Developing a Basic Package of Oral Care Training Program for Primary Health Care Nurses.

REVIEW QUESTION/OBJECTIVE The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia. More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. INCLUSION CRITERIA Types of participants This review will consider studies that include residents with a formal diagnosis of dementia currently residing in permanent care in Residential Aged Care Facilities. This review will exclude participants that have not received a formal diagnosis of dementia as well as those who are not living as a permanent admission in Residential Aged Care Facilities. Studies conducted on community dwelling individuals with a formal diagnosis of dementia will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the efficacy of professional oral health care performed by a dental hygienist. These studies involve professional oral health care performed by a dental hygienist using a toothbrush, interdental brushes, floss and hand scalers if necessary to remove plaque and food debris and in some instances hardened calculus or tartar. If there are studies involving the professional oral health care being performed by dentists or a combination of dentists and dental hygienists they will be included in the analysis. This review will exclude interventions involving staff training interventions and interventions performed by nurses/assistant nurses. TRUNCATED AT 250 WORDS

BackgroundOral diseases and poor oral hygiene are prevalent among frail older adults in nursing homes. Despite well-known organizational barriers such as low prioritization, time and staff shortages, and lack of routines and training, research on the perspective of nursing home management remains limited in this area.PurposeTo investigate the views and experiences of professionals in leadership roles regarding oral health needs and routines as well as barriers and facilitators in providing effective oral care for frail older adults in nursing homes.MethodsA web-based survey was sent to 1,526 nursing home professionals (managers, coordinators and registered nurses) in Sweden. The survey comprised a 52-item questionnaire covering oral health needs, oral care barriers and facilitators, routines, education, collaboration with dental care services, and the use of the quality register Senior Alert, designed to support a preventive approach in nursing care and the Revised Oral Assessment Guide-Jönköping (ROAG-J).ResultsResponses were received from 166 managers, 55 coordinators and 243 nurses, yielding a 32% response rate. About half of the respondents perceived residents’ oral health as poor, and 83% reported that most residents required assistance with oral care. The main barriers were difficulties for nursing staff to perform oral care and residents’ unwillingness to participate, often due to dementia. Increased and regular training in oral care for nursing staff was viewed as the most important facilitator; however, only 41% of respondents reported that their staff had received training regularly. The Senior Alert register and the ROAG-J were widely used and generally perceived as effective. Oral health was also frequently discussed during regular Senior Alert team meetings, with a high level of management involvement.ConclusionsThe significant and complex oral care needs of older adults in nursing homes, coupled with the fact that nursing staff often lack adequate training, stress the importance of management allocating resources, ensuring regular staff training and strengthening collaboration with dental care services. Senior Alert’s structured approach seems to have the potential to enhance the engagement of nursing home professionals in managing residents’ oral health.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12903-025-07327-x.

Objective This pilot study aimed to produce and evaluate training resources and training in oral health care, including oral hygiene, for carers in care homes in Surrey and Medway.Methods During two training days, for carers from these homes, short, interactive presentations were given on a range of topics relevant to oral health care and oral hygiene of older people, followed by practical training. Prior to any training all attendees completed a 39 question questionnaire to establish their baseline knowledge of oral health and hygiene. At the end of the training day they completed an evaluation form. Fourteen weeks later, they were visited at their place of work and completed the same questionnaire again. Differences in responses between baseline and after 14 weeks were statistically tested using the chi-squared test.Results Sixty-six carers attended the training sessions and 44 were followed up 14 weeks later. The results showed an improvement in carer knowledge at follow up. The majority of carers (36/44) spoke English as their first language. They had a mean age of 41 years, 37 were female and 7 male. They had worked as carers for a mean of 10.9 years (range 4 months-34 years). Over 90% stated that the training day fully met or exceeded their requirements and expectations.Conclusions The results indicated improvements in carer knowledge. However, the carers were atypical of carers in general, as they were self-selected and well-motivated. Nevertheless the content of the training day and the questionnaire should inform future work in this area.

Education in oral health is important to prepare future medical professionals for collaborative roles in maintaining patients' oral health, an important component of general health and well-being. The aims of this study were to determine the perceptions of medical students in Malaysia and Australia of the quality of their training in oral health care and their perceptions of their professional role in maintaining the oral health of their patients. A survey was administered in the classroom with final-year Malaysian (n=527; response rate=79.3%) and Australian (n=455; response rate: 60%) medical students at selected institutions in those countries. In the results, most of these medical students reported encountering patients with oral health conditions including ulcers, halitosis, and edentulism. A majority in both countries reported believing they should advise patients to obtain regular dental check-ups and eat a healthy diet, although they reported feeling less than comfortable in managing emergency dental cases. A high percentage reported they received a good education in smoking cessation but not in managing dental trauma, detecting cancerous lesions, or providing dietary advice in oral disease prevention. They expressed support for inclusion of oral health education in medical curricula. These students' experience with and perceptions of oral health care provide valuable information for medical curriculum development in these two countries as well as increasing understanding of this aspect of interprofessional education and practice now in development around the world.

