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Background: A large number of older people depend on others for help with their daily personal care, including oral health care. Nursing home and elder-care staff often face challenges identifying older people, who are exposed to or at an increased risk of oral diseases. Thus, the aim of this study was to identify risk factors that non-dental care staff can use to identify older people at risk of oral diseases and poor oral hygiene. Methods: In this cross-sectional study, the oral health and risk factors for poor oral health were determined for 217 care dependent older people living in two nursing homes and a rehabilitation centre or receiving home care in two Danish municipalities. The outcome variables for oral disease i.e. caries, periodontitis, and gingivitis, and oral hygiene, i.e. plaque and calculus, were assessed using standardised oral examinations. Risk factors for oral diseases and poor oral hygiene were assessed based on a questionnaire concerning (1) background information, (2) health status, (3) social support, (4) oral health behaviours, and (5) self-reported oral health. The associations between oral health and risk factors were investigated using logistic regression analyses. Results: In general, older people with different living arrangements had quite similarly distributed risk factors. The oral examinations showed that 54.5% had oral diseases, and 14.8% had poor oral hygiene. Not seeing a dentist regularly was significantly associated with having oral diseases (Odds Ratio, 2.87; CI, 1.53–5.39) and poor oral hygiene (OR, 4.50; CI, 1.83–11.05). A significant association was found between the presence of an oral disease and adversely affected quality of life (OR, 2.65; CI, 1.42–4.95), especially due to challenges eating (OR, 3.76; CI, 1.64–8.60) and/or smiling and showing teeth (OR, 3.64; CI, 1.27–10.42). A significant association was also found between poor oral hygiene and taking psychotropic drugs (OR, 2.61; CI, 1.08–6.30). Conclusion: Questions regarding the use of the dental care system and oral health problems could be used by nondental care staff in conversations with older people to determine their risk of oral diseases and poor oral hygiene. [ABSTRACT FROM AUTHOR]

Objectives: One approach for improving oral health is focusing on oral health literacy (OHL). In this study, we aimed to investigate the association between OHL and oral health‐related quality of life (OHRQoL) and to identify relevant OHL intervention targets that can be used to improve oral health. Methods: We performed a cross‐sectional questionnaire study among 1889 10th grade female students in the Eastern Province of the Kingdom of Saudi Arabia (KSA). We then assessed OHL using the Arabic version of the short version of the Health Literacy in Dentistry scale (A‐HeLD‐14). OHRQoL was assessed using the 14‐item oral health impact profile (OHIP‐14). Information on socio‐demographics and oral health‐related behaviours (e.g., toothbrushing, sugary diet consumption and dental attendance) was also collected. The relationship between OHL and OHRQoL was investigated using binary logistic regression adjusted for sociodemographic information and oral health‐related behaviours. Results: In both the adjusted and unadjusted models, poor OHL was significantly associated with OHRQoL problems (odds ration [OR] = 2.90, p < 0.001). Having any OHL problem was significantly associated with having an OHRQoL problem (p < 0.001). The ORs were highest for the domains of financial barriers (OR = 2.49, p < 0.001) and receptivity (OR = 2.16, p < 0.001). Conclusion: Interventions targeted at individuals with low OHL are crucial to improving OHRQoL in the population. The most relevant interventions concern (a) dedicating time and attention to oral health and (b) financial barriers. [ABSTRACT FROM AUTHOR]

Background and objectives: The aim of the study was to examine oral care utilisation among older Danes and to describe the extent to which oral care use is associated with the co‐existence of challenges relating to general health and care dependency. Materials and methods: The study used registry data covering the entire population of older adults (≥65 years) in seven municipalities in Denmark (N = 178 787 individuals). Oral care services utilisation was computed from administrative data on oral care contacts up to and including 2019, including both private oral care and a municipal oral care programme (MOCP). Various registry data sources were used to compute risk factors to describe oral care utilisation across indicators of general health and care dependency. Results: Indicators for poorer health were associated with larger proportions of individuals enrolled in the MOCPs and larger proportions of non‐users of any type of oral care. Higher degrees of care dependency were associated with larger proportions of individuals enrolled in MOCPs and individuals with no use of any oral care services, with the exception of nursing home residents, who comprised a lower proportion of non‐users than individuals receiving at‐home care. Municipal oral care mainly enrolled older adults who were nursing home residents (60% of nursing home residents were enrolled). Conclusion: Our findings support existing evidence on the link between oral care utilisation and general health and frailty. While the municipal care programmes assisted in covering oral care for those with the highest level of care dependency, future preventive strategies for ensuring care continuity for older adults that are increasing in frailty may want to focus on the earlier stages of frailty and of general health deterioration. [ABSTRACT FROM AUTHOR]

