title: Carers' education improves oral health of older people suffering from dementia - results of an intervention study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of carers' education on improvements in oral health and denture hygiene of care-dependent and cognitively impaired older people in nursing homes compared to those without intervention.
  
  
  METHODS
  A total of 219 seniors living in 14 nursing homes in southwest Germany (intervention: n=144; control: n=75) were enrolled in this study. For each participant, Plaque Control Record (PCR), Gingival Bleeding Index (GBI), Denture Hygiene Index (DHI) and Community Periodontal Index of Treatment Needs (CPITN) were assessed at baseline and six months following the interventions. In addition, demographic parameters such as age, sex, chronic diseases, permanent medications, level of dependency and cognitive state were recorded. In the intervention homes, education for caregivers was provided and ultrasound baths for denture cleaning were implemented. Changes in the dental target variables PCR, GBI, CPITN and DHI during the six-month study period were compared between subjects in the intervention and the control groups as well as between subjects with and without dementia. Additionally, multivariate models were compiled for each dental index to evaluate possible confounders.
  
  
  RESULTS
  In the intervention group, PCR and DHI significantly improved during the study period (P<0.001). Oral health and denture hygiene improved likewise in subjects with and without dementia. In the control group, no significant improvements were observed (P>0.05).
  
  
  CONCLUSIONS
  Carers' education improves oral health of people in nursing homes over a clinically relevant period of time. Implementation of ultrasound baths is a simple and effective measure to improve denture hygiene of both institutionalized elderly people and seniors with dementia and in severe need of care. From a clinical standpoint, it is noteworthy that the respective interventions can be easily implemented in everyday care routine.
authors.affiliation: Department of Prosthetic Dentistry, University of Heidelberg.
authors.forename: Andreas
authors.initials: A
authors.lastname: Zenthöfer
authors.affiliation: Institute of Gerontology, University of Heidelberg; Section of Geriatric Psychiatry, Center of Psychiatry, University of Heidelberg, Heidelberg, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Meyer-Kühling
authors.affiliation: Department of Prosthetic Dentistry, University of Heidelberg.
authors.forename: Anna-Luisa
authors.initials: AL
authors.lastname: Hufeland
authors.affiliation: Institute of Gerontology, University of Heidelberg; Section of Geriatric Psychiatry, Center of Psychiatry, University of Heidelberg, Heidelberg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Schröder
authors.affiliation: Department of Prosthetic Dentistry, University of Heidelberg.
authors.forename: Tomas
authors.initials: T
authors.lastname: Cabrera
authors.affiliation: Department of Prosthetic Dentistry, University of Heidelberg.
authors.forename: Dominik
authors.initials: D
authors.lastname: Baumgart
authors.affiliation: Department of Prosthetic Dentistry, University of Heidelberg.
authors.forename: Peter
authors.initials: P
authors.lastname: Rammelsberg
authors.affiliation: Department of Prosthetic Dentistry, University of Heidelberg.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Hassel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000193:education*; D002908:Chronic Disease; D015897:Comorbidity; D003704:Dementia / Q000628:therapy*; D003778:Dentures; D005260:Female; D005858:Germany; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D009909:Oral Health / Q000706:statistics & numerical data*; D009910:Oral Hygiene / Q000193:education*; D012737:Sex Factors
keywords: intervention; longitudinal; nursing home; older people; oral health