Table 3.
Key study findings (N = 62)
| Authors (Year) [Ref.#] | Intervention | Duration | Interven-tionist | Key Findings |
|---|---|---|---|---|
| Intervention Studies | ||||
| Little et al., (1997) [53] | Five 90-minute oral hygiene classes to intervention group. Control group: usual care | 4 mos | Dental hygienist | Brushing frequency & skills margi-nally better in treatment group, but mean % sites with plaque, gingival bleeding & bleeding after probing were similar in both groups |
| Mojon et al. (1998) [54] | Educational sessions (Oral hygiene courses) to healthcare providers & regular calls to residents. Control group treated by dentist with mobile equipment by request | 18 mos | Dental hygienist | |
| Simons et al. (2001) [55] | Chlorhexidine acetate/ xylitol gum. Control group: usual care | 12 mos | Not clear | Improved plaque & gingival scores with chlorhexidine/ xylitol gum |
| Engfors et al. (2004) [56] | 5-year clinical & radiologic performances of fixed implant-supported prostheses (Retrospective) | Retrospective study (5 years) | Not clear | The result of Implant treatment among the older adults & younger age group were comparable. |
| Mariño et al. (2004) [57] | ORHIS implemented (incl. Access to services & referrals). Control group: usual care | 12 mos | Not clear | ORHIS approach significantly improved oral health attitudes, knowledge & behaviours on oral care |
| Wyatt et al. (2004) [58] | Application of 15 ml of either 0.2% neutral NaF or 0.12% chlorhexidine gluconate. Control group: placebo | 24 mos | Dentist | Reduced incidence of caries |
| Peltola et al. (2007) [59] | Group A: tooth cleaning (electric toothbrushes & interdental brushes) by dental hygiene students; group B: same services by dental hygienist trained nurses. Control usual care. | 11 mos | Dental hygienist (students) Nurse | Intervention group B performed best in terms of improved denture & dental hygiene |
| Hakuta et al. (2008) [60] | Intervention participants received educational sessions & encourage-ment for facial muscle & tongue exercise, & salivary gland massages. Control gtoup received usual care | 3 mos | Dental hygienist | Reduced tongue coating scores, organoleptic score for oral mal-odours & food debris in oral cavity. Improved tongue dryness, lip movement & clearer pronunciation |
| Baca et al. (2009) [61] | Application of a chlorhexidine-thymol varnish. Control group = Placebo group | 12 mos | Dentist | Reduced incidence of root caries lesions |
| Tan et al. (2010) [62] | 4 different methods: i) individualized OHI; ii) OHI & 1% chlorhexidine varnish every 3 mos; iii) OHI & 5% sodium fluoride varnish every 3 mos; iv) OHI & annual 38% SDF solution | 36 mos | Unclear | SDF solution, sodium fluoride varnish & chlorhexidine varnish more effective in preventing new root caries lesions than oral health instructions alone |
| Blinkhorn et al. (2011) [63] | Design & produce oral hygiene trolley, develop protocol & educate staff. Comparison between baseline & endline | 12 mos | Nurse Dentist Dietician | Reduced plaque & gingivitis scores & pocket depths |
| Tashiro et al. (2011) [64] | Pre-post-intervention in 3 groups i) oral cleaning by toothbrushing alone; ii) tongue coat removal using sponge brush; iii) wiping oral mucosa with gargling solution containing chlorhexidine gluconate | 5 conse-cutive days every 3 weeks | Dentist Dental hygienist | Improved oral malodour; decreased plaque & gingival index scores |
| Mariño et al., (2013) [65] | A series of oral health seminars & 4 supervised brushing sessions at club premises. Control group: usual care | 6 mos | Not clear | Improved gingival status & self-efficacy, but no effect regarding dental plaque |
| Van Der Putten et al., (2013) [66] | The supervised “oral health care Guideline for older people in long-term care institutions” (OGOLI) was introduced to the intervention arm. Control group: usual care | 6 mos | Dental hygienist | Improved dental plaque scores |
| Zenthofer et al. (2013) [67] | Professional cleaning of teeth & dentures. Control group: usual care | 3 mos | Dentist | Improved dental hygiene, plaque & gingival index scores |