Background: There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health. Objective: The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people. Methods: We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta‐analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system. Results: We included a total of 30 randomised clinical trials assessing educational and non‐educational interventions for community‐dwelling older people (n = 2) and those residing in long‐term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long‐term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system. Conclusion: Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long‐term effect of interventions, and further research is needed, especially targeting community‐dwelling older people. PROSPERO ID: CRD42021231721. [ABSTRACT FROM AUTHOR]

Objectives: Persons with Parkinson's disease (PD) have a higher prevalence of oral diseases and orofacial dysfunction, but knowledge about the use of dental care and whether their dental care needs are met is sparse. This study aimed to investigate the dental attendance and usage of dental care services of the total PD population in Denmark and compare it with a control group. Methods: National registers were used to identify the total PD population in Denmark (n = 6874) and to obtain data on their dental care from 2015 to 2019. These data were compared with a five‐fold age‐, gender‐ and geographically matched control group without PD (n = 34 285). Register data on age, gender, civil status, educational level, income, nursing homes status and mortality were also collected and adjusted for in the analyses. The dental attendance was analysed using χ2‐test with Bonferroni correction, and the type of dental care services was analysed using negative binomial regression analysis. Results: A significantly higher proportion of persons with PD were irregular attenders of the dental care system (21.0%), compared with the control group (16.9%). Persons with PD had a significantly higher overall usage of dental cares services. Most prominent was the high usage of treatment services, where persons with PD had a 1.50 times higher incidence rate of tooth extractions and a 1.71 times higher incidence rate of tooth fillings in the five years compared with the control group. Conclusion: Persons with PD are more often irregular users of dental care and receive more treatment services than the control group. This indicates a need for high‐quality prophylactic initiatives to prevent high filling and tooth extraction rates. Furthermore, this knowledge can be used by clinicians and decision makers to ensure optimal dental care for persons with PD. [ABSTRACT FROM AUTHOR]

