Oral health-related quality of life among elderly patients visiting special clinics in public hospitals in Delhi, India: A cross-sectional study

Background: Oral health is recognized as an integral component of general health, and poor oral health is reflected in general health and quality of life (QoL). India has seen a profound shift in the elderly population and is currently home to 103.9 million elders. General Oral Health Assessment Index (GOHAI) is a self-reported oral health assessment index used in elderly population and has been tested in multiple countries. Objective: The study aimed to assess the oral health-related QoL (OHRQoL) using GOHAI and various factors affecting it, among elderly patients visiting special Sunday geriatric clinics at Delhi public hospitals. Methods: A cross-sectional study was conducted among four purposively selected special geriatric public clinics in Delhi, India, and a convenience sample of 145 elderly patients was obtained. OHRQoL was measured using a prevalidated instrument (GOHAI) along with other variables (sociodemographic factors, self-perceived oral health, utilization of medical/dental services, dental problems in the past 12 months, and prosthetic status/need). Statistical analysis was done using Statistical Package for the Social Sciences software version 21, and descriptive results were obtained. Results: The sample consisted of 66 males (45.5%) and 79 females (55.5%), and around 58% (n = 84) of the participants were illiterate. Around 39% (n = 57) of the elderly had never visited a dentist and 48% (n = 69) were financially dependent (no income) on others. The mean GOHAI score for the population was 26.69 + 4.44 (median = 25, interquartile range = 23�). GOHAI score was compared for age, oral hygiene practices, dental problems in the past 12 months, self-reported oral health, and prosthetic need, and a statistically significant difference was observed. Conclusions: The current study assessed GOHAI score and highlighted important determinants of OHRQoL in elderly population visiting the special clinics in Delhi. Thus, OHRQoL should be considered as a surrogate measure to clinical oral examination.

A study on impact of oral health on general health among the elderly residing in a slum of Kolkata: A cross-sectional study

Context: Oral health means more than only good teeth. It is a state-of-being-free from mouth and facial pain, oral and throat cancer, oral infections, periodontal diseases, tooth decay or loss, and other diseases/disorders. The age distribution of the world's population is changing. With advances in medicine, the proportion of older people continues to increase worldwide. Aims, Setting, Materials and Methods: A cross-sectional study was carried out among 158 elderly (>60 years) residing in a slum of Kolkata during the period from April 2017 to June 2017 to assess the impact of oral health on general health. Data were collected using a pretested predesigned schedule containing Geriatric Oral Health Assessment Index. Data analysis was performed in R software. Poisson regression was used to find the associates of the impact of oral health. Results: Mean (standard deviation) age was 68.54 (5.9) years. A total of 104 (65.8%) participants reported; foul breath as a problem and 88 (55.7%) reported gum bleeding as a problem. All participants used to clean their teeth daily but only 36.1% used to clean their teeth at least twice daily. More than half the participants reported that they have limited the kind of food they eat due to dental/gum condition and trouble chewing. Conclusion: There is a need to provide sensitive oral health services that are accessible, affordable, appropriate, and acceptable. Knowledge regarding oral health and hygiene should be provided to all elderly, especially diabetics. Further research with the broader conceptual framework, in different age groups and in different settings are warranted.

Evaluation of relationship between nutritional status and oral health related quality of life in complete denture wearers

The prevalence of malnutrition increases with old age, especially in developing countries like India, and it is the most common cause of morbidity and mortality, because of many factors out of which dentate status is one. Aim and Objective: The aim of this study is to evaluate and determine the effect of nutritional status and dietary intake on the oral health-related quality of life (OHRQOL) of elderly edentulous complete denture-wearing patients and to know whether elderly complete denture wearers have a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counseling during prosthodontic rehabilitation of elderly edentulous patients. Materials and Methods: A cross-sectional study was conducted among 200 elderly denture-wearing patients above 60 years of age from Nagpur, Maharashtra. Mini-Nutritional Assessment (MNA) questionnaire was used to assess nutritional status, and Geriatric Oral Health Assessment Index (GOHAI) questionnaire was used to determine the OHRQOL of these patients. Descriptive statistics were used to analyze data using SPSS version 21 (SPSS Inc., Chicago, IL, USA). Results: Among the assessed participants, nearly 95% of them had total scores of GOHAI between 12 and 57 which require “needed dental care.” As per MNA, 10.5% had adequate nutrition, 70% were at risk of malnutrition, and remaining 19.5% of participants were malnourished. There was a significant correlation between GOHAI and MNA scores. Conclusion: Low nutritional status was associated with the poor OHRQOL among the elderly. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL. The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly. Dietary analysis and counseling should be strictly incorporated into geriatric treatment planning during prosthetic rehabilitation.

