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Suzuki H, Furuya J, Hidaka R, Motomatsu Y, Hara R, Kabasawa Y, Tohara H, Minakuchi S. Comparison of nurse-led oral health care and dental professional-led oral health management in terminally ill cancer patients receiving palliative care: a longitudinal study. Support Care Cancer 2025; 33:386. [PMID: 40237889 DOI: 10.1007/s00520-025-09453-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 04/10/2025] [Indexed: 04/18/2025]
Abstract
PURPOSE To examine the impact of oral health care provided by nurses who received instruction from dental professionals on the oral health of terminally ill cancer patients and determine the optimal cutoff value of the Oral Health Assessment Tool (OHAT) total score for triaging patients in need of oral health management by dental professionals. METHODS In total, 115 terminally ill cancer patients (66 males and 49 females; average age 73.5 ± 10.9 years) who received oral health management during palliative care at Tokyo Medical and Dental University Hospital between April 2017 and August 2019 were included. Oral health management was conducted by dental professionals (D group) or nurses educated by dental professionals (Ns group). Oral health status was evaluated using the OHAT at the initial dental consultation in palliative care and approximately 2 weeks later. RESULTS Both groups showed significant improvement in the OHAT total score and OHAT sub-items of the lips, tongue, gums and tissues, saliva, oral cleanliness, and dental pain. However, sub-items of natural teeth and dentures improved significantly only in the D group. Additionally, the optimal cutoff value for the OHAT total score in determining the need for oral health management by dental professionals was 6. CONCLUSION Oral health care conducted by nurses who received instruction from dental professionals can improve oral health status. Patients with OHAT total scores of ≥ 6 should be considered for oral health management by dental professionals.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Oral Function Management, Graduate School of Dentistry, Showa Medical University, Tokyo, Japan
| | - Junichi Furuya
- Department of Oral Function Management, Graduate School of Dentistry, Showa Medical University, Tokyo, Japan.
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuko Motomatsu
- Department of Nursing, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Ryuzo Hara
- Department of Oral Function Management, Graduate School of Dentistry, Showa Medical University, Tokyo, Japan
| | - Yuji Kabasawa
- Department of Oral Care for Systemic Health Support, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Naik S, Vellappally S, Alateek M, Al Kheraif AA, Alghamdi M, Anil S. Association Between Oral Health Complaints and Nutritional Status among Patients with Cancer: A Study Utilising the Mini Nutritional Assessment Short Form. ORAL HEALTH & PREVENTIVE DENTISTRY 2025; 23:83-91. [PMID: 39846970 PMCID: PMC11881756 DOI: 10.3290/j.ohpd.c_1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 11/15/2024] [Indexed: 01/24/2025]
Abstract
PURPOSE Oral health problems in patients with cancer can substantially affect their quality of life, treatment outcomes, and overall nutritional well-being. This study investigated the relationship between nutritional status and self-reported oral health complaints in patients with cancer. MATERIALS AND METHODS A cross-sectional study was conducted among patients with cancer at the King Saud University Medical City Oncology Center in Riyadh, Saudi Arabia. Patients' nutritional status was assessed using the mini nutritional assessment short form (MNA-SF), and self-reported oral health problems were documented. Data were analysed using the Chi-square test and multinomial logistic regression. RESULTS This study included 200 participants who completed both the MNA-SF assessment and self-reported their oral health complaints. Common oral health problems included xerostomia (81%), bleeding gums (60.5%), toothaches (35%), and mouth ulcers (24%). Malnourished individuals reported higher rates of all oral complaints, with 54% of them experiencing bleeding gums, 50% reporting toothaches, and 54% experiencing speech problems. Notably, 71% of malnourished patients reported mouth ulcers (P 0.05). Regression analysis revealed a statistically significant association (P 0.05) between xerostomia and the 'At risk of malnutrition' group, with an odds ratio of 1.004 (95% confidence interval [CI]: 0.411-2.449). In the 'Malnourished' category, mouth ulcers showed a statistically significant association (P 0.05) with an odds ratio of 1.402 (95% CI: 0.409-4.800). CONCLUSION Our findings highlighted statistically significant correlations between nutritional status, as assessed using the MNA-SF, and oral health complaints in patients with cancer. Well-nourished individuals reported fewer oral complaints, whereas malnourished patients reported a higher prevalence of oral health issues.