To investigate the impact of the Covid-19 pandemic on the patient flow and economy as experienced by dental practices in Denmark. A survey regarding experience of patient flow, economical turnover, financial strain and willingness to pay for large treatments during the first year of the Covid-19 pandemic (March 2020 to March 2021), along with information on the characteristics of the practice (specialist practice, ownership, practice operation and size) was distributed to all dental practices in Denmark in March 2021. Of the 1728 practices, 581 (33.6%) answered the survey. A decline in patient flow and a decline in economical turnover were reported by 79% and 84.4% of the practices, respectively. Financial strain was reported by 15.8% and an increased willingness to pay for large treatments was reported by 32.1%. A large decline in turnover and financial strain were associated with non-specialized practices, practices with a single owner and small practices. Logistic regressions showed that practices not receiving referrals had an odds ratio of 2.34 (CI: 1.32-4.14) for having a large decline in economic turnover compared with practices receiving referrals and that small practices had an odds ratio of 1.92 (CI: 1.16-3.19) for reporting financial strain compared with large practices. Reportedly, the Covid-19 pandemic resulted in a decline in both patient flow and economical turnover in Danish dental practices. Large and more specialized practices seem to have managed the economic crisis better. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) has a negative effect on oral health and orofacial function, but the subjective experience of orofacial symptoms and their impact on the quality of life is not fully investigated. In addition, knowledge of how to improve the subjective oral symptoms is lacking. Objectives: To assess the self‐reported orofacial function and oral health in patients with PD. Furthermore, to investigate the effect of interventions for improvement of oral hygiene and function on oral health–related quality of life (OHRQoL). Methods: A randomised controlled study with delayed intervention was conducted in 29 patients with moderate to advanced PD. Patients were instructed in a standardised exercise programme for the jaw and orofacial muscles and given an individualised oral hygiene programme. The effect on self‐reported orofacial function and OHRQoL was measured after 2 and 4 months using the Nordic Orofacial Test—Screening (NOT‐S), the oral health impact profile (OHIP‐14), self‐reported drooling score and subjective mastication ability. Results: Self‐reported oral health and function before the intervention was significantly correlated to the severity and duration of PD. The NOT‐S and drooling score were significantly improved by the interventions after 2 months and the OHIP‐14 after 4 months. Conclusion: The interventions improve the self‐reported orofacial function and OHRQoL. These simple interventions can be implemented in the allied multidisciplinary health care surrounding the PD patient. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the responsiveness of the Danish treatment pathway for head-and-neck-cancer (HNC) patients receiving oral rehabilitation.Material and Methods: Eighteen HNC-patients who had received oral rehabilitation as well as five medical and four oral health care professionals involved in the treatment of HNC-patients filled in a questionnaire on responsiveness. The responsiveness was further described in individual interviews in the HNC-patients and focus group interviews in the health care professionals. All interviews were semi-structured and analysed using the grounded theory.Results: Patients and health care professionals overall reported good responsiveness of the pathway. Prompt attention was in both groups considered the most important aspect, although the patients found it difficult to cope mentally with the fast-track and the health care professionals reported insufficiencies giving prompt attention. The patients in general described a good relationship with their health care professionals, but along with the health care professionals also reported some problems regarding communication. Further, the health care professionals reported a gap between medical treatment and oral rehabilitation.Conclusions: The Danish treatment pathway for HNC-patients was, in general, evaluated positively. Communication and relationship between patient and health care professional can affect the responsiveness of the pathway. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether the location of tooth loss and prosthesis are associated with self‐reported oral health, general health, socioeconomic position and satisfaction with life. Methods: From the Copenhagen Aging and Midlife Biobank (CAMB) investigation, 1517 persons had their oral status ranked (full dentition, fixed prosthesis in the masticatory zone, tooth loss in the masticatory zone, fixed prosthesis in the aesthetic zone, removable prosthesis, tooth loss in the aesthetic zone). Self‐reported oral health, general health, socioeconomic position and satisfaction with life were obtained. Information on gender, normative socioeconomic position, frequency of seeing a dentist, acute dental treatment within the last 5 years and general diseases was also recorded. Results: Patients with tooth loss in the aesthetic zone and removable prosthesis showed high odds ratios for reporting poor rather than good oral health compared to patients having a full dentition. Having a removable prosthesis was further associated with rating socioeconomic position as low rather than high (odds ratio = 27.7 [95% CI: 5.07; 151.6]) compared to a full dentition after controlling for normative socioeconomic position and gender. In the bivariate analyses, a tendency towards poorer general health and poorer satisfaction with life was found with worse oral status, meanwhile the multiple regression analyses did not show significant associations between oral status and general health and satisfaction with life. Conclusions: Missing teeth and having prostheses are associated with worse self‐reported oral health compared to having a full dentition. Removable dental prosthesis may be associated with a worse self‐perception of socioeconomic status. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) is diagnosed in more than 500 000 patients every year worldwide with increasing prevalence. Oral rehabilitation is often needed after HNC treatment to regain oral function, aesthetics and oral health‐related quality of life (OHRQoL). The objectives were to evaluate OHRQoL, oral aesthetics and oral function after oral rehabilitation in HNC patients and compare it to that of non‐HNC patients. Eighteen patients treated for HNC who subsequently had oral rehabilitation (2014‐2017), and a control group of eighteen age‐ and gender‐matched non‐HNC patients treated with removable prostheses (2014‐2018) were included in a cross‐sectional study. The OHRQoL was assessed by the Oral Health Impact Profile 49 questionnaire (OHIP‐49), the oral aesthetics by the Prosthetic Esthetic Index (PEI) and the Orofacial Esthetic Scale (OES), and the oral function by the Nordic Orofacial Test‐Screening (NOT‐S). The HNC patients had worse oral function and OHRQoL than the control patients (mean NOT‐S score 4.56 vs 0.56, P < 0.01 and mean OHIP‐49 score 42.50 vs 20.94, P = 0.050). When including number of replaced teeth and type of prosthesis in the tests, no significant difference in OHRQoL was found between the groups. No difference was found in the overall aesthetic outcomes (mean PEI total score 32.28 vs 30.67, P = 0.367 and mean OES total score 48.78 vs 53.56, P = 0.321). Multiple regression analyses showed that being HNC patient compared to control patient impaired the oral function. Oral function is significantly impaired in HNC patients compared to non‐HNC patients after oral rehabilitation. [ABSTRACT FROM AUTHOR]

