Theoretical and hands-on guidance from dental hygienists promotes good oral health in elderly people living in nursing homes, a pilot study.

OBJECTIVES: Oral health in nursing homes for elderly is often unsatisfactory, and oral health education to nursing staff has not shown sufficient results why there is need for novel approaches. The aim of the study was to trial a new oral healthcare educational programme and to evaluate the effects on residents' oral health. In addition, attitudes among the nursing staff in the intervention nursing home were explored. METHODS: In a controlled clinical trial, two comparable nursing homes were randomly assigned for intervention or control. Interventions included weekly theoretical and hands-on guidance from dental hygienists on oral hygiene procedures and discussions on oral care routines. The residents' oral health, measured by the Revised Oral Assessment Guide (ROAG), dental plaque and gingival bleeding were evaluated at baseline and after 3 months. Attitudes among the staff to oral health care were measured at the intervention nursing home. RESULTS: Revised Oral Assessment Guide gums and lips scores showed a tendency to decrease in the intervention group, but remained high in the control group. Plaque levels improved significantly after intervention, and a trend towards less gingival bleeding was observed. The intervention nursing staff seemed to be more aware of their own limitations concerning oral health care after intervention and valued more frequent contact with dental services to a greater extent. CONCLUSIONS: The oral healthcare situation for elderly people today is so complex that theoretical education at the group level regarding different aspects of oral health is not sufficient. Individual hands-on guidance by dental hygienists on a regular basis in everyday care may be a new approach.

Oral care perspectives of professionals in nursing homes for the elderly.

OBJECTIVES: Good oral health is an important aspect of quality of life. However, a number of studies have shown that oral care for the dependent elderly is unsatisfactory. The aim was to explore in nursing homes for the elderly what professionals with different responsibilities may consider as being important aspects of well-functioning daily oral care. METHODS: A total of 23 informants from three municipalities in the region of Värmland, Sweden, were interviewed. An interview guide was used, containing some demographic and open-ended questions about individual perceptions of issues according to the study aim. The interviews were tape-recorded and transcribed verbatim. RESULTS: In the manifest and latent analyses, six categories and three themes emerged. The categories were Key Processes, Communication, Priorities, Competence, Good Oral Health and Autonomy. The themes were Organization, Staff Approach and Staff's Views on Residents' Needs. An overall picture emerged that oral care, rather than occupying an integral position, played a peripheral role in nursing care. CONCLUSIONS: To improve oral care, there are opportunities to work with existing structures and clarify responsibilities and key processes. Oral care should be included in nursing work as a more highly prioritized task, and nurses' knowledge needs to be enhanced. A network of activities at all levels is needed to implement oral care in nursing care.