The advantages of occupational therapy in oral hygiene measures for institutionalised elderly adults.
OBJECTIVE
To investigate a new method in teaching and supervising tooth and denture brushing activities by employing occupational therapy techniques.


METHODS
Sixty-one residents, 44 women and 17 men, with an average age of 85.7 +/- 6.6 years (range 72-97 years) living in a Long-Term Care home (LTC) in Geneva were enrolled in a randomised controlled trial. They were divided at random into experimental (EG) and control groups (CG) with matched age and sex distribution. Two subjects passed away during the 3-month experimental period. Following medical history, plaque scores and tooth brushing habits were evaluated within the context of a comprehensive clinical assessment. Furthermore, a Mini Mental State and a vision test were taken. Based on the results of these health assessments both the EG and the CG were divided into an 'assisted' (IA) and an 'independent' (II) subgroup. In the EG, tooth brushing was initially taught and in the IA monitored and re-educated once a week by an occupational therapist. In contrast, the CG-IA group received a weekly placebo activity such as manicure by the same person.


RESULTS
From the individual movements taught and monitored by the occupational therapist, opening a tube of toothpaste (n.s.) and denture brushing (p < 0.05) were performed more independently after 3 months. Both the occupational therapy and the placebo activity led to a significant improvement in oral (p < 0.01 and 0.05) and in denture hygiene (p < 0.001 and 0.05). From all participants, the EG-IA subgroup presented the most significant amelioration in plaque (p < 0.01) and denture hygiene scores (p < 0.001). This group consisted mostly of subjects with an impaired cognitive state.


CONCLUSIONS
Despite the marked placebo effect, the results indicate that occupational therapy is particularly useful to improve the oral and denture hygiene in dependent and cognitively impaired LTC residents and may promote their autonomy in the execution of activities of daily life such as denture brushing.
Bellomo
Fleurange
F
Division of Gerodontology and Removable Prosthodontics, Dental School, University of Geneva, Geneva, Switzerland. fleurange.bellomo@medicine.unige.ch
de Preux
Frédérique
F
Chung
Jean-Pierre
JP
Julien
Noëlle
N
Budtz-Jørgensen
Ejvind
E
Müller
Frauke
F
D000368:Aged; D000369:Aged, 80 and over; D003774:Dental Plaque Index; D003778:Dentures; D005260:Female; D006801:Humans; D007326:Institutionalization; D008134:Long-Term Care; D008297:Male; D009788:Occupational Therapy / Q000379:methods*; D009910:Oral Hygiene / Q000379:methods*; D018709:Statistics, Nonparametric; D014099:Toothbrushing / Q000379:methods*