Guidance for the planning, implementation and evaluation of oral health care demonstration projects for under-served populations

Executive summaryObjective The objective of this systematic review was to report on the best available evidence relating to oral hygiene for adults with dementia in residential aged care facilities, including: documenting the prevalence and incidence, as well as the experiences and increments, of oral diseases and conditions the use of assessment tools by carers to evaluate oral health oral hygiene care strategies to prevent oral diseases and conditions the provision of dental treatment and the ongoing management of oral diseases and conditions. Inclusion criteria This review considered any randomised or non‐randomised controlled studies, cohort studies, case‐control studies, multiple time series studies, uncontrolled studies, descriptive studies and opinions of respected authorities (including theses and other publications) related to residents with dementia living in residential aged care facilities in Australia and overseas; community‐dwelling adults with dementia; and special needs adult populations (for preventive oral hygiene care strategies and interventions).The review considered studies and publications designed to: quantify the oral health status of older adults living in residential aged care facilities; quantify the oral health status of adults with dementia living in the community and in residential aged care facilities; evaluate tools used to assess the oral health of residents by staff and carers working in residential aged care facilities; evaluate preventive oral hygiene care strategies and interventions used in special needs adult populations (including adults with dementia); and evaluate oral health care training and oral hygiene care provision, staff and carers working in residential aged care facilities. Dental outcome measures of interest were those relating to the prevalence, incidence, experiences and increments of oral diseases and conditions including: denture problems, coronal and root caries, periodontal diseases (plaque accumulation, gingivitis, loss‐of‐attachment), oral mucosal conditions, xerostomia and salivary gland hypofunction, tooth loss, difficulty chewing, behavioural problems and pain/discomfort. Related characteristics and outcomes of interest included: medical conditions, medications, cognitive status, functional status, nutritional status and sociodemographics.Search strategy The aim of the search was to locate relevant English‐language studies and publications appearing between 1980 and 2002. The search utilised a two‐step approach, involving an initial search of electronic databases using combinations of key words followed by a second extensive search carried out using the identified key words. This was supplemented with a secondary search of the references cited in the identified studies. Electronic database searched were: Cinahl, Embase, Psycinfo, Medline and Current Contents.Methodological quality All selected studies were critically appraised by two reviewers prior to inclusion in the review.Results In regards to relevance, incidence, experiences, and increments of oral diseases and conditions, possible risk factors identified included: saliva dysfunction, polypharmacy, comorbid medical conditions, swallowing and dietary problems, increased functional dependence, need for assistance with oral hygiene care, and poor access and utilisation of dental care.Evidence on the use of assessment tools by carers to evaluate residents’ oral health showed that successful assessment of residents with and without dementia by nursing staff requires appropriate staff training by a dental professional. Coupled with appropriate training, an oral assessment screening tool designed for residents with dementia has been successfully used by nursing and care staff to identify residents requiring further review by dental professionals. Expert opinion in the field indicates that oral assessment screenings by a staff member and then by a dentist would ideally be undertaken upon admission to a facility, and regularly thereafter by staff and/or dentists as required.Clinicians and researchers suggested that oral hygiene care strategies to prevent oral diseases and conditions were found to be effective in preventing oral diseases, and thus are relevant for use in the resident with dementia.In regards to the provision of dental treatment and ongoing management of oral diseases and conditions, the use of adjunctive and preventive aids were found to be effective when introduced in conjunction with a staff training program:Expert opinion suggests that behaviour management techniques will increase the potential of performing oral hygiene care interventions.Conclusions This review suggests that the training of staff in the form of a comprehensive practically oriented program addressing areas such as oral diseases, oral screening assessment, and hands‐on demonstration of oral hygiene techniques and products is likely to have a positive impact on the management of oral hygiene care within residential aged care facilities. The review also identified that regular brushing with fluoride toothpaste, use of therapeutic fluoride products and application of therapeutic chlorhexidine gluconate products are validated by research as effective for the general population and some populations with special needs.

Atraumatic restorative treatment, developed in the mid 1980s, was a milestone in primary oral health care in developing countries. In 2001, the basic package of oral care was implemented in Gambia (West Africa) by training nurses to become community oral health workers. It was therefore the aim of this study to evaluate the processes of the operative units of this programme. The study was conducted in the form of a visitation, an employee attitude survey, and an analysis of the medical records. The evaluation revealed a continuous oral health care by competent community oral health workers in 5 out of 8 units. The patient catchment area considerably exceeded the village limits. Predominantly, pain therapy as a result of dental caries was administered with a restoration-extraction ratio of 1:10. Within a 12-month period, 5,524 patients of all ages were treated. The dental supply rate was 35%. Health care delivery in a primary oral health-care programme in the Repubilc of Gambia with community oral health workers was rated successfully. There is room for improvement in the organisational supervision of the operative units. The curriculum of future trainings should be adapted to changing epidemiological trends.

