Effect Of Comprehensive Oral Care Intervention On Elderly In A Nursing Home

The oral health of elderly people declines with age,especially in elderly in nursing homes due to the limited self-care ability of the elderly.Poor oral health brings a series of physical health problems for the elderly,and effective interventions are urgently needed to improve the oral health of elderly people.Objectives:This study combined a variety of oral care methods such as teeth-brushing or mechanical scrubbing integrated the use of a toothbrush,toothbrushes,cotton swabs and other care tools to perform the comprehensive oral care intervention on the elderly in a nursing home in Changchun,Jilin Province,to explore the effect of comprehensive oral care intervention on oral hygiene,nutrition,quality of life,cognitive function,and the ability of daily activity of nursing home residents,to strengthen the elderly oral health consciousness and behaviors,Methods:This study is a non-randomized controlled trial.The subjects of this study were the elderly over 60 years old in a long-term care facility.Both intervention group and control group recruited 32 subjects.The experimental group carried out comprehensive oral care to clean the oral cavity for 5 minutes after every meal.The cleaning area included teeth,tongue surface and oral mucosal surface.The independent elderly people cleaned their oral cavity with toothbrushes and interdental brushes.The semi-disabled elderly people were assisted by nursing staffs to clean their oral cavity with toothbrushes and interdental brushes.Nursing staffs cleaned the oral cavity of disabled elderly people with cotton balls,cotton swabs,oral sponge.The elderly in the control group received routine care without any intervention.Plaque Index(PLI),General Oral Health Assessment index(GOHAI),Modified Barthel index(MBI),Mini-mental state examination(MMSE)and Mini Nutritional Assessment(MNA)were used to evaluate the baseline information and oral hygiene,oral health related quality of life,activities of daily living,cognitive function and nutritional status of the elderly before or after the intervention.Results:1.General informationThere was no significant difference in age,gender,degree of dependence,educational level,marital status,profession,religious belief,ethnicity,drinking situation,smoking status,and chronic disease situation between two groups(P>0.05).Subjects of the two groups were homogeneous and comparable.No significant difference was observed in terms of teeth-brushing frequency,the use of toothpicks or floss,the use of soft-bristle toothbrush and the frequency of toothbrush replacement(P>0.05).2.Baseline assessmentThere was no significant difference in PLI,GOHAI total scores and three dimensions,MBI scores,MMSE scores,and MNA scores between the two groups before intervention(P>0.05).3.Effect of interventionPLI scores of the elderly in the experimental group significantly decreased after 12 weeks of intervention(P<0.05),and the total scores of GOHAI scale,pain and discomfort dimension scores,and psychosocial function dimension scores were significantly increased compared with the control group(P<0.05).There was no significant difference in other indice(P>0.05).Compared with baseline,MMSE scores of the elderly in both groups decreased,and the difference was statistically significant(P<0.05).Subgroup analysis results showed that the PLI scores of semi-disabled elderly people in experimental group decreased after 12 weeks of invention(P<0.05),and the total scores of GOHAI scale,pain and discomfort dimension scores and psychosocial function dimension scores of semi-disabled elderly people in experimental group increased significantly compared with the control group(P<0.05).The scores of pain and discomfort dimension scores and psychosocial function dimension scores of disabled elderly people in experimental group increased after 12 weeks ofintervention,and the difference was statistically significant(P<0.05).Conclusion:We concluded that the comprehensive oral care intervention with a high cleanliness can improve the oral hygiene of the elderly in nursing homes.The comprehensive oral care intervention can improve the oral pain and tooth appearance of the elderly,enhance the self-esteem of the elderly and improve the psychological status of old people,and improve oral health related quality of life of the elderly.The comprehensive oral care intervention is suitable for older people in nursing homes,especially for semi-disabled elderly people and disabled people.It has important significance in well-being of older people.