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Oral Health and Its Associated Factors Among Older Institutionalized Residents—A Systematic Review

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  • Florence M. F. Wong

    (School of Nursing, Tung Wah College, Hong Kong SAR, China)

  • Yannies T. Y. Ng

    (North District Hospital, Hospital Authority, Hong Kong SAR, China)

  • W. Keung Leung

    (Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China)

Abstract

The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. Objective: The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Methods: Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender, educational level, acquired systemic conditions or dementia/cognitive impairment). Results: Twenty-five surveys (or study series) from 19 countries were included. The level of evidence reported by these studies was generally moderate to strong. The reported oral cleanliness and health of the surveyed institutionalized elderly were poor (>50% of residents had calculus; denture hygiene index > 80%). Gum (approximately 30% of dentate residents had moderate to severe periodontitis), teeth (decayed, missing or filled teeth >20), mucosa (>10% had mucosal lesions) and denture problems (up to 40%) were prevalent and were associated with a poor OHRQoL, especially in females, socially deprived residents or those with mild or above cognitive impairment. Those with a poor OHRQoL might show signs of poor nutrition. Conclusions: This report reviewed evidence-based knowledge on oral health, the OHRQoL and the associated factors among elderly institutional residents. Further research is needed to confirm these observations. For improved oral health, a better OHRQoL and the general well-being of older residents, clinical trials are needed, targeting modifiable factors, such as social inequality, oral healthcare accessibility, and/or nursing home service quality. The relationship between oral health, the OHRQoL and nutrition in this at-risk population also warrants exploration.

Suggested Citation

  • Florence M. F. Wong & Yannies T. Y. Ng & W. Keung Leung, 2019. "Oral Health and Its Associated Factors Among Older Institutionalized Residents—A Systematic Review," IJERPH, MDPI, vol. 16(21), pages 1-29, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:21:p:4132-:d:280676
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    4. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    7. Sara Lopes & Vitor Tavares & Paulo Mascarenhas & Marta Lopes & Carolina Cardote & Catarina Godinho & Cátia Oliveira & Carla Adriana Santos & Madalena Oom & José Grillo-Evangelista & Jorge Fonseca, 2022. "Oral Health Status of Adult Dysphagic Patients That Undergo Endoscopic Gastrostomy for Long Term Enteral Feeding," IJERPH, MDPI, vol. 19(8), pages 1-13, April.
    8. Florence M.F. Wong, 2020. "Factors Associated with Knowledge, Attitudes, and Practices Related to Oral Care Among the Elderly in Hong Kong Community," IJERPH, MDPI, vol. 17(21), pages 1-15, November.
    9. Rocío Trinidad Velázquez-Cayón & Ana Isabel Contreras-Madrid & Susell Parra-Rojas & David Pérez-Jorge, 2022. "Oral Health and Pathologies in Migrants and Vulnerable Population and Their Social Impact: The Good Practices of the Intervention Model of a University Dental Clinic," IJERPH, MDPI, vol. 20(1), pages 1-11, December.
    10. Ove Spreckelsen & Guido Schmiemann & Alexander Maximilian Fassmer & Bettina Engel & Falk Hoffmann & Michael Hermann Freitag, 2020. "How Do German General Practitioners Assess Medical Specialist Care Needs of Nursing Home Residents? Results of a Postal Survey in North-Western Germany," IJERPH, MDPI, vol. 17(19), pages 1-10, September.
    11. Florence M. F. Wong, 2021. "First Data in the Process of Validating a Tool to Evaluate Knowledge, Attitude, and Practice of Healthcare Providers in Oral Care of Institutionalized Elderly Residents: Content Validity, Reliability ," IJERPH, MDPI, vol. 18(8), pages 1-15, April.
    12. Lisa Bellander & Pia Andersson & Helle Wijk & Catharina Hägglin, 2021. "Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults’ Oral Health in a Longitudinal Perspective," IJERPH, MDPI, vol. 18(24), pages 1-15, December.
    13. Kanako Yamawaki & Takahiro Mori & Sakiko Itaki & Azusa Haruta & Chiho Takeda & Aya Hiraoka & Mariko Maruyama & Mineka Yoshikawa & Mitsuyoshi Yoshida & Kazuhiro Tsuga, 2022. "Relationship between Food Crushing and Oral Function in Older Adults Requiring Nursing Home Care: A Pilot Study," IJERPH, MDPI, vol. 19(6), pages 1-11, March.
    14. Daria Madunic & Lidia Gavic & Ivan Kovacic & Neven Vidovic & Jasen Vladislavic & Antonija Tadin, 2021. "Dentists’ Opinions in Providing Oral Healthcare to Elderly People: A Questionnaire-Based Online Cross-Sectional Survey," IJERPH, MDPI, vol. 18(6), pages 1-12, March.
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