|dc.identifier.isbn||978-82-308-0819-1 (print version)||eng
|dc.description.abstract||Aim: The main aim of this thesis was to generate initiatives promoting good oral
health for institutionalised elderly. It was therefore essential to investigate how their
oral health status has changed over time, whether care professionals have adequate
oral care knowledge and if the oral hygiene of the institutionalised elderly can be
improved in the long-term by a new quality assurance system.
Methods: Several different methods were used, with both descriptive and analytical
study designs. Factors relating to both residents and caregivers were investigated.
Clinical examinations of long-term care (LTC) residents from five LTC institutions
were performed in 2004. Dental status, caries, periodontal disease, stomatitis and
presence of prosthodontic restorations were registered and the results were compared
with a similar study from 1988.
In 2005, a questionnaire-study was carried out among all Norwegian colleges
educating care professionals working with basic care in LTC institutions. Quantity and
quality of oral care training provided were assessed.
A new quality system aimed at improving and maintaining oral hygiene standards of
the elderly in long-term care was implemented in a nursing home. This oral hygiene
programme included 1) motivation and oral care training of the nursing staff, 2)
production of picture-based oral care procedure cards, 3) distribution of adequate oral
care equipment, 4) practical implementation of new routines and 5) assessment of
results attained. The level of oral hygiene in the nursing home was assessed using the
mucosal-plaque score (MPS) index. Overall evaluation was made before the start of
the study, after 3 months and eventually after 6 years. During this time care staff’s
opinion about the use of electric toothbrushes on the care-dependent resident was
investigated by a questionnaire-study.
Results: Several significant changes in the oral health status among the
institutionalised elderly have occurred since 1988, the most important being a decrease in the frequency of edentulism and an increase in the prevalence of oral diseases.
Regarding the oral care training in the basic education of caregivers, variations
between the different types of colleges were found. However, the majority of schools
seem to provide information and training to cover basic requirements regarding oral
care. Sustained improvements of LTC residents’ oral hygiene were found 6 years after
implementing the oral hygiene programme. Most of the caregivers preferred electric
toothbrushes rather than manual ones. Many reported it made oral hygiene provision
easier and less time-consuming, especially for residents without severe dementia.
Conclusion: The change in oral health of the institutionalised elderly constitutes a twosided
challenge, affecting both dental personnel and caregivers. The public dental
service should be strengthened to handle the increased dental treatment need in this
group. Lack of oral care training in the basic education of care professionals can not
account for the inadequate oral hygiene in Norwegian LTC institutions. Putting
resources into the implementation of a preventive oral hygiene programme is therefore
more likely to lower the incidence of oral infections among LTC residents. For such a
programme to be effective, training, mandatory routines, adequate equipment and
support from dental personnel must be present. On-site staff training is important if
unskilled as well as the professional caregivers are to attain adequate oral care
knowledge and skills. The programme should also place responsibility at the
individual level and reflect an institution-based philosophy with high oral hygiene
|dc.publisher||The University of Bergen||eng
|dc.relation.haspart||Paper I: Acta odontologica scandinavica 66(6), Samson, H.; Strand, G. V.; Haugejorden, O., Change in oral health status among the institutionalized Norwegian elderly over a period of 16 years, pp. 368-373. Copyright 2008 Informa Healthcare, Taylor & Francis. Full text not available in BORA due to publisher restrictions. The published version is available at: <a href="http://dx.doi.org/10.1080/00016350802378654" target="_blank">http://dx.doi.org/10.1080/00016350802378654</a>||eng
|dc.relation.haspart||Paper II: Gerodontology 27(2), Samson, H.; Iversen, M. M.; Strand, G. V., Oral care training in the basic education of care professionals, pp. 121-128. Copyright 2009 The Gerodontology Society and John Wiley & Sons. Full text not available in BORA due to publisher restrictions. The published version is available at: <a href="http://dx.doi.org/10.1111/j.1741-2358.2009.00304.x" target="_blank"> http://dx.doi.org/10.1111/j.1741-2358.2009.00304.x</a>||eng
|dc.relation.haspart||Paper III: European Journal of Oral Science 117(5), Samson, H.; Berven, L.; Strand, G. V., Long-term effect of a quality assurance system on oral hygiene in a nursing home. Published as: Long-term effect of an oral healthcare programme on oral hygiene in a nursing home, pp. 575-579. Copyright 2009 The Authors, journal compilation 2009 European Journal of Oral Science. Published by Wiley-Blackwell. Full text not available in BORA due to publisher restrictions. The published version is available at: <a href="http://dx.doi.org/10.1111/j.1600-0722.2009.00673.x" target="_blank"> http://dx.doi.org/10.1111/j.1600-0722.2009.00673.x</a>||eng
|dc.relation.haspart||Paper IV: Gerodontology 23(2), Wolden, H.*; Strand, G. V.; Gjellestad, A., Caregivers’ perceptions of electric versus manual toothbrushes for the institutionalised elderly, pp. 106-110. Copyright 2006 The Gerodontology Association and Blackwell Munksgaard. Full text not available in BORA due to publisher restrictions. The published version is available at: <a href="http://dx.doi.org/10.1111/j.1741-2358.2006.00114.x" target="_blank"> http://dx.doi.org/10.1111/j.1741-2358.2006.00114.x</a> <br/>*Samson H, née Wolden H.||eng
|dc.title||Oral health and institutionalised elderly||eng
|dc.subject.nsi||VDP::Medisinske Fag: 700::Klinisk odontologiske fag: 830::Andre kliniske odontologiske fag: 849||nob
|dc.rights.holder||Copyright the author. All rights reserved||