Self-reported oral health and oral health-related quality of life among older adults receiving home care services in South-eastern Norway
DOI:
https://doi.org/10.2340/aos.v84.43425Keywords:
Older adults, self-reported oral health status, oral health-related quality of life, subjective dry mouth, tooth loss, pain and discomfortAbstract
Objective: To map self-reported oral health status, oral health-related quality of life (OHRQoL), and associated factors among older adults receiving home care services (HCS) in south-eastern Norway.
Material and methods: For this cross-sectional study, older adult users of HCS, aged ≥ 65 years were interviewed using an interviewer-administered questionnaire. Information about demographics, number of medicines, and Activity of Daily Living (ADL-score) was obtained. Self-reported oral health status and subjective dry mouth (Summated Xerostomia Inventory-Duch version, SXI-D) were assessed. OHRQoL was measured using Oral Health Impact Profile-14 (OHIP-14).
Results: Of 116 participants (mean age 83 years), 52.6% were female. Half of the participants reported missing < 5 of their natural teeth and 6.9% were edentulous. Pain and discomfort were reported by 16.4%, and subjective dry mouth was common (40.7%). Poor oral health status was reported by 8.6%, and experiencing problems or discomfort fairly often or very often was reported by 20.7%. Good self-perceived oral health was reported by 61%. Younger (< 75 years) and less dependent (ADL < 2) individuals and those missing ≥ 5 natural teeth reported a negative impact on OHRQoL more often.
Conclusions: Half of older adults receiving HCS in Norway retain most of their natural teeth, few are edentulous and xerostomia is common. Younger and less dependent individuals and those missing ≥ 5 natural teeth reported a negative impact on OHRQoL more often.
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Rechel B, Grundy E, Robine JM, Cylus J, Mackenbach JP, Knai C, et al. Ageing in the European Union. Lancet. 2013;381(9874):1312–22. https://doi.org/10.1016/S0140-6736(12)62087-X DOI: https://doi.org/10.1016/S0140-6736(12)62087-X
United Nations Department of Economic and Social Affairs Population Division. World population prospects 2022, summary of results [Internet]. 2022 [cited 2024 May 27]. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf:www.un.org
Hugoson A, Koch G, Göthberg C, Helkimo AN, Lundin S-A, Norderyd O, et al. Oral health of individuals aged 3–80 years in Jönköping, Sweden during 30 years (1973–2003). II. Review of clinical and radiographic findings. Swed Dent J. 2005;29(4):139–55.
Gluzman R, Meeker H, Agarwal P, Patel S, Gluck G, Espinoza L, et al. Oral health status and needs of homebound elderly in an urban home-based primary care service. Spec Care Dentist. 2013;33(5):218–26. https://doi.org/10.1111/j.1754-4505.2012.00316.x DOI: https://doi.org/10.1111/j.1754-4505.2012.00316.x
Ástvaldsdóttir Á, Boström AM, Davidson T, Gabre P, Gahnberg L, Sandborgh Englund G, et al. Oral health and dental care of older persons – a systematic map of systematic reviews. Gerodontology. 2018;35(4):290–304. https://doi.org/10.1111/ger.12368 DOI: https://doi.org/10.1111/ger.12368
Ministry of Health and Care Services. Forskrift om kvalitet i pleie- og omsorgstjenestene for tjenesteyting etter lov av 19. november 1982 nr. 66 om helsetjenesten i kommunene og etter lov av 13. desember 1991 nr. 81 om sosiale tjenester m.v.: lovdata.no [Internet]; 2003 [cited 2024 Mar 30]. Available from: https://lovdata.no/forskrift/2003-06-27-792
Ministry of Health and Care Services (Helse- og omsorgsdepartementet). Lov om tannhelsetjenesten (tannhelsetjenesteloven) 01.01.1984 [cited 2024 May 25]. Available from: https://lovdata.no/dokument/NL/lov/1983-06-03-54
Statistics Norway (Statistisk sentralbyrå). ssb.no: statistisk sentralbyrå [Internet]. [cited 2024 Jun 11]. Available from: https://www.ssb.no/statbank/table/11961/tableViewLayout1/