| Zhang et al. (2013) [68] | 2 groups: i) OHI & SDF; ii) OHI & SDF, plus OHE. Control group: OHI | 24 mos | Dentist Dental hygienist | Intervention group had greater num-ber of active root caries surfaces that became arrested than control group |
| Bonwell et al. (2014) [69] | Two 45-mintes in-service training sessions with demonstrations to health care providers. Pre- & post-test comparison | 3 mos interval | Periodon-tist, Oral pathologist, Pharmacist, Dietitian Occupatio-nal therapist | ~ 80% of the 145 participants indicated they would make a change in patient care |
| Morino et al. (2014) [70] | Professional oral health care & toothbrushing. Control group: usual care | 5 mos | Dental hygienists | Improved dental plaque score |
| Kammers et al. (2015) [71] | Application of adapted toothbrush handles. Control group: conventional toothbrush | 0.75 mos | Dentist | Reduction in biofilm coverage among those using adapted toothbrush handles |
| Khanagar et al. (2015) [72] | Educational sessions (through PowerPoint). Control group: usual care | 6 mos | Not clear | Improved oral health knowledge of caregivers & reduced scores for plaque, debris, denture plaque & denture stomatitis |
| Komulainen et al. (2015) [73] | Intervention group received individually tailored personal guidance in dental & denture hygiene. Control group: usual care | 24 mos | Dentist Dental hygienist | Improved oral health among intervention group compared to control |
| Ohara et al., (2015) [74] | Intervention group received OHE programs. Control group received pamphlets describing only general information about oral health | 3 mos | Dental hygienist | Improved resting salivation, second & third swallowing times as well as taste sensitivity for bitterness |
| Kim et al. (2016) [75] | Oral health promotion program (Combined Watanabe method & oral functional exercise). Control group: usual care | Not clear | Not clear | Improved oral hygiene & oral function scores |
| Mariño et al. (2016) [76] | Pre- & post-ORHIS model via com-puter interactive presentations; no direct role of oral health professionals | 12 mos | Not clear | Significantly improved oral health attitudes, knowledge & self-efficacy & self-reported oral hygiene practices |
| Avellaneda et al. (2017) [77] | Educational sessions & demon-strations on oral care & tooth brushing techniques. Comparison between baseline & endline | 6 mos | Dental students assessed by panel of experts | Reduced plaque & gingival scores |
| Deutsch et al. (2017) [78] | Educational sessions & training to nurses in oral assessments & saliva testing & develop care plan. Com-parison between baseline & endline | 10 weeks | Oral health therapists | Enhanced competencies of nurses so they could choose the appropriate intervention similar to oral health therapists |
| Ildarabadi et al. (2017) [79] | Educational session through training. Control group: usual care | 2 mos | Not clear | Improved oral health status |
| Nihtila et al. (2017) [80] | Oral/written dental hygiene instruc-tions & cleaning of oral mucosa provided to participants/caregivers/ nurses. Control group: usual care | 6 mos | Dental hygienist | Improved denture hygiene & reduced number of plaque-covered teeth |
| Sakashita et al. (2017) [81] | Knowledge, skill & experience sharing on self-care. Private consul-tation to manage condition through oral examination. Baseline, 3- & 6-mos intervention comparisons | 6 mos | Nurse, Dentist Dental hygienist | Improved use of dental floss & interdental brushing, Community Periodontal Index scores & deposits of plaque & oral & physical quality of life |
| Schwindling et al. (2017) [82] | Educational sessions & practical training (different types of prosthe-tic restorations) for care-givers. Control group: no intervention | 12 mos | Dentist | Improved plaque & gingival bleeding scores |
| Fjeld et al. (2018) [83] | New toothbrush by own preference & application of 1450 ppm NaF toothpaste | 12 mos | Dentist, Dental hygienist | No differences in plaque scores between manual and electric toothbrush |
