Oral Health Assessment by Lay Personnel for Older Adults

Summary

The goal of this protocol is to enable non-dental professionals to assess oral health status for research or health-screening purposes. Aspects assessed include lips, tongue, soft and hard tissues, natural and artificial teeth, oral cleanliness, plaque, swallowing, and impact of oral health on quality of life.

Abstract

Oral health is an often-undervalued contributor to overall health. The literature, however, underscores the myriad of systemic diseases influenced by oral health, including type II diabetes, heart disease, and atherosclerosis. Thus, assessments of oral health, called oral screenings, have a significant role in assessing risk of disease, managing disease, and even improving disease by oral care. Here we present a method to assess oral health quickly and consistently across time. The protocol is simple enough for non-oral health professionals such as students, family, and caregivers. Useful for any age of patient, the method is particularly key for older individuals who are often at risk of inflammation and chronic disease. Components of the method include existing oral health assessment scales and inventories, which are combined to produce a comprehensive assessment of oral health. Thus, oral characteristics assessed include intraoral and extraoral structures, soft and hard tissues, natural and artificial teeth, plaque, oral functions such as swallowing, and the impact this oral health status has on the patient's quality of life. Advantages of this method include its inclusion of measures and perceptions of both the observer and patient, and its ability to track changes in oral health over time. Results acquired are quantitative totals of questionnaire and oral screening items, which can be summed for an oral health status score. The scores of successive oral screenings can be used to track the progression of oral health across time and guide recommendations for both oral and overall health care.

Introduction

Oral health affects overall health. Oral movement serves to move food and debris immediately from the mouth, and together with the protective functions of saliva, they are the body's natural defense mechanism against oral infections and tooth decay¹. Lack of oral health leaves individuals highly prone to accumulation of oral pathogens, inflammation, and infection that can spread to the body. For example, patients with type II diabetes are at higher risk of developing periodontitis, an inflammatory gum disease. So too, patients with periodontitis are more likely to develop type II diabetes, as periodontal disease can affect glycemic control<....

Protocol

The Institutional Review Board (IRB) of The University of Texas Health Science Center at Houston has approved all methods described here.

1. General recommendations

1. If time allows, complete the questionnaires and the oral health assessment on subsequent days or with a break between them as this reduces patient fatigue and resistance.
2. Begin with the questionnaires to create rapport and trust between the screener and patient, which eases the transition to the oral screening.......

Discussion

Here we demonstrate a widely accessible and comprehensive methodology to assess oral health. These tools include the GOHAI⁹, the swallowing subscale of the ROMP¹⁰, the BOHSE¹¹, and the OHI-S¹². Currently, oral health professionals such as dentists, dental therapists, dental hygienists, and dental assistants nearly exclusively evaluate oral health. They have the advantage of training, dental chairs, and instruments for advanced.......

Materials

Name	Company	Catalog Number	Comments
Hurriview Plaque Indicating Snap-n-Go Swabs	Henry Schein	916553
Non-latex examination gloves	VWR	76246-462	any vendor will do; optional if you use only tongue depressor to touch the mouth
Small flashlight or pen light (Energizer LED Pen Flashlight)	VWR	500033-336	any vendor will do; unnecessary, but helpful
Sterile, individually wrapped tongue depressor	VWR	500011-108	any vendor will do