Oral Environment Status and Related Factors among Older Adult Home Care Patients Who Use Visiting Nursing Services

Abstract

This study aimed to examine the oral environment of older adult home care patients who use visiting nursing services and to explore related factors. Direct observation of the participantsʼ oral cavity was conducted using the Japanese version of the Oral Health Assessment Tool (OHAT-J) on patients at a visiting nursing station. The OHAT-J is an oral assessment tool for older adults and consists of eight items: “lips”, “tongue”, “gums and tissues”, “saliva”, “natural teeth”, “dentures”, “oral cleanliness”, and “dental pain”. The range of possible scores is 0-16, and the higher the score, the worse the oral environment. Path analysis using the OHAT-J total score as the final endogenous variable was employed to explore the factors related to the oral environment of the patients. Of the 129 older adult home care patients asked to complete the survey, 67 did so (51.9% acceptance rate). The mean OHAT-J total score was 4.2 (SD 2.6). Items such as “tongue” and “oral cleanliness” were evaluated as “oral changes” or “unhealthy” for most of the patients. The path analysis indicated that the item with the highest overall effect on the OHAT-J total score was “nursing care level 3 or higher” ( β = 0.31). The oral environment of the patients in this study was poorer than that of older community-dwelling adults with access to outpatient dental services in previous studies. It is recommended that support be given to those who require a high level of nursing care, who are experiencing cognitive decline, and whose fam-ily are having difficulties in providing oral care for them.