Educational program in oral health for caregivers on the oral hygiene of dependent elders

LAGO, Jéssica Damares; FAIS, Laiza Maria Grassi; MONTANDON, Andréia Affonso Barretto; PINELLI, Lígia Antunes Pereira

doi:10.1590/1807-2577.23916

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Revista de Odontologia da UNESP

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ORIGINAL ARTICLE • Rev. Odontol. UNESP 46 (5) • Oct 2017 • https://doi.org/10.1590/1807-2577.23916 copy

Educational program in oral health for caregivers on the oral hygiene of dependent elders

Programa educacional em saúde bucal para cuidadores sobre a higiene oral de idosos dependentes

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Due increased number of elders living in long-term care institutions, actions designs to improve their oral health are essential. Thus, the aim of this study was to evaluate the impact of an educational program for the caregivers through the assessment of the oral hygiene of institutionalized elders.

Material and method

The education program consisted in lectures to caregivers about oral health that were performed once a month. The subjects were 40 functionally dependent institutionalized elders and 14 caregivers. Hygiene habits, plaque index, and tongue coating/discoloration of the elders were measured before the educational program (baseline- T0) and after 6 (T1), 12 (T2), 18 (T3) and 24 months (T4). Caregivers answered questions about their knowledge, doubts and implementation of dental care (T0 to T4).

Result

After analyzing the data (Friedman, Chi-square and Spearman α = 0.05), a gradual improvement in the oral hygiene of the subjects was observed, with an increased frequency of brushing (p=0.0005), a change in the brush type (p=0.0065) and a reduction in the plaque index (p<0.05) and tongue coating (p<0.05). Caregivers showed a marked improvement in their dental care knowledge.

Conclusion

It was concluded that the educational program for caregivers had a positive impact in the oral health of institutionalized elderly observed by the increased in the effectiveness of oral hygiene parameters such as plaque index and tongue coating, contributing to the knowledge gain in hygiene by caregivers.

Descriptors:
Caregivers; dental care for aged; education; homes for the aged; old age assistance

Variables	T0	T1	T2	T3	T4	P
Tooth brushing frequency	^a	^a	^ab	^b	^b
Never	0	0	0	0	0	0.0005
Once a day	9	9	2	0	0
Twice a day	19	19	21	17	14
Three or more times	12	12	17	23	26
Brush type	^a	^ab	^ab	^ab	^b
Soft	20	23	26	29	33	0.0065
Medium	9	8	9	10	7
Hard	11	9	5	1	0
Mouthwash
Once a day	2	2	4	6	12	0.13
More than once a day	1	0	3	3	3
Do not use	37	38	33	31	25
Others	0	0	0	0	0
Dental floss
Once a day	1	1	3	5	7	0.39
Twice a day	1	0	1	1	1
Three or more times	0	0	0	0	0
Do not use	18	19	16	14	12
Eventually	0	0	0	0	0
GPI	2.79 ^a	2.51 ^ab	1.86 ^bc	1.50 ^cd	1.38 ^d	< 0.0001
Tongue coating	2.93 ^a	2.30 ^b	1.70 ^bc	1.35 ^c	1.28 ^c	< 0.0001
Tongue discoloration	^a	^ab	^b	^b	^b
No discoloration	0	0	8	13	17
Light discoloration	22	35	29	19	13	< 0.0005
Severe discoloration	18	5	3	8	10

	Period	GPI	Tongue coating	Tongue discoloration
Frequency of tooth brushing	T0	ρ = -0.0953 p = 0.56	ρ = -0.1284 p = 0.43	ρ = -0.1648 p = 0.31
	T2	ρ = -0.0953 p = 0.56	ρ = 0.0482 p = 0.77	ρ = -0.0396 p =0.81
	T4	ρ = -0.0684 p = 0.67	ρ = -0.3789 p = 0.02*	ρ = -0.0971 p = 0.55
Type of toothbrush	T0	ρ = -0.0414 p = 0.80	ρ = -0.0075 p = 0.96	ρ = -0.0664 p = 0.68
	T2	ρ = -0.0832 p =0.61	ρ = 0.1452 p = 0.37	ρ = 0.0550 p = 0.74
	T4	ρ = 0.0267 p = 0.87	ρ = -0.0680 p = 0.68	ρ = -0.0061 p = 0.97
Use of mouthwash	T0	ρ = -0.1939 p = 0.23	ρ = 0.0956 p = 0.56	ρ = 0.0620 p = 0.70
	T2	ρ = -0.4127 p =0.008*	ρ = -0.1768 p = 0.27	ρ = 0.0576 p = 0.72
	T4	ρ = -0.2954 p = 0.06	ρ = 0.1703 p = 0.29	ρ = 0.0275 p = 0.87
Use of dental floss	T0	ρ = -0.2557 p = 0.11	ρ = -0.0319 p = 0.84	ρ = -0.0173 p = 0.91
	T2	ρ = -0.2431 p =0.13	ρ = -0.2908 p = 0.07	ρ = -0.0762 p = 0.64
	T4	ρ = -0.0250 p = 0.88	ρ = 0.0749 p = 0.65	ρ = -0.0030 p = 0.98

*Questions*	T0	T4
*Questions*	*N(%)*
Are dental caries a disease?
Yes	14 (100)	14 (100)
No	0	0
Do you know what periodontal disease is?
Yes	4 (28.6)	12 (85.7)
No	10 (71.4)	2 (14.3)
Can periodontal disease cause tooth loss?
Yes	4 (28.6)	6 (42.9)
No	0	0
I do not know	10 (71.4)	8 (57.1)
Have you lost any teeth?
Yes	14 (100)	14 (100)
No	0	0
Do you think it is possible maintain healthy teeth for your whole life?
Yes	13 (92.9)	14 (100)
No	1 (7.1)	0
Do you brush/clean the mouths of your elderly patients?
Yes	14 (100)	14 (100)
No	0	0
Have you ever had the experience of having to perform oral hygiene for an elderly person?
Yes	13 (92.9)	14 (100)
No	1 (7.1)	0
Do you routinely examine “look at” the mouths of the elderly residents?
Yes	1 (7.1)	11 (78.6)
No	13 (92.9)	3 (21.4)
Can oral disease be indicative that something is not right in the body?
Yes	1 (7.2)	5 (75.7)
No	3 (21.4)	0
I do not know	10 (71.4)	9 (64.3)
Should the elderly sleep without their prosthesis (at night)?
Yes	14 (100)	14 (100)
No	0	0
Are the prostheses of the elderly clean?
Yes	14 (100)	14 (100)
No	0	0
Can the dentures, when stored together, transmit diseases?
Yes	4 (28.6)	9 (64.3)
No	1 (7.1)	0
I do not know	9 (64.3)	5 (35.7)

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[1] CONFLICTS OF INTERESTS The authors declare no conflicts of interest.