Effectiveness of Educating Caregivers on Oral Health of Institutionalized Older Adults: A Systematic Review and...

This systematic review and meta-analysis augments the existing body of evidence concerning the effect of oral health education or caregiver training on the oral hygiene status of institutionalised older adults.

The study follows a protocol registered in PROSPERO (CRD42022309962). We systematically searched four electronic databases, complemented by manual literature searches. We screened eligible studies and extracted data utilising a meticulously designed form. The quality of the studies has been appraised using RoB 2 and RoB 2 CRT. For quantitative analysis, RevMan 5.4.1 has been employed.

We screened 4962 records and evaluated 31 full texts. We conducted qualitative synthesis on 14 trials and subjected data from four trials to quantitative analysis. We assessed the effectiveness of training caregivers regarding the oral health of older adults on denture hygiene status using the post-intervention denture hygiene index scores (mean ± SD). Sub-group analysis, considering the cognitive ability of the study population, revealed a significant difference favouring the intervention compared to no intervention: SMD -0.59; 95% CI (-0.88 to -0.31). Similarly, the oral health education of caregivers was noted to have a statistically significant improvement in the dental plaque scores: SMD -0.51; 95% CI (-0.76 to -0.26). Three studies showed a 'high risk of bias', and five studies showed 'some concerns'.

Oral health education programmes on caregiver training by health care/para-health care professionals significantly improve the oral hygiene status of institutionalised older adults. More robust clinical trials are needed to substantiate the evidence on the effectiveness of educating caregivers about the oral health of older adults.