Elderly patients, especially those requiring special care, often show low oral hygiene levels. Reduced motoric, sensual or cognitive function is typically observed. But how could it be determined (measured), when assistance in oral hygiene is necessary?
I'm looking for a sort of test, which can be handled by nurses/medical doctors (NOT dentists) and helps to decide which patient should receive assistance and which patient should be helped to clean teeth and dentures alone.
according to my knowledge there is no such instrument. you can check it my the plaque disclosing tablets.
hi Ina
very interesting question. In my experience conducting research on elderly, it is very difficult to measure the competency of tooth brushing among elderly especially their psycho-motor status is not stable. I do agree with Mr Sajid that measuring their plaque as a proxy is good indicator but how about those edentulous patient? another method is by assessing the caregiver KAP and do a clinical correlation
Hello, I don't think there is an validated instrument, but staining the plaque attached to both prothetic devices and remaining teeth seems the highest evidence you can get. The are some studies that have used such solutions to stain prosthesis and teeth, and then evaluate the performance of elderly people and caregivers in brushing.
Thank you all for your answers. In the geriatric assessment the elderly have to perform so many tests (MMS, Barthel, Lachs etc etc.) so I thought that somebody tried to find an assessment tool of the comptence to clean teeth and prosthesis.
what you can do is to see whether there is a correlation between geriatric assessment test scores and plaque score /gingival index etc. so that you can recommend at what level of geriatric assessment one needs help in oral hygiene maintenance.
Dear Ina, a very relevant question, especially considering the aging of populations (including in emerging countries such as Brazil) and the (still few) gerodontists educated and trained to understand the aging process and all care the elderly needs, including prevention, education, motivation and supportive therapy that seniors deserve. Here in Brazil it is estimated that over 50% of GDP is generated by retirements, or even for those who do not think with their own heart, the need adds value for both patients and dentists.
Specifically regarding your question, I agree that tablets with of plaque disclosing agent in tablets, or even in mouthwashes and also in a dentifrice (Silva, Débora Dias da et al. Aggregation of plaque disclosing agent in a dentifrice. J. Appl. Oral Sci., June 2004, vol.12, no.2, p.154-158. ISSN 1678-7757), such as those of fuchsin are both motivators and educators. There are some (simple) devices, use of strain gauges coupled to cadcam systems for measuring the pressure of use and accuracy of the set toothbrush / toothpaste. Also the adaptation of "handles" from handlebars of bicycles and motorcycles to toothbrushes cables, helps a lot on hold and use the toothbrush for the elderly. In addition to this, a high dose of patience, repetition and affection are essential for the best results.
Yes
http://www.ncbi.nlm.nih.gov/pubmed/1749783
http://www.ncbi.nlm.nih.gov/pubmed/15686280
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