Oral care is an important element of care for older people in care homes as oral health is often poor and can deteriorate rapidly causing pain discomfort and impacting on nutrition and quality of life.  With growing numbers of older people this is an area of increasing demand. This aim of the review was to assess article the literature on the effect of providing oral healthcare education to care home nurses on their oral healthcare knowledge and attitude and their oral hygiene care skills.

The databases Medline, Web of Science, Cochrane library, Embase and CINHAL were searched from 1990-2011. Only articles with regard to care home residents of 65 years and older were eligible.  Study selection and grading of evidence and data extraction was carried out independently by two reviewers.

• 14 studies were initially selected, with 7 being summarised qualitatively.  3 were randomised controlled trials, 2 describing different elements of the same study.  Of the remaining studies 2 were cross-sectional, 1 quasi-experimental and the final one longitudinal
• The studies revealed some scientific evidence and indications that an oral healthcare education programme for care home nurses may improve the nurses’ oral healthcare knowledge and attitude. Any effect of oral healthcare education to care home nurses’ oral hygiene care skills could not be determined.

The authors concluded

Oral healthcare education may have a positive effect on care home nurses’ oral health- care knowledge and attitude and on care home residents’ oral hygiene. Scientific evidence for the potential association between oral healthcare education of care home nurses and improvement in their oral hygiene care skills could not be found.

Comment

This review could only find a limited amount of poor quality evidence on which to address this question. The searches for the review were limited to just a twenty year period which may have been an appropriate times scale given the increase in interest in the care of older people.   Since the date of the last search for this review at least one small randomised controlled trial has been carried out (Dental Elf- Oct 9^th 2012).   Inconsistency in training is one issue raised by the authors in the discussion as a potential factor and readers might find the training support pack for this group of patients developed by NHS Scotland (Caring for Smiles) of interest.

Links

de Lugt-Lustig KH, Vanobbergen JN, van der Putten GJ, De Visschere LM, Schols  JM, de Baat C. Effect of oral healthcare education on knowledge, attitude and skills of care home nurses: a systematic literature review. Community Dent Oral Epidemiol. 2013 Jul 30. doi: 10.1111/cdoe.12063. [Epub ahead of print] PubMed PMID: 23895301.

Dental Elf – 9th Oct 2012 – Professional oral hygiene interventions and follow-up support provided short term improvement in oral health for older adults.

NHS Health Scotland  -Caring for Smiles