The aim of this systematic review was to examine the association between malnutrition and oral health in older people (≥ 60 years of age). A comprehensive systematic literature search was performed in four databases (PubMed, CINAHL, Dentistry and Oral Sciences Source, and Embase) for literature from January 2000 to May 2020. Both observational and intervention studies were screened for eligibility. Two reviewers independently screened the search results to identify potential eligible studies, and assessed the methodological quality of the full-text studies. A total of 3240 potential studies were identified. After judgement for relevance, 10 studies (cross-sectional (n = 9), prospective cohort (n = 1)) met the inclusion criteria. Three studies described malnourished participants as having fewer teeth, or functional (tooth) units (FTUs), compared to well-nourished participants. Four studies reported soft tissue problems in malnourished participants, including red tongue with blisters, and dry or cracked lips. Subjective oral health was the topic in six studies, with poorer oral health and negative self-perception of oral health in malnourished elderly participants. There are associations between (at risk of) malnutrition and oral health in older people, categorized in hard and soft tissue conditions of the mouth, and subjective oral health. Future research should be focused on longitudinal cohort studies with proper determination of malnutrition and oral health assessments, in order to evaluate the actual association between malnutrition and oral health in older people.
Objective: To conduct a capacity and needs assessment identifying important factors for the successful implementation of an oral health coach (OHC) at well-baby clinics. This Toddler Oral Health Intervention (TOHI) provides oral health promotion to parents to prevent early childhood caries. Methods: A two-round Delphi study was conducted with an expert panel consisting of OHCs and paediatric staff. The survey was based on the Consolidated Framework for Implementation Research (CFIR), consisting of 39 constructs divided over 5 domains: intervention characteristics (8), inner setting (14), outer setting (4), characteristics of individuals (5) and the process of implementation (8). Results: Constructs relating to the inner setting, outer setting and implementation process were identified as essential. Availability of resources, information on how to execute or facilitate the intervention, and the integration of the intervention into existing work tasks were also essential. Alignment and partnership between OHCs and paediatric staff, along with the prioritization of parents' and children's needs were emphasized. A formally appointed internal implementation leader within each organization, capable of transferring their enthusiasm to the team, and regular meetings for progress and experience sharing were considered essential. Conclusion: Specific strategies are needed in the implementation phase to increase the adoption, implementation and maintenance of the TOHI, ultimately leading to improved oral health in children. This study provides valuable insights into important factors for implementation of an oral health intervention in a public health setting.
LINK
Background: Dental fear and uncooperative behavior can hinder dental treatment quality. Pediatric Procedural Sedation and Analgesia (PPSA) is used to facilitate treatment when the coping capacity is exceeded. Out-of-hospital PPSA has been associated with more adverse outcomes compared to when it is used in hospital-based settings. The updated Dutch PPSA guidelines have increased costs and raised concerns about the accessibility of specialized high-quality dental care for children in the Netherlands. This study aimed to investigate the impact of the updated 2017 guidelines on the occurrence rate of adverse events during PPSA in twelve Dutch dental clinics. Methods: The data of 25,872 children who were treated at twelve dental clinics between 1997 and 2019 were analyzed. A logistic two-level mixed-effects model was used to estimate the updated guidelines’ impacts on adverse events. Results: The OR of the occurrence rate of an adverse event adjusted for age, weight, and duration of treatment was 0.75 (95% CI 0.64–0.89) after the implementation of the updated guidelines. This outcome was significant with p = 0.001, indicating a protective effect. Conclusions: Our findings demonstrate that there was a significant reduction in adverse events after the implementation of the updated guideline and highlight the importance of adhering to evidence-based practices in out-of-hospital dental clinics.
In het PRIMa mond CARE project wordt onderzocht in hoeverre de mondgezondheid bijdraagt aan de voorspelling van kwetsbaarheid bij thuiswondende ouderen.Doel Het doel van het PRIMa mond CARE project is te onderzoeken in hoeverre mondgezondheid bijdraagt aan de voorspelling van kwetsbaarheid bij thuiswonende ouderen. Resultaten Voor het onderzoek zijn 1202 ouderen geïncludeerd, waarvan 45% mannen. De gemiddelde leeftijd van de participanten was 73 jaar. De eerste resultaten laten verbanden zien tussen kwetsbaarheid en onderstaande gezondheidsfactoren: • het bezoeken van de tandarts voor een spoedconsult; • het ervaren van ongemakken in de mond; • het aanpassen van de voeding als gevolg van ongemakken in de mond en • het dragen van een gebitsprothese. De volgende artikelen over dit onderzoek zijn inmiddels gepubliceerd: 'Probing problems and priorities in oral health among community dwelling elderly in the Netherlands' in het International Journal of Health Sciences and Research. In het International Journal of Health Services is het artikel 'Needs in Sevice Provision for Older People: An comparison Between Greater Manchester (United Kingdom) and Utrecht (the Netherlands)' gepubliceerd. Recentelijk verscheen ‘’Measurement properties of oral health assessments for non-dental professionals in older people: a systematic review’’ in het BMC Geriatrics. Looptijd 01 november 2016 - 01 juli 2020 Aanpak De huisarts brengt met een softwareprogramma genaamd ‘’U-PRIM’’ de groep potentieel kwetsbare ouderen in kaart. De mensen uit deze screening komen in fase twee: U-CARE. Zij ontvangen een vragenlijst: de Groningen Frailty Indicator. Met de uitkomsten van de vragenlijsten worden de domeinen van kwetsbaarheid gedefinieerd. Deze mensen krijgen huisbezoek van een praktijkverpleegkundige die een zorgplan op maat maakt. De verpleegkundige screent tijdens dit bezoek de oudere ook op mondgezondheidsproblemen, naast de algemene gezondheidscontrole. Daarnaast zijn de gegevens uit het tandartsenbestand gekoppeld aan de gegevens van de huisarts. Ook zijn twee vragen over mondgezondheid toegevoegd aan de Groningen Frailty Indicator. Aan de deelnemers van het onderzoek is toestemming gevraagd om de tandartsgegevens op te vragen bij de tandarts en deze te koppelen aan de huisartsgegevens. Daarnaast zijn alle gegevens anoniem verwerkt.
