Extending Dental Care to Nursing Home Residents to Reduce Mouth Infections and Incidence of Pneumonia and Improve Diabetic Glucose Control
NHOralHealth
Extending Infection Control Dental Care to Nursing Home Residents Using Telehealth-Mediated Supervision: a Novel Solution to Nursing Home Acquired Pneumonia Morbidity and Mortality.
2 other identifiers
interventional
150
1 country
1
Brief Summary
The goal of this study is to learn if dental infection control treatment delivered to older adult nursing home residents at their place of residence will result in :
- improved dental health
- reduced risk of pneumonia
- better glucose control for diabetic patients compared to the pre-project dental and general health evaluations of residents and the pre-project facility incidence of pneumonia. Dental infection control treatment includes treating gum infections, stopping or slowing decay with fluoride, and assisting residents with effective tooth brushing and denture cleaning daily. Previous studies indicate dental infections can be inhaled and cause pneumonia or make diabetes worse. A shortage of dentists has limited care for nursing home residents. This project will allow dental hygienists and specially trained dental assistants to treat nursing home residents using telehealth methods (computers, cameras, internet, and telephone) to talk and work with dentists in different locations.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Mar 2024
Typical duration for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
March 1, 2024
CompletedFirst Submitted
Initial submission to the registry
March 17, 2025
CompletedFirst Posted
Study publicly available on registry
March 24, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 28, 2026
ExpectedStudy Completion
Last participant's last visit for all outcomes
August 28, 2026
March 26, 2025
March 1, 2025
2.5 years
March 17, 2025
March 21, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Periodontal Health
I. To evaluate the periodontal health of nursing home residents who receive dental infection control treatment compared to their pre-treatment peroidontal assessment using periodontal probe and inflammation diagnostic criteria endorsed by the American Academy of Periodontists and the European Federation of Periodontists.
One year from the delivery of the infection control interventional care
Secondary Outcomes (8)
Pneumonia Incidence
One year from the delivery of the infection control interventional care
Diabetic Glucose Control
One year from the delivery of the infection control interventional care
Oral Hygiene Assistance Instruction
One year from the delivery of the infection control interventional care
Decay Stabilization Treatment
One year from the delivery of the infection control interventional care#
Frailty Assessment
One year from the delivery of the infection control interventional care
- +3 more secondary outcomes
Study Arms (1)
Infection Control Arm
EXPERIMENTAL* Dental Hygienists and EFDA Teams travel to nursing homes and gather medical and dental data for residents participating in the study while collaborating with distant dentists using telehealth. * Clinical data is sent to the supervising dentist, who reviews medical history, assigns an ASA class and Frailty class, and prescribes an infection control treatment plan. * Emergent infections outside the scope of hygienists / EFDAs result in a transport order for care to an outside facility. * Hygienist/EFDA teams treat residents in their facility for gum infections, stabilize decay with fluoride and temporary fillings, and clean dentures. * The hygienist/EFDA team teaches LTCF staff oral hygiene assistance techniques to help residents with daily care and minimize reinfection. * The hygienist and EFDA team will continue to see LTCF residents at regular intervals to provide maintenance care, collect data, and monitor progress. * Treatment Outcome Data collected.
Interventions
A thorough check-up of teeth, gums, and surrounding tissues, including medical and dental history, to assess overall oral health and identify any infections.
A series of x-rays of the whole mouth intended to display the, teeth, roots, periapical areas, bone, and areas without teeth.
The delivery or coordination of care for a patient using synchronous; real-time or aysnchronous communication between care providers or between care providers and a patient.
A therapeutic procedure designed to remove plaque and calculus (hardened plaque) causing gum infections that can lead to tooth loss and other medical complications.
A periodic evaluation and therapeutic support procedure for patients with a history of gum infections.
Topical application of decay arresting or inhibiting medicament.
Dental procedures aimed at educating patients on, and assisting patients with ,proper oral hygiene practices removing food debris, germ-laden plaque, and soft tartar using cloth wipes, toothbrush, floss, and using oral hygiene aids.
Diagnosis and treatment of oral infection outside the scope of a dental hygienist or Expanded Function Dental Assistant.
Eligibility Criteria
You may qualify if:
- Adult \> 60 years of age residing in a nursing home or communal care setting;
- Review of Medical history results in an assigned American Society of Anesthesiologists Physical Status Evaluation of Class II or III;
- Frailty Assessment of Low or Moderate using the Modified FRAIL Questionnaire;
- Consent is required for study participation, disease control oral healthcare, and access to medical records.
You may not qualify if:
- Age \< 60;
- American Society of Anesthesiologists Physical Status Evaluation of Class IV or V;
- High frailty evaluation using the Modified FRAIL Questionnaire;
- Resident deemed behaviorally or physically difficult to treat by initial clinical assessment.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Office of Dental Health, Department of Health and Senior Services
Jefferson City, Missouri, 65102, United States
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NA
- Masking
- NONE
- Masking Details
- The Primary investigator and Outcomes Assessor are blinded to the identities of the patients and facilities. The data will be pooled and considered in affregate.
- Purpose
- TREATMENT
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Project Specialist
Study Record Dates
First Submitted
March 17, 2025
First Posted
March 24, 2025
Study Start
March 1, 2024
Primary Completion (Estimated)
August 28, 2026
Study Completion (Estimated)
August 28, 2026
Last Updated
March 26, 2025
Record last verified: 2025-03
Data Sharing
- IPD Sharing
- Will not share
Data will be analyzed in aggregate to ensure the confidentiality of each study participant and the facilities involved in the study