Development of an Oral Health Assessment Tool for Critically Ill Patients / 중환자간호학회지

PURPOSE: This methodological study develops an oral health assessment tool for critically ill patients.METHOD: From February 15 to April 30, 2014, this study was conducted to test the validity and reliability of the tool at two general hospitals and three medical and surgical intensive care units (ICUs) in Seoul, Korea.RESULTS: The result of the intraclass correlation coefficient to test the between-observer reliability by analyzing the oral health assessment scores before and after oral nursing care showed that .93 of before oral care and .90 of after oral care. The correlation coefficient values of .68 (p < .001) and .71 (p < .001) before and after providing oral nursing care, respectively, indicated the presence of a statistically significant correlation between the tool and the criterion. Using the paired t-test, the differentiated validity of the tool was tested in patients who had developed pneumonia after entering the ICU. A statistically significant difference in scores was found between the time of entering the ICU and that of developing pneumonia (t=−8.73, p < .001), which provided evidence for the differentiated validity of the tool.CONCLUSION: Since the validity and reliability of the tool developed in this study were verified, this tool can be used to assess the oral health conditions of critically ill patients.

Assessment of validity and reliability of Hindi version of geriatric oral health assessment index (GOHAI) in Indian population.

Objective: The objective of this study was to translate the Geriatric Oral Health Assessment Index (GOHAI) into the Hindi language and assess its validity and reliability for use among people in India. Materials and Methods: GOHAI was translated into the Hindi language and self-administered to 420 subjects aged 55 years or above. The measures for reliability, and concurrent, convergent, and discriminant validity were assessed. The questionnaire sought information about sociodemographic details, habits related to tobacco, dental visits, tooth brushing, and self-reported perceptions of general and oral health. Results: Cronbach's alpha (0.774) showed high internal consistency and homogeneity between items. Low GOHAI scores were associated with the perceptions of poor oral and general health, low satisfaction with oral health, and a perceived need for dental care. Respondents with high socioeconomic status were likely to have high GOHAI scores. Conclusion: The Hindi version of the GOHAI demonstrated acceptable validity and reliability, and will be an important instrument to measure oral health-related quality of life (OHRQoL) for people in this region.

Assessment of oral health status of children with special needs in Delhi, India

Introduction: Children with special needs are considered to be a high risk group for dental diseases especially dental caries and periodontal diseases. Objective: Assessment of oral health status of children with special needs in Delhi, India. Material and methods: A cross sectional survey was conducted on 414 children with special needs belonging to four different disability groups i.e. Intellectually Disabled (ID), Physically Challenged, visually and hearing impaired. WHO Oral Health Assessment Form for children, 2013 was used for assessment of various parameters of oral health among the study population. Results: Of the 414 children, 305 were males and 109 females. Overall caries prevalence was 38%. Mean DMF value was 3.71 with ID children having higher mean than the other groups. A significant positive correlation was also observed between age and dental caries. Gingival condition was also worse in ID children and best in physically challenged ones. Highest numbers of trauma cases were recorded in visually impaired group. Delayed eruption of permanent teeth was most common in hearing impaired. 98.7% children required some form of dental treatment. Conclusion: Oral health of children with special needs was poor and urgent attention is required to plan a comprehensive dental health care programme for them.

Comportamiento del Geriatric/General Oral Health Assessment Index (GOHAI) y Oral Impacts on Daily Performances (OIDP) en una población de adultos mayores de la Ciudad de México / Behavior of the Geriatric/General Oral Health Assessment Index (GOHAI) and Oral Impacts on Daily Performances (OIDP) in a senior adult population in Mexico City

Objetivo: Determinar el comportamiento del Geriatric/General Oral Health Assessment Index y Oral Impacts on Daily Performances como medidas de efecto de la salud bucodental relacionada con la calidad de vida en adultos mayores en una misma población. Métodos: Muestra representativa de adultos mayores derechohabientes del Instituto Mexicano del Seguro Social del suroeste de la Ciudad de México. Se realizaron entrevistas domiciliarias para conocer las características de la muestra y aplicación de los instrumentos Geriatric/General Oral Health Assessment Index y Oral Impacts on Daily Performances. Evaluación clínica para determinar la experiencia de caries coronal y caries radicular. Resultados: Un total de 531 sujetos de 60 años y más participaron, 68.4% mujeres. La media (desviación estándar) de edad fue de 71.4 (7.0) años. El Geriatric/General Oral Health Assessment Index presentó una media de 46.8 (6.2), y 4.1 (12.4) para el Oral Impacts on Daily Performances. La escolaridad mayor de seis años, no presentar limitaciones, con deterioro cognitivo y sin depresión, presentaron una media mayor del puntaje del Geriatric/General Oral Health Assessment Index en comparación con los que no presentaban (p < 0.05). La escolaridad mayor de seis años, con una actividad laboral remunerada y sin depresión, presentaron una media menor del puntaje del Oral Impacts on Daily Performances en comparación a los que no presentaban (p < 0.05). Existe una correlación entre el Geriatric/General Oral Health Assessment Index y componentes obturados, dientes funcionales (p < 0.05). Los componentes perdidos, obturados e índice caries coronal, así como coronas sanas y dientes funcionales presentaron una correlación con el Oral Impacts on Daily Performances (p < 0.05). Conclusión: El Geriatric/General Oral Health Assessment Index tuvo mayor discriminación en las características de la población y el Oral Impacts on Daily Performances presentó mayor correlación con el estado de la dentición.

