Effect of oral health interventions for dependent older people—A systematic review

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Gerodontology Pub Date : 2023-10-17 DOI:10.1111/ger.12720

Josefina Salazar, Christina Andersen, Esben Boeskov Øzhayat

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Abstract

Background

There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health.

Objective

The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people.

Methods

We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta-analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system.

Results

We included a total of 30 randomised clinical trials assessing educational and non-educational interventions for community-dwelling older people (n = 2) and those residing in long-term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long-term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system.

Conclusion

Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long-term effect of interventions, and further research is needed, especially targeting community-dwelling older people.

PROSPERO ID: CRD42021231721.

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依赖性老年人口腔健康干预的效果——系统综述。

背景：全世界老年人的比例越来越高，其中很大一部分人依赖他人的照顾。依赖性老年人更容易患口腔疾病，这会严重影响他们的生活质量（OHRQoL）和总体健康。目的：本系统综述的目的是全面评估改善口腔健康或保证依赖性老年人获得和坚持牙科治疗的干预措施。方法：检索MEDLINE、EMBASE、CENTRAL和临床试验注册中心。两名评审员使用Cochrane偏倚风险工具进行了选择、数据提取、偏倚风险评估和证据确定性评估。在可能的情况下，我们进行了荟萃分析，以计算效果估计值及其95%置信区间。主要结果是OHRQoL、口腔/牙科健康和口腔护理系统的使用。结果：我们纳入了30项随机临床试验，评估社区老年人的教育和非教育干预措施（n = 2）以及那些居住在长期护理机构的人（n = 28）。大多数研究评估了口腔卫生，并表明干预措施可能在短期内减少牙菌斑（证据的确定性较低），但长期有效性的证据有限。只有一项研究评估了OHRQoL，没有一项评估口腔卫生保健系统使用的变化。结论：我们的研究结果没有提供支持任何具体干预的有力结论，主要是由于研究质量和不精确性。关于干预措施的长期效果的信息有限，需要进一步研究，特别是针对居住在社区的老年人。Prospero id:CRD42021231721。

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来源期刊

Gerodontology 医学-老年医学

CiteScore

4.10

自引率

10.00%

发文量

审稿时长

3-6 weeks

期刊介绍： The ultimate aim of Gerodontology is to improve the quality of life and oral health of older people. The boundaries of most conventional dental specialties must be repeatedly crossed to provide optimal dental care for older people. In addition, management of other health problems impacts on dental care and clinicians need knowledge in these numerous overlapping areas. Bringing together these diverse topics within one journal serves clinicians who are seeking to read and to publish papers across a broad spectrum of specialties. This journal provides the juxtaposition of papers from traditional specialties but which share this patient-centred interest, providing a synergy that serves progress in the subject of gerodontology.