ObjectiveThe total years lived with disability among older people, and the concomitant burden of tooth loss in ageing societies have increased. This study is an overview of the burden of oral diseases and access to oral care in an ageing society. MethodsWe selected key issues related to the burden of oral diseases and access to oral care and reviewed the relevant literature. ResultsThe rising number of older people with teeth increases their oral health care needs. To improve access to oral care, affordability of care is a great concern with respect to universal health coverage. In addition, accessibility is a crucial issue, particularly for vulnerable older adults. To improve oral care access, attempts to integrate oral health care into general care are being made in ageing countries. For this purpose, provision of professional oral care at home through domiciliary visits and provision of daily oral health care by non-dental professional caregivers are important. Oral health care for older people reduces general diseases such as pneumonia and malnutrition, which in turn could reduce further healthcare costs. ConclusionsTo address the growing burden of oral care in ageing societies, special provision of oral health care to vulnerable older people, and integration of oral care with primary care will be required.

Firmly establishing oral health care professionals’ roles as vaccinators within the health care system

The aim of this study was to assess the oral health knowledge, attitude and behavior among geriatric care workers in long-term care facilities. A self-administered questionnaire was obtained from 212 geriatric care workers attending a professional education program of 2014 dementia pilot project. The questionnaire consisted of 4 parts of the training experience (2 items), knowledge (16 items), attitude (13 items), and behavior (4 items) on oral health care. Collected data were analyzed by frequency analysis, independent t-test, and one-way ANOVA using SPSS Statistics ver. 20.0. The percentage of educational experience on oral care was 27.9% and most respondents answered that they have received the education about denture cleaning (98.3%) and brushing method (91.4%). The average knowledge score was , and respondents showed high-level agreement in 8 of the 10 items in attitude questions. They revealed difficulties in providing oral care to the elderly people because of their lack of knowledge. The deficiencies of knowledge about oral care would have a decisive effect on not only oral and general health, but also quality of life of the elderly people. Therefore, it is required to develop professional oral care training programs for geriatric care workers and support systems should be legalized.

Valuing oral health: Accomplishments and challenges

This study evaluated the effectiveness of community referrals to complimentary oral care services in improving access to care for immigrant children in Canada. It also explored financial and non-financial factors influencing parental adherence to their children's oral care referrals. Data from 610 parent-child pairs, including demographics and oral health behaviours of children aged 1 to 12 years, were analyzed. Oral health examinations were conducted at a community site, and 151 children needing treatment were referred to a university dental clinic. Univariate analyses and backward stepwise logistic regression identified factors associated with attending at least one oral care appointment. Among the 151 referred children (average age: 6 years), 48% were girls and 40% were born in Canada. Only 42% had visited a dentist in the past year and only 36% had dental coverage. Oral health behaviours varied; 40% brushed their teeth once or less daily and 46% consumed at least one sugary snack per day. Approximately 66% of mothers had college education or higher. Despite the offer of complimentary care, attendance at referred appointments was 38%, with higher attendance among girls (p = 0.025). Despite the elimination of financial barriers to oral care, attendance at appointments remained low, emphasizing the role of non-financial factors, including the unique social and cultural challenges encountered by immigrants, in accessing oral health care. Higher attendance among girls suggests gendered parental perceptions of oral health care. Addressing these factors requires culturally tailored outreach and improved provider-family communication. Financial support alone is insufficient to improve access to oral care for immigrant children. A multidimensional approach addressing both financial and non-financial barriers is essential to enhance oral health care utilization.

Caregivers deal with oral health care of the dependent elderly; however, this has a low priority among them, and their education in daily oral care is deficient. Therefore, studying the oral care practices as well as their oral health beliefs is important as these affect the quality of the oral care they perform. To compare formal and informal caregivers' oral care practices and oral health beliefs when taking care of severely dependent elderly. A cross-sectional study was conducted on a convenience sample of 21 formal caregivers from a long-term residence and 18 informal caregivers from a local primary health care domiciliary programme. Caregivers were surveyed using a questionnaire designed to elicit oral care practices and oral health beliefs. The nursing Dental Coping Beliefs Scale questionnaire was translated and validated in Chile. Significant differences were observed between formal and informal caregivers' performance of some oral health care practices. There were no significant differences between formal and informal caregivers' oral health beliefs. Although there are some differences in formal and informal caregivers' oral health care practices, we cannot state that one caregiver's performance is better than the other, in fact, negative oral health beliefs were found in both groups.

