Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review.

BACKGROUND: People with intellectual and developmental disability (IDD) have poor oral health and need support to maintain optimal oral health outcomes. Little is known about how, when and where to intervene for this population. Thus the aim of this review was to summarise the existing evidence surrounding improving oral health outcomes for people with IDD. METHODS: A scoping literature review was conducted focusing on 'oral health' and 'intellectual disability'. Systematic searches of five electronic databases were conducted in line with the study aims and two authors independently examined all records for relevance, with consensus achieved by a third author. RESULTS: A small number of approaches and interventions were identified to support people with IDD to independently maintain optimal oral hygiene. Identified studies highlighted that caregivers play a vital role in the provision of oral health support, emphasising the effectiveness of educational interventions for caregivers. However, there was uncertainty regarding the efficacy of specific tooth brushing interventions for people with IDD. In cases of more severe IDD and/or dental-related behavioural problems, dental treatment under general anaesthesia was often both a necessary and effective method of oral health care provision. The findings also identified outreach and exclusive oral health services as successful strategies for increasing the limited access of people with IDD to oral care services. CONCLUSIONS: A uniform approach to supporting oral health for people with IDD is unlikely to succeed. A system-based approach is needed to address the diverse needs of the population of people with IDD, their caregivers and service context. Further high quality evidence is required to confirm these findings.

Oral health knowledge, attitude and practices among nurses in a tertiary care hospital in Bangalore, India: a cross-sectional survey.

Background: Maintaining good oral health among hospitalized individuals is essential for health outcomes and quality of life. Nurses, being the primary oral care givers require adequate knowledge, attitude and practice in this area to provide effective oral health care. However, limited studies have been undertaken to evaluate this aspect of nursing care in India. Aim: To determine the knowledge, attitude and practices of nurses regarding oral care for hospitalized patients. Design: Cross-sectional survey. Methods: A total of 244 nurses working in a tertiary care hospital in Bangalore, South India were purposively recruited for this study. Data was collected using a structured questionnaire with both closed and open-ended questions about knowledge, attitude and practice regarding oral care. Results: The mean oral health knowledge score was 6.74 out of maximum score of 22. Most nurses were aware of the importance of oral care among inpatients and the effect poor oral hygiene and systemic diseases have on oral health. Deficiencies in knowledge were prevalent in areas including common medications that affect oral health and regarding care of dentures. Nurses, with higher nursing qualifications and working in departments with longer length of stay had higher attitude scores. Most nurses assessed oral health needs within 24hrs of admission. However, there were inconsistencies in the oral health assessment and care protocols followed and documentation. Conclusion: Nurses' attitude towards oral health was positive yet their knowledge in specific aspects of care was inadequate. Their oral health practices needs improvement.

Oral hygiene care status of elderly with dementia and in residential aged care facilities.

OBJECTIVE: To explore the effectiveness of oral hygiene care on plaque and gingival status of residents with dementia. BACKGROUND: Oral hygiene and oral hygiene care has been reported to be poor among the institutionalised elderly with dementia. The severity of oral diseases has been shown to increase with the severity of physical and cognitive impairment related with dementia. Little research has been carried out on plaque and gingival status of elderly with dementia and the impact of disability related with dementia on oral health in residential aged care facilities (RACF). MATERIALS AND METHODS: A cross-sectional study of 205 elderly residing in RACF in Perth. RESULTS: Forty-one percent of the residents in RACF had dementia. Sixty percent of the residents with dementia and 75% of the residents with an Activities of Daily Living Oral Health score of D were assisted with oral care. Mean plaques scores and extent of gingival inflammation were higher for residents in the DD and D subgroups and resident with dementia. Residents assisted with brushing had higher mean plaque score and more moderate gingival inflammation. CONCLUSION: Oral hygiene care status in residents with dementia was poor despite the fact that oral care assistance was being provided.