Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults' Oral Health in a Longitudinal Perspective.

Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide-Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011-2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was "Assistance with cleaning teeth". Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.

Oral health among older adults in nursing homes: A survey in a national quality register, the Senior Alert.

AIM: To investigate the extent to which the Revised Oral Assessment Guide-Jönköping (ROAG-J) is used by nursing staff routinely in nursing homes in Sweden and to describe oral health status of the residents. DESIGN: An observational, retrospective register-based study. METHODS: Data from different validated health assessments instruments, including ROAG-J, for the period 2011-2016 were obtained from the Web-based national quality register Senior Alert. The basis for the analyses was 190,016 assessments. RESULTS: About half of all residents had underwent at least one annual ROAG-J assessment (2014-2016). During the period 2011-2016, 42% of the residents (n = 92,827) were registered to have oral health problems. Significantly more oral health problems were found for men and for those with younger age, poorer physical condition, neurophysiological problems, underweight, impaired mobility and many medications. In conclusion, poorer oral health was found for more care-dependent individuals, which shows a need of preventive actions.