Domiciliary Professional Oral Care for Dependent Older Adults

NCT05335239 | Completed

• 1 other identifier: KarolinskaDalarnaGävleborg
• Study Type: interventional
• Target: 194
• Locations: 1 country
• Sites: 1

Brief Summary

Keep brushing your teeth, twice a day, during life for healthy teeth and body. Not brushing your teeth regularly and well, may have a devastating effect on your teeth and your general health. The teeth could develop root caries resulting in pain, fractured teeth, tooth loss and trouble eating. Further, brushing your teeth insufficiently leads to higher number of bacteria in the oral cavity and could in frail individuals lead to aspirations pneumonias. With age, some of us will depend on daily care activities from others and help with daily toothbrushing. However, care dependent older adults often lack basic dental care (tooth brushing with fluoride tooth paste twice a day). Dental care at home is a service proved by dental personnel. Visits at a dental clinic decrease with age and especially with a dementia diagnosis. Dental care at home can deliver regular dental check-ups and dental treatments to individuals who experience difficulties attending a dental clinic. The effect of teeth cleaning performed at home on root caries development, has not yet been explored in care dependent older adults. Therefore, the aim is to study if the combination of high fluoride toothpaste used daily with teeth cleaning/ a reminder to use the toothpaste every third month, could be a method for preventing root caries development in this patient group. The hypothesis is that domiciliary professional cleaning will improve the oral health, as measured by root caries development, gingival bleeding, plaque accumulation and oral mucosal status, compared with a control group that receives oral care as usual.

Conditions

Dental Caries of Root Surface; Aging

Keywords

Dental prophylaxis; Aged; Dental devices, Home Care; Root Caries; Sodium Fluoride

Outcome Measures

Primary Outcomes (1)

• Dental root caries

  Registered by the Fejerskov´s five levels root caries index at baseline and after twelve months.

  12 months

Secondary Outcomes (5)

• Oral health-related quality of life

  12 months

• Oral hygiene

  12 months

• Gingival bleeding

  12 months

• Oral microbiota

  12 months

• General health

  12 months

Study Arms (2)

Intervention group

EXPERIMENTAL

Every third month, a dental assistant will visit at home and deliver professional dental cleaning and delivery of one new toothbrush and fluoride toothpaste (\>4000ppm) (n:3) for the next three months. The visit is expected to take at the most 30 minutes.

Other: Professional dental cleaning

Controll group

NO INTERVENTION

Continuous with oral care as usual, either by themselves or nursing assisted (help with oral hygiene procedure) during the whole study period. Home care aides working with the control study participants delivers a toothbrush and fluoride toothpaste (\> 4000 ppm) (n:3) every third month during the study period.

Interventions

Professional dental cleaning OTHER

The dental assistant will visit at home and delivers professional dental cleaning, a reminder to use the fluoridated toothpaste (\> 4000 ppm ) and oral hygiene instruction to participants accompanied by home care aides, with manual toothbrush, fluoridated toothpaste (\> 4000 ppm) and relevant interproximal aids.

Intervention group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Home-living older adults
• Age ≥65
• Eligible for subsidized dental care for those with in-home care
• Accepted oral health assessment by dental hygienists
• Non-smokers
• Ability to cooperate during oral assessment for 5-10 minutes
• At least one natural tooth
• Understand and able to communicate in Swedish.
• Additionally: For oral microbiota, grade 1-2 according to mirror slide friction test.

You may not qualify if:

• Edentulousness
• Full dentures
• Cognitive limitations that is an obstacle for cooperation
• Malignancies and/or immunosuppressive diseases
• Coagulation defects.
• Moving or planned to move to a nursing home
• For oral microbiota: grade 3 according to mirror slide friction test

Sponsors & Collaborators

• Karolinska Institutet: lead

Study Sites (1)

Karolinska institute

Huddinge, 114 41, Sweden

Location

Related Publications (1)

• Girestam Croonquist C, Dalum J, Skott P, Sjogren P, Wardh I, Moren E. Effects of Domiciliary Professional Oral Care for Care-Dependent Elderly in Nursing Homes - Oral Hygiene, Gingival Bleeding, Root Caries and Nursing Staff's Oral Health Knowledge and Attitudes. Clin Interv Aging. 2020 Aug 6;15:1305-1315. doi: 10.2147/CIA.S236460. eCollection 2020.

  PMID: 32982191 RESULT

Related Links

• Fulltext Girestam et al 2020

MeSH Terms

Conditions

Root Caries

Condition Hierarchy (Ancestors)

Dental Caries; Tooth Demineralization; Tooth Diseases; Stomatognathic Diseases

Study Officials

• Inger Wårdh

  Karolinska Institutet

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Single - blind
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Randomized controlled trial

Study Record Dates

• First Submitted: April 12, 2022
• First Posted: April 19, 2022
• Study Start: December 6, 2021
• Primary Completion: December 1, 2023
• Study Completion: April 4, 2024
• Last Updated: December 3, 2025

Record last verified: 2023-06

Locations

SE (1)