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Affiliation(s)
- Sachin Naik
- Sachin Naik Associate Professor, Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O Box. 10219, Riyadh, 11433, Saudi Arabia. Conceptualisation, methodology, writing (original draft preparation)
| | - Sajith Vellappally
- Sajith Vellappally Associate Professor, Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O Box. 10219, Riyadh, 11433, Saudi Arabia. Conceptualisation, methodology, writing (original draft preparation), resources
| | - Mohammed Alateek
- Mohammed Alateek Dental University Hospital, King Saud University, Medical City, Riyadh, Saudi Arabia. Conceptualisation, formal analysis and investigation
| | - Abdulaziz Abdullah Al Kheraif
- Abdulaziz Abdullah Al Kheraif Professor, Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O Box. 10219, Riyadh, 11433, Saudi Arabia. Methodology, writing (review and editing), funding acquisition, supervision
| | - Mohammed Alghamdi
- Mohammed Alghamdi Director, Oncology Centre, King Khalid University Hospital, King Saud University Medical City, Riyadh, 11433, Saudi Arabia. Methodology, writing (review and editing)
| | - Sukumaran Anil
- Sukumaran Anil Pushpagiri Institute of Medical Sciences and Research Centre,Thiruvalla,689101, Kerala, India. Methodology, writing (review and editing)
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Lee YJ, Hwang IC, Choi YS, Ahn HY, Lee EJ, Kim DE. Association Between Oral Health Status and Survival Time in Terminally Ill Cancer Patients. Am J Hosp Palliat Care 2024; 41:1138-1144. [PMID: 38063372 DOI: 10.1177/10499091231221204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2024] Open
Abstract
INTRODUCTION Patients with terminal cancer often experience various oral problems. Whether oral health status is associated with the survival of terminally ill cancer patients receiving palliative care remains unclear. METHODS We analyzed the data of 59 Korean patients with terminal cancer receiving palliative care, including their oral health status, using a modified Korean version of the Oral Health Assessment Tool (OHAT). Patients were categorized into "Good," "Moderate," or "Poor" groups based on OHAT scores. The Kaplan-Meier method was used to compare the median survival time, and the prognosis between groups was estimated using Cox proportional hazard models. RESULTS The most common oral symptoms observed were xerostomia (69.5%) and mucositis (17.0%). Significantly shorter survival times were observed in patients with hyperbilirubinemia, elevated creatinine levels, and no use of dentures. The "Poor" group had a shorter survival than the "Good" oral group (P = .010). A multivariate Cox proportional hazards analysis revealed that the "Poor" group was significantly associated with poor survival compared to the "Good" group (hazard ratio, 2.05; P = .047). CONCLUSION Terminally ill cancer patients with poor oral health may have a higher risk of shorter survival. Palliative care professionals should pay attention to oral health. Further research is needed to determine the effects of oral care on survival.
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Affiliation(s)
- Yoo Jeong Lee
- Palliative Care Center and Department of Family Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Youn Seon Choi
- Palliative Care Center and Department of Family Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, South Korea
| | - Eun Jeong Lee
- Palliative Care Center, Korea University Guro Hospital, Seoul, South Korea
| | - Da Eun Kim
- Department of Medicine, Korea University College of Medicine, Seoul, South Korea
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Uhlig S, Doberschütz F, Hallmann F, Salm H, Sigle JM, Pink D. Exploring the integration of dentistry within a multidisciplinary palliative care team: does bedside dental care improve quality of life and symptom burden in inpatient palliative care patients? Support Care Cancer 2024; 32:491. [PMID: 38976073 PMCID: PMC11231016 DOI: 10.1007/s00520-024-08671-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/18/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Despite the significant impact of oral problems on the quality of life of palliative care patients, comprehensive studies are lacking. This study is the first of its kind to address this gap by including both a dental examination and an intervention and assessing quality of life using the EORTC QLQ OH 15 questionnaire. OBJECTIVES The objective of this study is to explore the impact of incorporating dentists into inpatient palliative care, with a focus on enhancing quality of life and alleviating symptom burden. METHODS In this monocentric study, data were gathered from a palliative care unit over an 8-month period. At the beginning of the multidisciplinary treatment, T0, patients underwent both a dental examination and interviews utilizing established questionnaires, the EORTC QLQ-C30 (core, general) and OH 15 (oral health). A week later, at T1, patients underwent a follow-up examination and interview. The QLQ-C30 and OH15 are widely recognized instruments developed by the European Organisation for Research and Treatment of Cancer (EORTC) for evaluating health related quality of life in cancer patients. RESULTS A total of n = 103 patients (48.5% women) were enrolled in the study. The median duration since their last dental visit was 1 year, and the dental condition at T0 was desolate. At T1, statistically and clinically significant changes in oral quality of life and symptom burden were observed. Noteworthy changes were noted in the OH-QoL score (median 63 vs. 92, p < 0.001), sticky saliva (median 33 vs. 0, p < 0.001), sensitivity to food and drink (median 33 vs. 0, p < 0.001), sore mouth (median 33 vs. 0, p > 0.001), and poorly fitting dentures (median 33 vs. 0 p < 0.001). Additionally, improvements were observed in xerostomia candidiasis and mucositis. CONCLUSION The study highlights the powerful contribution of integrating a dentist in inpatient palliative care. With very little dental effort and simple ward and bedside treatments, significant improvements in the oral symptom burden of critically ill palliative patients can be achieved. This contributes to improved care status, relief of distressing symptoms, and ultimately improved quality of life. The results strongly support the consideration of dental support as an integral part of palliative care units.
