Marusiak, M.

Insufficient Oral Health Programs For Older Adults in Long-Term Care: A Literature Review
Marusiak, M.

The rationale for this study is to address the increasing number of older adults with dementia who are retaining their natural dentition and suffering in mouth pain because of oral neglect caused by a dirty mouth. The purpose of this study is to synthesize the research gaps found in three promising programs provided for older adults with dementia residing in long-term care (LTC) facilities.

The justification for the study is to recommend oral health programs for older adults with dementia residing in LTC that significantly decrease: 1) Incidence, prevalence, and impact of aspiration pneumonia (AP) and deaths; 2) Oral health inequity by lessening oral pain and discomfort by preventing acute and chronic dental disease and systemic disease; and 3) Economic costs associated with oral neglect and AP.

Qualitative data from an "14-item Oral Health Impact Profile questionnaire" showed that residents of LTC experienced significantly more "negative impacts" from their teeth compared to their peers in the community. A cost-effective solution to improve the OHRQoL outcomes and to address negative impacts from the teeth and gums are prevention and restoration of the dental caries and periodontitis. Quantitative data collected in Canadian LTC facilities using the resident assessment instrument - minimum data set (RAI-MDS) 2.0 lacks validity. Not only does this result in underestimating the need, severity, and outcomes of oral health problems but demonstrates the inadequacy of non oral health professionals conducting oral assessments.

Sufficient evidence is needed in demonstrating effective oral health outcomes and methods to prevent and restore oral health diseases in older adults. Urgent research is needed in demonstrating the association between AP and oral hygiene, implying that effective methods to improve oral hygiene would probably have far-reaching positive consequences both for the health of the older adult and for the overall costs.