Context: It is needless to state that health and hygiene go hand in hand and of the various categories of hygiene, oral hygiene has a colossal contribution to positive health for any individual. Zealous and correct lifestyle characteristics are related to high standards of oral hygiene, and good habits must be inculcated in the early years of one's life. With this background, a study was conducted among some school-going adolescents. Aims: The aim of this study is to find out the status of their oral hygiene and oral health along with their associated risk factors. Methodology: It was a school-based, observational, cross-sectional study conducted among students of standard 7th, 8th, and 9th of the school who were approached, and the parents of 151 students gave their consent for the oral checkup. Students first filled in a self-administered questionnaire following which their oral health and hygiene were examined. Data were analyzed using statistical package of social science software version 16.0 (IBM, SPSS Inc., Chicago, USA) Descriptive statistics and inferential statistics were performed. Results: Among 151 students, 64.2% had poor oral health, 52.3% and 64.2% student had unsatisfactory awareness toward oral health and oral hygiene practice, respectively. Females had better oral health awareness and better practice scores than males. Factors such as satisfactory practice of oral hygiene (odds ratio [OR] = 6.7 [3.4–12.2]); satisfactory awareness toward oral health (OR = 2.9 [1.9–3.5]); and gender (OR = 2.9 [1.5–5.8]) were associated with good oral health. Awareness toward oral health (OR = 5.8 [2.8–12.2]) are also strongly associated with the good practice of oral hygiene. In the final model of multivariable logistic regression analysis, factors such as the practice of oral hygiene (adjusted OR [AOR] = 6.8 [3.2–14.5]) and awareness toward oral health (AOR = 2.1 [1.3–3.6]) retained significance. Conclusion: Oral health promotion programs and periodic health checkups are needed.

To assess the value of Smiles for Life: A National Oral Health Curriculum (SFL) in influencing oral health practices of primary care professionals (PCPs).The National Maternal and Child Oral Health Resource Center’s Partnership for Integrating Oral Health Care into Primary Care (PIOHCPC) project is working with five project teams in Georgia, Illinois, Maryland, Michigan, and Rhode Island that are integrating interprofessional oral health core clinical competencies into primary care practice. The competencies were developed to facilitate change in the clinical practice of PCPs working with vulnerable or underserved populations that lack or have limited access to oral health care.An initial PIOHCPC project requirement was for PCPs (physicians, nurse practitioners, nurse midwives, nurses) to complete at least two SFL courses based on their project population of focus (eg, pregnant women, children, adolescents). The curriculum consists of the following courses: Course 1: Relationship of Oral and Systemic Health; Course 2: Child Oral Health; Course 3: Adult Oral Health; Course 4: Acute Dental Problems; Course 5: Oral Health for Women: Pregnancy and Across the Lifespan; Course 6: Caries Risk Assessment, Fluoride Varnish, and Counseling; Course 7: The Oral Exam; and Course 8: Geriatric Oral Health. Three months after completion of the SFL courses, a 10‐question feedback form was sent to PCPs.PCPs working in primary care settings (community health centers, local health department, medical center women’s health clinic) serving pregnant women, children, and adolescents who completed at least two SFL courses as part of the PIOHCPC project.Thirteen PCPs (three physicians, three nurse practitioners, three nurse midwives, four nurses) completed the feedback form. One hundred percent of respondents strongly agreed/agreed that SFL courses (1) reinforced the importance of oral health to a patient’s overall health and well‐being, (2) increased their awareness of and familiarity with oral health issues in their patients, and (3) increased their confidence in integrating oral health care into primary care. Seventy‐seven percent of respondents strongly agreed/agreed that SFL courses helped reduce barriers to incorporating oral health care into primary care. Sixty‐two percent of respondents strongly agreed/agreed that integrating oral health care into primary care improved their patients’ oral health outcomes. The majority (ranging from 85 to 100 percent) of PCPs strongly agreed/agreed that SFL courses helped them integrate the interprofessional oral health core clinical competencies into primary care.Three months after completing SFL courses, PCPs indicated that the curriculum had a positive influence on oral health practices in the primary care setting. These findings are consistent with a 2017 study that examined SFL influence on clinical practice and found that the curriculum positively influenced oral health practices in the primary care setting. Additional feedback could be gathered 1 year post‐training to assess retention of PCPs’ practices related to integrating oral health care into primary care.Oral health training is essential for enhancing PCPs’ knowledge and practices related to integrating oral health care into primary care. To respond to the need to integrate oral health care into primary care, SFL should be considered as a training for PCPs.Health Resources and Services Administration.