title: Is Cognitive Status Related to Oral Hygiene Level and Appropriate for Determining Need for Oral Hygiene Assistance?
abstract: BACKGROUND
  With declining general health, the maintenance of oral health becomes increasingly difficult. Unfortunately, health care resources are limited. An assessment tool for detecting a patient's need for oral health care assistance would promote its adequate distribution. The aim of this study is to evaluate if the Shulman clock-drawing test score is a suitable assessment tool for determining the need for oral hygiene assistance.
  
  
  METHODS
  Data collected from recent dental checkups of 126 inhabitants of five Austrian residential care facilities were analyzed. The Shulman clock-drawing test score was used as a measure for cognitive abilities and related to tooth and denture hygiene indices, which were assessed using the approximal space plaque index (API) and the denture plaque index (DPI).
  
  
  RESULTS
  Shulman score values were distributed almost evenly in the study population. The mean API was 83.6% (SD 20.2%) for the maxilla and 94.9% (SD 15.6%) for the mandible. The mean DPI was 43.9% (SD 31.4%). Cognitive impairment was not statistically related to the dental or denture hygiene index.
  
  
  CONCLUSIONS
  A high Shulman clock-drawing test score indicates the need for oral hygiene assistance, but it is not suitable as a single tool to assess this need. Patients with other disabilities might equally qualify for assistance. Dentures, however, can be cleaned quickly and efficiently independently of patient compliance; therefore, cleaning the patients' dentures should be part of nursing personnel's daily care routine for every patient.
authors.affiliation: Department of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Patricia-Anca
authors.initials: PA
authors.lastname: Steinmassl
authors.affiliation: Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck.
authors.forename: Otto
authors.initials: O
authors.lastname: Steinmassl
authors.affiliation: Private practice, Absam, Austria.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Kraus
authors.affiliation: Department of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Dumfahrt
authors.affiliation: Department of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Grunert
mesh_terms: D001317:Austria; D003071:Cognition; D003778:Dentures; D006801:Humans; D009909:Oral Health; D009910:Oral Hygiene
keywords: Cognition disorders; dental care for aged; dental prophylaxis; dentures; oral hygiene; toothbrushing