Oral health among older adults in nursing homes: A survey in a national quality register, the Senior Alert.
Lisa Bellander, Pia Andersson, Dennis Nordvall and 1 others
PMID 33400398WHAT IT FOUND
Oral health problems were detected in 42% of nursing home residents who received a nursing oral assessment, especially those immobile, underweight, with severe dementia or depression, or poor physical condition.
Findings needing dental or medical referral were registered for 13%.
Key findings
01Oral health risk was detected in 42% of residents who received a nursing oral assessment, with regional variation from 33% to 55%.
02The most common risk items were teeth (27%), dentures (16%) and swallowing (13%).
03Immobility was associated with six times higher odds for oral problems, and poor or very bad physical condition with about four times higher risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a register-based observational study, so it shows associations between frailty and detected oral risk but cannot show that any treatment improves oral health. ROAG-J assessment is optional in Senior Alert, and use varied widely between regions, so the residents assessed may not represent all nursing home residents. Some analyses excluded people with missing values in fall, malnutrition or pressure ulcer assessments, reducing the linked dataset. Oral assessments were performed by nursing staff with variable training and limited equipment, so the 42% risk rate may underdetect true oral disease. Large sample sizes made small numerical differences statistically significant, so odds ratios should be read with clinical caution.
Declared interests
The authors declared no conflicts of interest. The article metadata lists non-U.S. government research support, but no funder is named in the supplied text.
The easy way to misread this
Do not read the 42% detection rate as the true prevalence of oral disease in nursing homes. It is the proportion detected by optional nursing staff assessments with variable training, and the authors report that dental professional studies found more oral problems.