| Janssens et al. (2018) [84] | Educational sessions & implemen-tation of oral healthcare guideline. Comparison between baseline & FU | 22.5 mos (Mean) | Dentist | Reduced proportion of oral health incident treatment need |
| Lavigne et al. (2018) [85] | Twice-daily use of a rotating-oscillating power toothbrush. Control group: usual care | 1.5 mos | Dental hygienist | Reduced periodontal inflammation including reduction in bleeding |
| Marchini et al. (2018) [86] | Group 1) Educational session; 2) educational session plus application of chlorhexidine varnish. Control group: usual oral hygiene practice | 6 mos | Dental hygienist | No clinical differences recorded in clinical or microbiological outcomes |
| Seleskog et al. (2018) [87] | Individualized guidance & support for each resident. Control group: usual care | 3 mos | Dental hygienist | Improved plaque levels in older adults; enhanced capacity of nursing staff to perform proper oral care |
| Berniyanti et al., (2019) [88] | Counselling about dental & oral health materials & ways of brushing toothless jaws | Not clear | Not clear | Average improvement of knowledge & application of toothbrushing method |
| Iwao et al. (2019) [89] | Educational sessions & demonstra-tions on physical exercise, oral health & nutritional guidance. Com-parison between baseline & endline | 3 mos | Dental hygienist | This intervention may contribute to healthy aging in older people |
| Keyong et al. (2019) [90] | OHE & demonstration of oral hygiene & denture cleaning, provi-sion of toothbrush & fluoride tooth-paste. Control group: those who did not practice tooth brushing | 6 mos | Dental nurses | Improved oral health perception, lower plaque & gingival & inflammation scores & less clinical attachment loss |
| Leon et al. (2019) [91] | Application of 5000 ppm NaF-dentifrice. Control group: 1450 ppm NaF-dentifrice | 24 mos | N/A | 5000 ppm F-dentifrice more effective than conventional dentifrice in preventing & arresting RCLs |
| Laurence et al. (2019) [92] | Educational sessions for nursing staff. Control group: those not receiving intervention | 2 mos | Dentist | Improved plaque scores |
| Saleem et al. (2019) [93] | Provided lip trainer device to one group, sonic toothbrush to other group & others as control | 6 mos | Clinician Dental hygienist | Lip training device improved salivary flow rates & oral wettability. But less improvement observed among those using a sonic electric toothbrush |
| Tellez et al. (2019) [94] | Motivational interview sessions | Not clear | Dental hygienist | Basic or greater proficiency achieved in improving oral health |
| Tellez et al. (2019) [95] | Motivational interview sessions. Compared with traditional OHE group & control group: usual care | 12 mos | Dental hygienist | Improved oral health self-efficacy (SE) & OHRQL in intervention groups. No change in control group |
| Ting et al., (2019) [96] | Brief OHE program incl. Education materials. Comparison between pre- & post-test | 8 mos | Not clear | Improved GOAHI score. Significant differences for RSST, ODT & CET |
| Johansson et al. (2020) [97] | Educational sessions for nursing staff. Demonstration sessions to each resident. Control group: usual care | 3 mos | Dental hygienist | Nursing staff moderate/high, residents good/acceptable oral health & oral health care-related beliefs at baseline, which was maintained |
| Konstantopoulou et al. (2020) [98] | Educational sessions. Control group: usual care | 2 mos | Not clear | Improved knowledge & attitude |
| Lee et al. (2020) [99] | Professional oral health care program. Control group: usual care | 3 mos | Dental hygienist | Reduced tongue coating, plaque & gingival scores |
| Lee et al., (2020) [100] | Oral health education only to 1 group & other group had additional access to contents of oral health education. Control group received usual care | 1.25 mos | Not clear | Increased oral health knowledge oral health recognition among the intervention group |
| Ho et al., (2021) [101] | Oral health education consisting oral health care for frail older adults, practical sessions on daily oral hygiene care | 12 mos | Geriatric dentist Dental hygienist Geria-trician | Increased oral health awareness amongst health care professionals |