Summary: Objectives: To quantify the patient‐reported effect of oral rehabilitation and investigate aspects associated with this. Methods: The patient‐reported effect in participants treated with fixed dental prosthesis (FDP; n = 72) or removable dental prosthesis (RDP; n = 58) was measured using the Oral Health Impact Profile 14 (OHIP‐14) and global oral ratings (GOR) of aesthetics, chewing and comfort before and after treatment and global transition judgements (GTJ) of aesthetics, chewing and comfort after treatment. Explanatory variables included gender, age, if a prosthetic replacement was present before treatment, type of prosthetic treatment performed, number of teeth replaced and zone of the teeth replaced. Results: The RDP and FDP treatments both significantly improved the OHIP‐14 score with a moderate to large effect and most participants had good patient‐reported effect. The effect varied depending on the method used. In the bivariate analyses, the number of participants with good effect was higher in the RDP group than the FDP group when using the OHIP‐14 and GOR whereas the effect was higher in the FDP group when using the GTJ. Multiple regression analyses showed that poor chewing ability before treatment was associated with good effect measured by the OHIP‐14 and GOR and that poor effect in chewing ability and RDP treatment was associated with poor effect in comfort measured by GTJ. Functional problems after treatment were associated with no/poor effect. Conclusions: Oral rehabilitation with fixed or removable prostheses in general yields good patient‐reported effect. Masticatory aspects highly influence the patient‐reported effect and treatment with RDP is associated with poor effect in oral comfort. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to investigate and describe the Oral Health Related Quality of Life (OHRQoL) in a socially endangered group of people and to compare the OHRQoL to other patient groups.Material and Methods: About 294 socially endangered persons attending a volunteer clinic in Copenhagen Denmark filled in the OHIP-14 questionnaire. The group was compared in mean score and reported problems to a group of patients with tooth loss and about to have a removable dental prosthesis (RDP), a group with tooth loss about to have a fixed dental prosthesis (FDP) and a control group without tooth loss.Results: Significantly higher OHIP-14 score was seen in the socially endangered group (15.5 (SD 12.6)) compared with the control (1.9 (SD 2.7)) and the FDP group (9.4 (SD 8.2)) but not the RDP group (13.1 (SD 10.5)). This difference was not changed after stratifying in age groups. Problems related to psychological disability, social disability, and handicap were more frequent in the social endangered group than for the other groups. The items pain, tense, diet, relax, life, and function stand out as problems in the socially endangered group compared to the other groups.Conclusion: The OHRQoL is highly impaired in the socially endangered persons and at least to the level of persons with great tooth loss about to have an RDP. The problems seem to be more handicapping in the socially endangered compared with other patient groups known to have high impairment. [ABSTRACT FROM AUTHOR]

Objective: Addressing social inequality in oral health and access to dental care is a global concern. This study aims to describe the utilization of a public subsidy scheme targeting vulnerable individuals out of labor in Copenhagen municipality (2013-2018) and to identify key characteristics of individuals eligible to apply., Material and Methods: Data from Copenhagen municipality were combined with data from population and health registers. Employing logistic regression analyses, we examined the association between demographic, socioeconomic, and health-related characteristics and (1) having applied, (2) being granted, and (3) using the subsidy., Results: The study included 65,174 individuals aged 18-65. Of these 10,369 (15.9%) applied for subsidies, submitting a total of 18,529 applications. Overall, 83% of the applications were granted and 85% were used. Significantly increased odds of applying for subsidies were observed among individuals receiving social benefits non-stop over the past year versus none (odds ratio [OR] = 15.45, 95% confidence interval [CI] = 14.24-16.76), aged 50-65 versus 18-29 years (OR = 4.41, CI= 4.15-4.69), and having combined indicators of social vulnerability versus none (OR = 2.90, CI= 2.73-3.07)., Conclusions: While the utilization of the public subsidy scheme is low, individuals who apply are likely to be granted a subsidy and use it. Vulnerability was associated with greater utilization of the scheme, yet a substantial portion of those at risk of poor oral health did not take advantage of it.