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Affiliation(s)
- Sarah Uhlig
- Klinik und Poliklinik für Innere Medizin C, Universitätsmedizin Greifswald, 17489, Greifswald, Germany.
- Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, 15526, Bad Saarow, Germany.
- Zentrum für Zahn-, Mund- und Kieferheilkunde, Universitätsmedizin Greifswald, Greifswald, Germany.
| | - Florian Doberschütz
- Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, 15526, Bad Saarow, Germany
| | - Franziska Hallmann
- Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, 15526, Bad Saarow, Germany
| | - Hanna Salm
- Klinik und Poliklinik für Innere Medizin C, Universitätsmedizin Greifswald, 17489, Greifswald, Germany
- Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, 15526, Bad Saarow, Germany
| | | | - Daniel Pink
- Klinik und Poliklinik für Innere Medizin C, Universitätsmedizin Greifswald, 17489, Greifswald, Germany
- Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, 15526, Bad Saarow, Germany
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Suzuki H, Furuya J, Nakagawa K, Hidaka R, Yoshimi K, Shimizu Y, Saito K, Hatanaka Y, Mukai T, Itsui Y, Tohara H, Minakuchi S. Impact of oral health management by nurses and dental professionals on oral health status in inpatients eligible for the Nutrition Support Team: A longitudinal study. J Oral Rehabil 2024; 51:938-946. [PMID: 38366354 DOI: 10.1111/joor.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/25/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE As the participation of dental professionals in multidisciplinary care is often limited, instructions on oral health management provided by dental professionals to other professionals are important to achieve transdisciplinary oral health management; however, the effectiveness of such instructions remains unclear. In this longitudinal study, we aimed to determine the impact of oral health management provided by dental professionals and nurses instructed on oral health management by dental professionals on the oral health of inpatients eligible for a Nurition Support Team (NST). METHODS The study participants were 117 patients (66 men and 51 women, mean age: 71.9 ± 12.5 years) who received oral health management during the NST intervention period. The participants received oral health management from nurses (Ns group) or dental professionals (D group). The nurses who conducted the oral health management received instructions from dental professionals. Oral health was assessed at the beginning and end of the NST intervention using the Oral Health Assessment Tool (OHAT). RESULT The Ns and D groups showed significant improvements in the total OHAT scores at the end of the NST intervention. Both groups showed significant improvements in the OHAT subitems of lip, tongue, gums and tissues, saliva, oral cleanliness and dental pain, while only the D group showed a significant improvement in the denture subitem. CONCLUSION Effective oral health management provided by dental professionals or by nurses trained by them improved the oral health status of inpatients eligible for NST at an acute-care hospital.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
| | - Junichi Furuya
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yukue Shimizu
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Keiko Saito
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Yukiko Hatanaka
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
| | - Tomoko Mukai
- Department of Oral Function Management, Graduate School of Dentistry, Showa University, Tokyo, Japan
| | - Yasuhiro Itsui
- Medical Education Research and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Serra R, de Oliveira CS, Roque S, Herrera F, Arco H. Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol. JBI Evid Synth 2024; 22:673-680. [PMID: 37791797 PMCID: PMC10986783 DOI: 10.11124/jbies-23-00096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVE The objective of this review is to examine the effectiveness of oral hygiene care in the management of oral symptoms in patients with cancer under specialist palliative care and the patients' experience of such symptoms and care. INTRODUCTION Oral symptoms, such as xerostomia, mouth pain, or dysgeusia, are highly prevalent in patients with cancer under specialist palliative care. These symptoms have a negative effect on patients' quality of life. Oral hygiene care can manage oral symptoms and could be improved with a more systematized approach, adequate guidelines, and training to properly integrate oral hygiene into the care provided in specialist palliative care. INCLUSION CRITERIA This review will consider quantitative, qualitative, and mixed methods studies on the effectiveness and experience of oral hygiene care intended to manage oral symptoms in patients with cancer aged 18 years or older, diagnosed with any type of cancer, under specialist palliative care. METHODS The search will be conducted in MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Central Register of Controlled Trials, Dentistry and Oral Sciences Source (EBSCOhost), and MedicLatina (EBSCOhost). Sources of unpublished studies and gray literature to be searched will include Networked Digital Library of Theses and Dissertations and Repositórios Científicos de Acesso Aberto de Portugal. Studies in English, Portuguese, and Spanish published from 2000 to the present will be considered. Methodological quality of included studies will be assessed and data will be extracted. Synthesis and integration will follow the JBI segregated approach for mixed methods reviews. REVIEW REGISTRATION PROSPERO CRD42023400554.
