Joanne B. Clovis

Oral health-related quality of life in an aging Canadian population

BackgroundThe purpose of the study is to describe the impact of oral health-related quality of life (OHRQoL) on the lives of pre-seniors and seniors living in Nova Scotia, Canada.MethodsThis cross-sectional study involved 1461 participants, grouped by age (pre-seniors [45–64] and seniors [65+]) and residential status (long-term care facility [LTC] or community). OHRQoL was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14) in a random digit dialing telephone survey (for community residents) or a face-to-face interview (for LTC residents). Intra-oral examinations were performed by one of six dentists calibrated to W.H.O. standards.ResultsApproximately one in four pre-seniors and seniors reported at least one OHRQoL impact ‘fairly/very often’. The most commonly reported impacts were within the dimensions ‘physical pain’ and ‘psychological discomfort’. It was found that 12.2% of LTC residents found it uncomfortable to eat any foods ‘fairly/very’ often compared to 7.7% in the community, and 11.6% of LTC residents reported being self-conscious ‘fairly/very often’ compared to 8.2% in the community. Of those residing in the community, pre-seniors (28.8%) reported significantly more impacts than seniors (22.0%); but there were no significant differences in OHRQoL between pre-seniors (21.2%) and seniors (25.3%) in LTC. Pre-seniors living in the community scored significantly higher than community dwelling seniors on prevalence, extent and severity of OHIP-14 scores. Logistic regression revealed that for the community dwelling sample, individuals living in rural areas in addition to those being born outside of Canada were approximately 2.0 times more likely to report an impact ‘fairly/very often’, whereas among the LTC sample, those having a high school education or less were 2.3 times more likely to report an impact.ConclusionsFindings indicate that the oral health and OHRQoL of both pre-seniors and seniors in LTC residents is poor. Community dwelling pre-seniors have the highest prevalence rate of oral impacts.

The oral health of ageing baby boomers: a comparison of adults aged 45-64 and those 65 years and older

OBJECTIVES To compare the oral health status of adults aged 45-64 (baby boomers) and those aged 65 and older. METHODS An observational, cross-sectional survey of adults living independently in rural and urban settings in Nova Scotia, Canada was conducted. Using random digit dialing, calibrated interviewers completed a telephone survey, and clinicians calibrated to WHO standards conducted clinical examinations. Weighting was used to correct for sampling bias. RESULTS 747 community dwelling adults completed both the clinical exam and the questionnaire (n=411, age 45-64; n=336, age 65 or older). Rates of edentulism were low (2.6% aged 45-64; 15.7% aged 65+; p<0.001). Untreated root caries was greater in the older dentate group (19.7 vs. 10.1%; p<0.001). Being 65 years of age or older was identified as a predictor of increased decayed, missing, filled teeth, presence of decayed and/or filled roots and presence of attachment loss≥4 mm, but was not a significant predictor of presence of untreated coronal caries. CONCLUSIONS A falling rate of edentulism and a higher risk for root caries with increasing age may predict the need for more complex dental care as our population ages.

Action planning for daily mouth care in long-term care: the brushing up on mouth care project.

Research focusing on the introduction of daily mouth care programs for dependent older adults in long-term care has met with limited success. There is a need for greater awareness about the importance of oral health, more education for those providing oral care, and organizational structures that provide policy and administrative support for daily mouth care. The purpose of this paper is to describe the establishment of an oral care action plan for long-term care using an interdisciplinary collaborative approach. Methods. Elements of a program planning cycle that includes assessment, planning, implementation, and evaluation guided this work and are described in this paper. Findings associated with assessment and planning are detailed. Assessment involved exploration of internal and external factors influencing oral care in long-term care and included document review, focus groups and one-on-one interviews with end-users. The planning phase brought care providers, stakeholders, and researchers together to design a set of actions to integrate oral care into the organizational policy and practice of the research settings. Findings. The establishment of a meaningful and productive collaboration was beneficial for developing realistic goals, understanding context and institutional culture, creating actions suitable and applicable for end-users, and laying a foundation for broader networking with relevant stakeholders and health policy makers.

Assessing the oral health of an ageing population: methods, challenges and predictors of survey participation

Assessing the oral health of an ageing population: methods, challenges and predictors of survey participation Objectives To examine predictors of participation and to describe the methodological considerations of conducting a two-stage population-based oral health survey. Methods An observational, cross-sectional survey (telephone interview and clinical oral examination) of community-dwelling adults aged 45–64 and ≥65 living in Nova Scotia, Canada was conducted. Results The survey response rate was 21% for the interview and 13.5% for the examination. A total of 1141 participants completed one or both components of the survey. Both age groups had higher levels of education than the target population; the age 45–64 sample also had a higher proportion of females and lower levels of employment than the target population. Completers (participants who completed interview and examination) were compared with partial completers (who completed only the interview), and stepwise logistic regression was performed to examine predictors of completion. Identified predictors were as follows: not working, post-secondary education and frequent dental visits. Conclusion Recruitment, communications and logistics present challenges in conducting a province-wide survey. Identification of employment, education and dental visit frequency as predictors of survey participation provide insight into possible non-response bias and suggest potential for underestimation of oral disease prevalence in this and similar surveys. This potential must be considered in analysis and in future recruitment strategies.