurrence. MethodsAfter PROSPERO protocol was registered, PubMed, Scopus, and Cochrane Database of Systematic Reviews were standardly searched from database inception to February 2021. The included studies were assessed for quality and risk of bias using the modified Newcastle-Ottawa scale. The indicators of poorer oral health were the presence of periodontitis, lower frequency of dental scaling, lower frequency of toothbrushing, and lower number of missing teeth. ResultsWe initially identified 424 studies; however, only 5 studies met the inclusion criteria. The included studies comprised 3 nationwide population-based retrospective cohort studies, 1 large prospective cohort study, and 1 case-control study that reported the association between oral health and AF. These studies demonstrated that poor oral health was associated with new-onset AF, and may promote AF recurrence and progression. Moreover, AF patients with poorer oral health may have a higher risk of arrhythmias and major adverse cardiovascular events during long-term follow-up. ConclusionImproved oral health potentially reduces new-onset AF. Periodontitis prevention, regular dental visits for professional dental scaling, and frequent tooth brushing, are oral health care interventions that contribute to AF protection. Therefore, promoting oral health should be integrated as a part of AF primary prevention.

Long COVID and oral health care considerations

BackgroundPeople who have recovered from the initial severe acute respiratory syndrome coronavirus 2 infection are at risk of developing long COVID, a prolonged suite of signs and symptoms that may interfere with daily life and the ability to undergo routine oral health care. MethodsThe available literature on long COVID was reviewed and compiled to produce a review of the syndrome as currently understood. Articles were evaluated with a focus on how long COVID may affect the provision of oral health care and on ways in which treatment may need to be modified to best care for this vulnerable patient population. ResultsLong COVID includes a wide variety of symptoms, such as fatigue, shortness of breath, chest pain, risk of developing thromboembolism, and neurologic and psychiatric complications. These symptoms may arise at various times and in a wide range of patients, and they may necessitate modification of routine oral health care interventions. ConclusionsRecommendations for the treatment of affected people in an oral health care setting are presented, including a thorough evaluation of the patient history and current status, understanding of how related symptoms may affect oral health care interventions, and which modifications to treatment are needed to provide safe and appropriate care. Practical ImplicationsOral health care professionals must be aware of long COVID, an increasingly prevalent condition with a widely variable presentation and impact. Oral health care professionals should be prepared to treat these patients safely in an outpatient oral health setting.

Sociodemographic, Behavioral and Oral Health Factors in Maternal and Child Health: An Interventional and Associative Study from the Network Perspective.

Oral healthcare during pregnancy needs to be part of the assistance routine given to pregnant women by health professionals as a way to encourage self-care and strengthen the general health of the mother and the baby. The aim of this study was to evaluate the effectiveness of an integrated oral healthcare intervention for pregnant women and to analyze the association of sociodemographic, behavioral, oral health and general maternal and child health factors in prenatal care at usual risk in primary care in a city in the northeast of Brazil, in 2018–2019. A controlled, randomized, single-blinded community trial was conducted. The intervention group (IG) received dental assistance and collective health education actions in conversation circles, while the control group (CG) received the usual assistance. All pregnant women (146 in total, 58 from IG and 88 from CG) that took part in the trial answered a questionnaire and underwent a dental examination at the beginning of prenatal care and at the puerperal visit. To assess the effect of the intervention, a network analysis was used. The results have shown that being in the control group was associated with neonatal complications (0.89) and prematurity (0.54); the use of tobacco and alcohol are associated with high risk in initial and final oral health; lower educational level of the pregnant women implicates high risk for initial oral health (−0.19), final oral health (−0.26), pregnancy complications (−0.13), low birth weight (−0.23), prematurity (−0.19) and complications in the newborn (−0.14). Having a low family income (≤261.36 USD) has shown a high risk for initial oral health (−0.14), final oral health (−0.20) and prematurity (−0.15). The intervention based on integrated oral healthcare for pregnant women indicated that socioeconomic and behavioral factors must be considered as determinants for the quality of women and children’s health and that multi-professional performance during prenatal care contributes to the positive outcomes of pregnancy.

Interventions for improving oral health in people after stroke.

Interventions for improving oral health in people after stroke.

Preliminary study for the development of a visiting oral health care intervention program for the elderly based on community healthcare

Preliminary study for the development of a visiting oral health care intervention program for the elderly based on community healthcare

Assessment of Dental Caries Status and Oral Hygiene Practices among 6-10-year-old Rural and Urban Schoolchildren in South Bengaluru, Karnataka, India.

Dental caries is the most common disease affecting oral cavity. Despite credible scientific advances and the fact that dental caries is preventable, the disease continues to be a major public health problem.AimTo assess the dental caries status and oral hygiene practices among 6–10-year-old rural and urban schoolchildren in south Bengaluru.Materials and methodsA total of 452 children from four schools which included one government school from rural and urban area and one private school from rural and urban area in south Bengaluru. Detailed pro forma was used, and information was recorded through an interview system. The examination for dental caries was made according to the dentition status and treatment needs as described by the World Health Organization (1997) using Community Periodontal Index Probe and Plane Mouth Mirror (type III examination), under natural day light in school premises. The examination was done by a single examiner and recorded by the trained personnel.ResultsPrevalence of dental caries was more in rural schoolchildren. More than five decayed teeth were documented in higher percentage of children in rural government school, while it was much less in children of other schools.ConclusionA comprehensive community-focused oral healthcare intervention that includes oral health education in elementary schools and homes is recommended to increase general oral health awareness.How to cite this articleChandregowda KY, Kumar VD, Shankarappa KB, et al. Assessment of Dental Caries Status and Oral Hygiene Practices among 6–10-year-old Rural and Urban Schoolchildren in South Bengaluru, Karnataka, India. Int J Clin Pediatr Dent 2020;13(4):348–354.

How useful are current caries risk assessment tools in informing the oral health care decision-making process?

BackgroundCaries risk assessment (CRA) tools could address oral health disparities and enhance the efficiency of the oral health care system. The authors aimed to explore the feasibility and limitations of using clinical CRA tools in informing oral health care policy-making processes. MethodsThe authors used the National Health and Nutrition Examination Survey to construct 10 CRA models from a sample of clinical CRA tools identified from the literature. They used these models to estimate the proportion of publicly insured people aged 1 through 20 years categorized as at low, moderate, and high risk, and they projected their oral health care costs. ResultsThe authors found substantial variation among the selected models in assigning risk levels. The weighted average proportions (range) of people categorized as at low, moderate, and high risk were 25% (0%-66%), 14% (0%-50%), and 61% (11%-100%), respectively. Depending on the CRA model, the projected annual cost of covering this population ranged from $18 billion to $127 billion. Conclusions and Practical ImplicationsDeveloping a valid, evidence-based, accurate, and reliable population-based CRA model could address the variability among clinical CRA tools, improve estimates of dental disease burden, help design targeted oral public health programs, and enable comparative effectiveness analyses among oral health care interventions.