Rødseth SC, Høvik H, Schuller AA, Bjertness E, Skudutyte-Rysstad R. Dental caries in a Norwegian adult population, the HUNT4 oral health study; prevalence, distribution and 45-year trends. Acta Odontol Scand. 2023;81(3):202–10. https://doi.org/10.1080/00016357.2022.2117735 DOI: https://doi.org/10.1080/00016357.2022.2117735
Holmén A, Strömberg E, Hagman-Gustafsson M-L, Wårdh I, Gabre P. Oral status in home-dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease. Gerodontology. 2012;29(2):e503–e11. https://doi.org/10.1111/j.1741-2358.2011.00507.x DOI: https://doi.org/10.1111/j.1741-2358.2011.00507.x
Czwikla J, Herzberg A, Kapp S, Kloep S, Schmidt A, Rothgang H, et al. Home care recipients have poorer oral health than nursing home residents: results from two German studies. J Dent. 2021;107:103607. https://doi.org/10.1016/j.jdent.2021.103607 DOI: https://doi.org/10.1016/j.jdent.2021.103607
Wong FMF, Ng YTY, Leung WK. Oral health and its associated factors among older institutionalized residents – a systematic review. Int J Environ Res Public Health. 2019;16(21):4132. DOI: https://doi.org/10.3390/ijerph16214132
World Health Organization (WHO). Oral health [Internet]. WHO; [cited 2024 May 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health
Glick M, Williams DM, Kleinman DV, Vujicic M, Watt RG, Weyant RJ. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. J Am Dent Assoc. 2016;147(12):915–7. https://doi.org/10.1016/j.adaj.2016.10.001 DOI: https://doi.org/10.1016/j.adaj.2016.10.001
Ramsay SE, Whincup PH, Watt RG, Tsakos G, Papacosta AO, Lennon LT, et al. Burden of poor oral health in older age: findings from a population-based study of older British men. BMJ Open. 2015;5(12):e009476. https://doi.org/10.1136/bmjopen-2015-009476 DOI: https://doi.org/10.1136/bmjopen-2015-009476
Gary D S, Spencer AJ. Development and evaluation of the oral health impact profile. Community Dent Health. 1994;11:3–11.
Locker D, Clarke M, Payne B. Self-perceived oral health status, psychological well-being, and life satisfaction in an older adult population. J Dent Res. 2000;79(4):970–5. https://doi.org/10.1177/00220345000790041301 DOI: https://doi.org/10.1177/00220345000790041301
Van Leeuwen KM, Van Loon MS, Van Nes FA, Bosmans JE, De Veti HCW, Ket JCF, et al. What does quality of life mean to older adults? A thematic synthesis. PLoS One. 2019;14(3):e0213263. https://doi.org/10.1371/journal.pone.0213263 DOI: https://doi.org/10.1371/journal.pone.0213263
Henni SH, Skudutyte‐Rysstad R, Ansteinsson V, Hellesø R, Hovden EAS. Oral health and oral health‐related quality of life among older adults receiving home health care services: a scoping review. Gerodontology. 2023;40(2):161–71. https://doi.org/10.1111/ger.12649 DOI: https://doi.org/10.1111/ger.12649
Registration of Health and Care Data in the Municipality. National guidelines [Internet]. https://www.helsedirektoratet.no: The Norwegian Directorate of Health; 2018 [updated 2023 Dec 12; cited 2024 Feb 09]. Available from: https://www.helsedirektoratet.no/veiledere/registrering-av-iplos-data-i-kommunen/om-funksjonsvurdering-og-skarinndeling#oversikt-over-skarinndelingen
Thomson W, Van der Putten G, De Baat C, Ikebe K, Matsuda K, Enoki K, et al. Shortening the Xerostomia Inventory. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(3):322–7. https://doi.org/10.1016/j.tripleo.2011.03.024 DOI: https://doi.org/10.1016/j.tripleo.2011.03.024
Van der Putten G-J, Brand HS, Schols JMGA, De Baat C. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. Clin Oral Investig. 2011;15(2):185–92. https://doi.org/10.1007/s00784-010-0382-1 DOI: https://doi.org/10.1007/s00784-010-0382-1
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25(4):284–90. https://doi.org/10.1111/j.1600-0528.1997.tb00941.x DOI: https://doi.org/10.1111/j.1600-0528.1997.tb00941.x