| Ki et al., (2021) [102] | Intervention group received 4 videos on oral exercise, intraoral & extraoral massage & oral hygiene on brushing & denture care methods along with a workbook & a poster. Control group: usual care | 1.5 mos | Not clear | Improved SWAL-QoL, increased tongue pressure & reduced oral dryness |
| Lee et al., (2021) [103] | Oral health education via smartphone app developed in this study & via PowerPoint lectures to non-app users. Control group: usual care | 1.25 mo | Not clear | Improved oral health knowledge & perception & reduced dental plaque & tongue coating scores amongsmartphone users |
| Northridge et al., (2021) [104] | Training on proper toothbrushing & flossing techniques. Encouraged regular dental visits & brushing with fluoride toothpaste & addressed any expressed concerns. Pre- & post-test comparison | 1 mo | Community health worker | > 98% participants strongly agreed/ agreed that CHWs helped them improve taking care of their oral health, answered participants’ questions/concerns & in-person demonstrations were effective to improve oral health |
| Peroz & Klein (2021) [105] | Education sessions & training for staff & oral hygiene treatment for residents. Control group: usual care | 1 year | Dentist | Oral parameters (pocket depth, denture hygiene, mucosal alterations) may be positively influenced |
| Patel et al. (2021) [106] | Fluoride toothpaste use & quarterly fluoride varnish. Comparison between baseline & endline | 12 mos |
Trained clinician Dentist Hygienist |
Prevented root caries |
| Pawluk et al. (2021) [107] | Educational sessions (Online modules). Comparison between pre- & post-test | Not clear | Dental hygienist | Limited impact on Personal Support Workers’ knowledge & beliefs regarding resident oral health care |
| Sun et al., (2021) [108] | Easy-to-read health education materials with PowerPoint slides. Control group received general text materials on oral health to read | 30 minutes after session | Not clear | Improved oral health literacy |
| Wanyoni et al., (2021) [109] | Text messages on dental & oral care to intervention group. Control group: received leaflet on dental & oral care | 2.5 mos | Not clear | 89% of participants in text arm would recommend the intervention versus 68.2% in the leaflet arm |
| Observational Studies | ||||
| Strayer (1991) [110] | The intervention program reduced Streptococcus mutans colonisation & caries prevalence | N/A | N/A | Oral health programs for the elderly reported in 30 states (63% of respon-dents). Perceived or documented need for oral health programs for the elderly & lobbying by local advocacy groups were instrumental in implementing or planning such programs |
| Chalmers et al. (2005) [111] | Practical Oral Care video | N/A | N/A | Intervention improved awareness about oral health issues |
| McAnulla et al., (2018) [112] | Poster containing instructions on maintaining oral care & provision of box containing oral hygiene resources | N/A | N/A | Improved awareness of & attention to the oral care of older adults |
| Lee et al., (2021) [113] | Implementation of National Health Insurance Coverage of Dentures for the elderly | 2011–2013 | N/A | Increased denture procedures for older adults and low-income & medical aid beneficiaries |
| Comparative/ Review Study | ||||
| Tynan et al. (2018) [114] | Integrated oral health program (screening, education & referrals). Control group: facilities without integrated program | N/A | Oral health therapist | Improved compliance with Australian Aged Care Quality Accreditation Standards |
CET Cheek expanding test, CHW Community health worker, FU Follow-up, mo(s) Month(s), GOAHI Geriatric/general oral health assessment index, incl. Inclusive, NaF Sodium fluoride, ODT Oral diadochokinesia test, OHE Oral health education, OHI Oral hygiene instructions, OHRQL Oral health-related quality of life, ORHIS Oral health information seminars/sheets, RCL(s) Root caries lesion(s), RSST Repetitive saliva swallowing test, SDF Silver diamine fluoride, SWAL-QoL Swallowing-related quality of life.