Objective: To determine the behavior of the Geriatric/General Oral Health Assessment Index as well as the Oral Impacts on Daily Performances as effective measures in oral-dental health related to quality of life in senior citizens in a given population. Methods: A representative sample of senior citizens entitled to medical services at the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security) located in the southwest region of Mexico City. Home interviews were conducted in order to ascertain the sample's characteristics as well as the application of the Geriatric/General Oral Health Assessment Index and Oral Impacts on Daily Performances instruments. Clinical evaluation in order to determine experience of crown caries (CPO-D) and root caries CO-R). Results: A total of 531 subjects aged 60 years and over participated in the study, of which 68.4% were female. Age average (AA) was 71.4 years (7.0). Geriatric/General Oral Health Assessment Index exhibited a mean of 46.8 (6.2) and Oral Impacts on Daily Performances showed 4.1 (12.4). Subjects included in the sample had attended school for over 6 years, did not present limitations of cognitive deterioration, and were depression-free, exhibited a higher mean in Oral Impacts on Daily Performances score than those which did not present those characteristics (p < 0.05). Six or more years of schooling with paid work and depression-free subjects presented lesser Oral Impacts on Daily Performances scores when compared to those who did not. (p < 0.05) A correlation was found between the Geriatric/General Oral Health Assessment Index and filled components, functional teeth (p > 0.05). Filled and lost components and CPO-D index as well as healthy crowns and functional teeth exhibited a correlation with Oral Impacts on Daily Performances (p < 0.05). Conclusion: Geriatric/General Oral Health Assessment Index exhibited higher discrimination in the population's characteristics whereas Oral Impacts on Daily Performances showed higher correlation with the state of the dentition.

Associação entre alterações do estado nutricional, perda dentária, uso de prótese e autopercepção das condições bucais de idosos no município de São Paulo: Estudo SABE ( 2000 e 2006) / Association between changes of nutritional status, tooth loss, use of dental prosthesis and self-perceived oral health among elderly people in São Paulo city SABE Survey (2000, 2006)

Objetivo: Verificar a associação entre alterações do estado nutricional, perda dentária, uso de prótese e autopercepção das condições bucais em uma coorte de idosos, segundo sexo e idade. Métodos: Foram analisados idosos (≥ 60 anos), de ambos os sexos, do Estudo SABE: Saúde, Bem-estar e Envelhecimento, epidemiológico, de base domiciliar, realizado no município de São Paulo, em 2000 e 2006. As variáveis de estudo foram: alterações no estado nutricional-segundo Índice de Massa Corporal (IMC), considerando baixo peso (≤ 23 kg/m²), peso adequado para estatura (> 23 e < 28 kg/m²) e excesso de peso (≥ 28 kg/m²), em 2000 e 2006; perda dentária (< ou ≥ 16 dentes); uso de prótese dentária (sim/não); autopercepção das condições bucais, segundo Geriatric Oral Health Assessment Index (GOHAI), considerando más condições bucais (GOHAI <50 pontos), regulares (GOHAI de 51 a 56 pontos) e boas (GOHAI de 57 a 60 pontos), sexo e grupos etários (60-74 e ≥ 75 anos), em 2000. Verificou-se a associação por meio do teste de Rao-Scotte da análise de regressão logística multinomial (p<0,05 e IC95%), utilizando o programa estatístico STATA 10.1. Resultados: De 773 idosos analisados, 59,94% eram mulheres e 80,55% do grupo 60 a 74 anos. Identificou-se diminuição da proporção de idosos com excesso de peso (37 para 29%) e aumento daquela com baixo peso (16 para 26%). Verificou-se menor risco para excesso de peso em 2006, aqueles que apresentaram peso adequado, em 2000 e referiram condições bucais regulares [RR = 0,31 (0,14-0,69)], e maior risco para peso adequado em 2006, nos homens, que apresentaram excesso de peso em 2000 [RR = 2,23 (1,09-4,55)]. Conclusão: Constatou-se associação entre alterações do estado nutricional, condições bucais regulares, segundo a autopercepção, e sexo masculino, em 2000 e 2006.

Objective: To investigate the association between changes of nutritional status and tooth loss, use of dental prost hesis and self-perceived oral health among elderly people, by gender and age. Methods: The sample consisted of 773 elderly people (≥ 60 years) community-dwelling, both genders, participants of Health, Well being and Aging Cohort Study (SABE Survey),epidemiological, home-based, from the city of São Paulo, from 2000 to 2006. The variables analyzed were: changes of nutritional status: by body mass index (BMI-kg/m²), considering underweight (≤ 23 kg/m²), appropriate weight for height (> 23 and <28 kg/m²) and overweight ( ≥ 28 kg/m²), to 2000 from 2006; tooth loss (