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):1623–7. https://doi.org/10.1371/journal.pmed.0040296 DOI: https://doi.org/10.1371/journal.pmed.0040296
Kossioni AE, Hajto‐Bryk J, Maggi S, McKenna G, Petrovic M, Roller‐Wirnsberger RE, et al. An expert opinion from the European College of Gerodontology and the European Geriatric Medicine Society: European policy recommendations on oral health in older adults. J Am Geriatr Soc. 2018;66(3):609–13. https://doi.org/10.1111/jgs.15191 DOI: https://doi.org/10.1111/jgs.15191
Dahl KE, Wang NJ, Holst D, Öhrn K. Oral health-related quality of life among adults 68–77 years old in Nord-Trøndelag, Norway: oral health-related quality of life in elderly. Int J Dent Hyg. 2011;9(1):87–92. https://doi.org/10.1111/j.1601-5037.2010.00445.x DOI: https://doi.org/10.1111/j.1601-5037.2010.00445.x
Lee Y-S, Kim H-G, Moreno K. Xerostomia among older adults with low income: nuisance or warning?: Xerostomia among older adults. J Nurs Scholarsh. 2016;48(1):58–65. https://doi.org/10.1111/jnu.12185 DOI: https://doi.org/10.1111/jnu.12185
Bruun T, Denison TM-L, Gjersing, Husøy L, Skrindo KnudsenAK, Strand BH, et al. Public health report, Health status in Norway; 2018 [Internet]. Available from: https://www.fhi.no: Norwegian Institute of Public Health (NIPH) Helse- og omsorgsdepartementet F. [cited 21.August.2024]
Soldato M, Liperoti R, Landi F, Finne-Sovery H, Carpenter I, Fialova D, et al. Non malignant daily pain and risk of disability among older adults in home care in Europe. Pain. 2007;129(3):304–10. https://doi.org/10.1016/j.pain.2006.10.016 DOI: https://doi.org/10.1016/j.pain.2006.10.016
Willumsen T, Fjaera B, Eide H. Oral health-related quality of life in patients receiving home-care nursing: associations with aspects of dental status and xerostomia. Gerodontology. 2010;27(4):251–7. https://doi.org/10.1111/j.1741-2358.2009.00344.x DOI: https://doi.org/10.1111/j.1741-2358.2009.00344.x
Nihtilä A, Tuuliainen E, Komulainen K, Nykänen I, Hartikainen S, Tiihonen M, et al. The combined effect of individually tailored xerostomia and nutritional interventions on dry mouth among nutritionally compromised old home care clients. Gerodontology. 2019;36(3):244–50. https://doi.org/10.1111/ger.12405 DOI: https://doi.org/10.1111/ger.12405
Diep MT, Jensen JL, Skudutyte‐Rysstad R, Young A, Sødal ATT, Petrovski BÉ, et al. Xerostomia and hyposalivation among a 65‐yr‐old population living in Oslo, Norway. Eur J Oral Sci. 2021;129(1):e12757. https://doi.org/10.1111/eos.12757 DOI: https://doi.org/10.1111/eos.12757
Åstrøm AN, Lie SA, Ekback G, Gülcan F, Ordell S. Self‐reported dry mouth among ageing people: a longitudinal, cross‐national study. Eur J Oral Sci. 2019;127(2):130–8. https://doi.org/10.1111/eos.12601 DOI: https://doi.org/10.1111/eos.12601
Cannon I, Robinson-Barella A, McLellan G, Ramsay SE. From drugs to dry mouth: a systematic review exploring oral and psychological health conditions associated with dry mouth in older adults with polypharmacy. Drugs Aging. 2023;40(4):307–16. https://doi.org/10.1007/s40266-023-01017-5 DOI: https://doi.org/10.1007/s40266-023-01017-5
Lee YH, Won JH, Auh QS, Noh YK, Lee SW. Prediction of xerostomia in elderly based on clinical characteristics and salivary flow rate with machine learning. Sci Rep. 2024;14(1):3423. https://doi.org/10.1038/s41598-024-54120-x DOI: https://doi.org/10.1038/s41598-024-54120-x
Diep MT, Skudutyte-Rysstad R, Sødal ATT, Young A, Hove LH. Caries experience and risk indicators of having decayed teeth among 65-year-olds in Oslo, Norway: a cross-sectional study. BMC Oral Health. 2023;23(1):1–726. https://doi.org/10.1186/s12903-023-03432-x DOI: https://doi.org/10.1186/s12903-023-03432-x
