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J Am Geriatr Soc. 2013 Jul;61(7):1158-63. doi: 10.1111/jgs.12317. Epub 2013 Jun 17.

Effect of a person-centered mouth care intervention on care processes and outcomes in three nursing homes.

Author information

1
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA. psloane@med.unc.edu

Abstract

OBJECTIVES:

To develop and test a person-centered, evidence-based mouth care program in nursing homes.

DESIGN:

Pre-post assessment, with an 8-week intervention period and a pilot 6-month extension at one site.

SETTING:

Three North Carolina nursing homes.

PARTICIPANTS:

Ninety-seven residents and six certified nursing assistants (CNAs).

INTERVENTION:

CNAs already working in the facilities were trained as dedicated mouth care aides. A psychologist and dental hygienist provided didactic and hands-on training in evidence-based mouth care products and techniques and in person-centered behavioral care.

MEASUREMENTS:

Primary outcome measures for natural teeth were the Plaque Index for Long-Term Care (PI-LTC) and Gingival Index for Long-Term Care(GI-LTC) and for dentures the Denture Plaque Index (DPI); a dentist unmasked to study design obtained measures. Secondary outcomes included quantity and quality of care provided.

RESULTS:

Outcome scores significantly improved (P < .001 for PI-LTC and GI-LTC; P = .04 for DPI). Coding of videotaped care episodes indicated that care was more thorough (P < .001-P = .03) but took more time (P < .001) after training. Consistency of care appeared to be more important for natural teeth than dentures.

CONCLUSION:

As little as 8 weeks of mouth care can significantly improve oral hygiene outcomes. Given the consequences of poor oral hygiene, greater attention to mouth care education and provision are merited. The dedicated worker model is controversial, and future work should assess whether other models of care are equally beneficial.

KEYWORDS:

culture change; mouth care; nursing home; oral hygiene; person-centered

PMID:
23772769
DOI:
10.1111/jgs.12317
[Indexed for MEDLINE]

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