Deploying Oral Health Therapists in Aged Residential Care in New Zealand: A Pilot Study

The proportion of older New Zealanders entering aged residential care facilities with at least some of their natural dentition remaining is steadily increasing, and high dental caries increments are evident in that setting, with important implications for quality of life.

To determine the effectiveness of a clinical intervention in aged residential care delivered by oral health therapists.

Two care homes were purposively selected, with 85 and 60 residents (respectively), from all care levels (rest home, hospital, dementia and psychogeriatric). Two clinical examinations (baseline and follow-up at 3 months) were undertaken by oral health therapists. In the intervention, residents-along with their family members and/or carer if appropriate-received personalised oral care advice, including (but not limited to) recommendations on tooth brushing, interdental cleaning, denture care and hygiene, and dietary advice, as needed. Outcomes assessed were plaque score, calculus score, gingival appearance, food debris score, tooth mobility and oral odour.

In total, 78 residents participated. Just over one-quarter were edentulous; most of the remainder were partially dentate in both arches, with a minority having an edentulous maxilla opposing a partially dentate mandible. Approximately one in eight residents was subsequently lost to follow-up. Mean plaque score worsened, although the effect size was small. There was a moderate improvement in mean calculus score, along with small improvements in gingival appearance and mean food debris score, but there was no improvement in tooth mobility. The proportion with an unpleasant oral odour increased, from one in 14 to one in nine.

Deploying oral health therapists in the care home setting to assist staff in caring for residents is possible, but obtaining meaningful improvement in clinical measures remains a challenge.