Dahl KE, Wang NJ, Skau I, Öhrn K. Oral health-related quality of life and associated factors in Norwegian adults. Acta Odontol Scand. 2011;69(4):208–14. https://doi.org/10.3109/00016357.2010.549502 DOI: https://doi.org/10.3109/00016357.2010.549502
Åstrøm AN, Haugejorden O, Skaret E, Trovik TA, Klock KS. Oral impacts on daily performance in Norwegian adults: the influence of age, number of missing teeth, and socio-demographic factors. Eur J Oral Sci. 2006;114(2):115–21. https://doi.org/10.1111/j.1600-0722.2006.00336.x DOI: https://doi.org/10.1111/j.1600-0722.2006.00336.x
Holst D, Skau I, Grytten J. Egenvurdert tannhelse, generell helse og tannstatus i den voksne befolkning i Norge i 2004 (Self-assessment of oral health, general health and dental status in a national sample of adult Norwegians in 2004). Nor Tannlegeforen Tid. 2005;115(10): 576-80 DOI: https://doi.org/10.56373/2005-10-2
Kuyken W, Orley J, Power M, Herrman H, Schofield H, Murphy B, et al. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9. https://doi.org/10.1016/0277-9536(95)00112-K DOI: https://doi.org/10.1016/0277-9536(95)00112-K
Carr AJ, Gibson B, Robinson PG. Measuring quality of life: is quality of life determined by expectations or experience? BMJ. 2001;322(7296):1240–3. https://doi.org/10.1136/bmj.322.7296.1240 DOI: https://doi.org/10.1136/bmj.322.7296.1240
Steele JG, Sanders AE, Slade GD, Allen PF, Lahti S, Nuttall N, et al. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol. 2004;32(2):107–14. https://doi.org/10.1111/j.0301-5661.2004.00131.x DOI: https://doi.org/10.1111/j.0301-5661.2004.00131.x
Baltes PB, Baltes MM. Psychological perspectives on successful aging: The model of selective optimization with compensation. Successful Aging,1990. p. 1-34. DOI: https://doi.org/10.1017/CBO9780511665684.003
Lantto A, Lundqvist R, Wårdh I. Quality of life related to tooth loss and prosthetic replacements among persons with dependency and functional limitations. Acta Odontol Scand. 2020;78(3):173–80. https://doi.org/10.1080/00016357.2019.1668054 DOI: https://doi.org/10.1080/00016357.2019.1668054
Strömberg E, Holmèn A, Hagman-Gustafsson M-L, Gabre P, Wårdh I. Oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living. Acta Odontol Scand. 2013;71(3–4):771–7. https://doi.org/10.3109/00016357.2012.734398 DOI: https://doi.org/10.3109/00016357.2012.734398
Jensen PM, Saunders RL, Thierer T, Friedman B. Factors associated with oral health-related quality of life in community-dwelling elderly persons with disabilities. J Am Geriatr Soc. 2008;56(4):711–7. https://doi.org/10.1111/j.1532-5415.2008.01631.x DOI: https://doi.org/10.1111/j.1532-5415.2008.01631.x
Hoeksema AR, Peters LL, Raghoebar GM, Meijer HJA, Vissink A, Visser A. Health and quality of life differ between community living older people with and without remaining teeth who recently received formal home care: a cross sectional study. Clin Oral Investig. 2018;22(7):2615–22. https://doi.org/10.1007/s00784-018-2360-y DOI: https://doi.org/10.1007/s00784-018-2360-y
Statistics Norway (Statistisk sentralbyrå). ssb.no2024 [Internet] [cited 2024 Sept 02]. Available from: https://www.ssb.no/en/befolkning
Coughlin SS. Recall bias in epidemiologic studies. J Clin Epidemiol. 1990;43(1):87–91. https://doi.org/10.1016/0895-4356(90)90060-3 DOI: https://doi.org/10.1016/0895-4356(90)90060-3
Høvik H, Kolberg M, Gjøra L, Nymoen LC, Skudutyte-Rysstad R, Hove LH, et al. The validity of self-reported number of teeth and edentulousness among Norwegian older adults, the HUNT Study. BMC Oral Health. 2022;22(1):82. https://doi.org/10.1186/s12903-022-02116-2 DOI: https://doi.org/10.1186/s12903-022-02116-2
Melbye EL. Dimensional structure of the OHIP-14 and associations with self-report oral health-related variables in home-dwelling Norwegians aged 70. Acta Odontol Scand. 2023;81(1):66–72. https://doi.org/10.1080/00016357.2022.2083674 DOI: https://doi.org/10.1080/00016357.2022.2083674
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