| 1. |
- Astvaldsdottir, A., et al.
(author)
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Oral health and dental care of older persons-A systematic map of systematic reviews
- 2018
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In: Gerodontology. - : Wiley. - 0734-0664 .- 1741-2358. ; 35:4, s. 290-304
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Research review (peer-reviewed)abstract
- Objectives: To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias. Background: Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing. Methods: A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps. Results: We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness. Conclusions: There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
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| 2. |
- Hägglund, Patricia, et al.
(author)
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Older people with swallowing dysfunction and poor oral health are at greater risk of early death
- 2019
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In: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 47:6, s. 494-501
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Journal article (peer-reviewed)abstract
- Objectives: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden.Methods: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI).Results: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02‐2.75; P = .041 and aHR: 1.98, 95% CI 1.07‐3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15‐5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%).Conclusions: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.
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| 3. |
- Hägglund, Patricia, et al.
(author)
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Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
- 2017
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 17
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Journal article (peer-reviewed)abstract
- Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.
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| 4. |
- Koistinen, Susanne, et al.
(author)
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Oral health-related quality of life and associated factors among older people in short-term care.
- 2020
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In: International Journal of Dental Hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 18, s. 163-172
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Journal article (peer-reviewed)abstract
- OBJECTIVES: It is well known that oral health status is associated with oral health-related quality of life (OHRQoL) in the general population. The aim of this study was to describe and analyze OHRQoL among older people in short-term care and its associated factors.MATERIALS AND METHODS: This cross-sectional study included 391 older people in 36 short-term care units. Data were collected via clinical oral assessments, questions about self-perceived oral and general health, Katz Index of Activities of Daily Living (Katz-ADL) and the Revised Oral Assessment Guide (ROAG). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Multivariate logistic regression models were applied in the analysis.RESULTS: Poor OHRQoL was reported by 34% of the older people. Associated factors were swallowing problems according to ROAG; quite poor/poor self-perceived physical, psychological, and oral health; and being a woman.CONCLUSIONS: There is an association between OHRQoL and older people's self-perceived health according to the OHIP-14. This indicates the importance of early detection of oral health problems in frail older people and to assess both oral health and swallowing problems among older people in short-term care.
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| 5. |
- Ståhlnacke, Katri, 1953-, et al.
(author)
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Self-perceived oral health among 65 and 75 years old in two Swedish counties
- 2010
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In: Swedish Dental Journal. - : Swedish Dental Journal (Sveriges Tandlakarforbund). - 0347-9994. ; 34:2, s. 107-119
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate self-perceived oral health in two elderly populations, ages 65 and 75 years, and its relation to background factors, socioeconomic, individual, and dental health service system factors. Another purpose was to investigate if there were any differences in these respects, between the two age groups, born in 1932 or 1942. In two counties in Sweden, Örebro and Östergötland, all persons born in 1942 have been surveyed by mail every fifth year since 1992. In the year 2007 all persons born in 1932 were also surveyed using the same questionnaire. Those born in 1932 consisted of 3735 persons and those born in 1942 6078 persons. From an outline of a general model of inequalities in oral health data were analyzed with descriptive statistics and contingency tables with ?2 analysis. Multivariable analysis was performed by using multiple regression analysis. Factors related to self-perceived oral health were age group, social network, ethnicity, education, general health, tobacco habits, oral hygiene routines, dental visit habits and cost for care. The self-perceived oral health was overall rather high, especially in view of the studied ages, although it was worse for those of age 75. Socio-economic factors, dental health service system as well as individual lifestyle factors affected self-perceived oral health. To have a satisfying dental appearance, in the aspect of how you are judged by other people, was important for these age groups.This presents a challenge for dental health planners especially since the proportion of older age groups are growing.
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| 6. |
- Svenson, Björn, 1941-, et al.
(author)
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Dentists' use of digital radiographic techniques : Part I - intraoral X-ray: a questionnaire study of Swedish dentists
- 2018
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In: Acta Odontologica Scandinavica. - : Taylor & Francis Group. - 0001-6357 .- 1502-3850. ; 76:2, s. 111-118
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Journal article (peer-reviewed)abstract
- Objective: The present study aims to gain knowledge about the dentist's use and choice of digital intraoral imaging methods.Materials and methods: A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the type of X-ray technique used, problems experienced with digital radiography, and reasons for choosing digital technology, and about indications, clinic size and type of service. Response rate was 53%.Results: Ninety-eight percent of the dentists had made the transition to digital radiography; only 2% used film technique, and solid-state detector (SSD) was the most used digital technique. More years in service decreases the likelihood of applying individual indications for performing a full mouth examination. More retakes were done with SSDs compared to storage phosphor plates. Reasons for choosing digital techniques were that work was easier and communication with the patients improved. However, dentists also experienced problems with digital techniques, such as exposure and projection errors and inadequate image quality. The Swedish Radiation Safety Authority states that all radiological examinations should be justified, something not always followed.Conclusions: This study showed that 98% of the respondents, Swedish dentists within the Swedish Dental Society, used digital techniques, and the most used was the solid-state technique.
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| 7. |
- Svenson, Björn, 1941-, et al.
(author)
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Dentists' use of digital radiographic techniques : Part II - extraoral radiography: a questionnaire study of Swedish dentists
- 2018
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 77:2, s. 150-157
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The present study aims to gain knowledge about the dentist's use and choice of digital extraoral imaging methods, panoramic radiography and cone beam computed tomography (CBCT).MATERIALS AND METHODS: A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the panoramic technique and CBCT technique used, education, clinic size and type of service. The response rate was 53%.RESULTS: The study showed that 61% of the Swedish dentists had access to panoramic techniques and that 84% used a direct digital sensor, while 6% used storage phosphor plate techniques. Around 8% of the Swedish dentists had access to CBCT. It was also observed that group practices had two times higher odds of having panoramic equipment compared with solo practices. Approximately 40% of the dentists had undergone postgraduate education in oral radiology during the last 5 years. Dental nurses and dental hygienists exposed 92% of the panoramic radiographs and 75% of the CBCTs. Thirty per cent of those clinics with access to a panoramic unit exposed >30 panoramic radiographs per month and 56% of the clinics having access to CBCT did more than 75 examinations per year.CONCLUSIONS: Today 61% of Swedish dentists have access to panoramic radiography and 8% have access to CBCT. There is a greater likelihood of having access if the dentist works in the public dental health service or in a group practice and if the dentist has undergone any postgraduate course in oral radiology.
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