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Affiliation(s)
- Ricardo Serra
- Department of Health Sciences and Technologies, Polytechnic Institute of Portalegre, Portalegre, Portugal
- Lisbon School of Nursing, Lisbon, Portugal
- University of Lisbon, Lisbon, Portugal
- Research Center for the Valorization of Endogenous Resources – VALORIZA, Polytechnic Institute of Portalegre, Portalegre, Portugal
| | | | - Sofia Roque
- Department of Health Sciences and Technologies, Polytechnic Institute of Portalegre, Portalegre, Portugal
- Research Center for the Valorization of Endogenous Resources – VALORIZA, Polytechnic Institute of Portalegre, Portalegre, Portugal
| | | | - Helena Arco
- Department of Health Sciences and Technologies, Polytechnic Institute of Portalegre, Portalegre, Portugal
- Research Center for the Valorization of Endogenous Resources – VALORIZA, Polytechnic Institute of Portalegre, Portalegre, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
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Matsubara C, Yamaguchi K, Imada R, Yoshizawa A, Bando Y, Kusaka T, Furuya J, Tohara H. Factors associated with the oral health status of patients with schizophrenia: A cross-sectional study. J Oral Rehabil 2024; 51:695-702. [PMID: 38044570 DOI: 10.1111/joor.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Oral function deterioration attributed to ageing and medications is one of the main contributory factors of dysphagia. Therefore, oral health management is essential in older patients with schizophrenia. However, no previous studies have evaluated the oral function in patients with schizophrenia. OBJECTIVE We surveyed patients with schizophrenia to identify factors associated with ageing-related variations in oral function. METHODS This cross-sectional study included 34 male patients diagnosed with schizophrenia who were hospitalised at a psychiatric hospital between July and September 2021 and underwent a screening examination during dental care. The survey items included basic information, oral hygiene information, oral (oral diadochokinesis [ODK] and tongue pressure), physical function, and nutritional status. Thirty-six male community-dwelling older individuals were included as controls, and their outcomes were compared with those of patients with schizophrenia. RESULTS Compared with healthy older adults, patients with schizophrenia demonstrated significantly lower teeth numbers, ODK, and calf circumference (CC) (p < .05). Multiple regression analysis revealed that ODK was associated with age and schizophrenia (p < .05). Conversely, tongue pressure was associated with CC (p < .05), suggesting different factors' association with the parameters indicating decreased oral function. CONCLUSIONS Our study findings suggest that older patients with schizophrenia have decreased tongue pressure and generalised muscle mass, highlighting the need to manage oral function. Interventions for tongue pressure were more strongly associated with muscle mass and could be easier to manage than those with disease-dependent changes in ODK. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, Shizuoka, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Medical Corporation Takanawakai, Tokyo, Japan
| | - Akira Yoshizawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental Oral Surgery, Nasu Chuo Hospital, Tochigi, Japan
| | | | - Teruo Kusaka
- Takatsuki Hospital, Tokyo, Japan
- Welfare Planning Office Minister's Secretariat Ministry of Economy, Trade and Industry, Tokyo, Japan
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Furuya
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Nakao M, Shimosato M, Sakane N, Nakashima T. Association between poor oral health and overall mortality in palliative care patients: An analysis using time-dependent receiver operating characteristic curves. SPECIAL CARE IN DENTISTRY 2024; 44:513-519. [PMID: 37191549 DOI: 10.1111/scd.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/30/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023]
Abstract
AIMS To determine the Oral Health Assessment Tool (OHAT) critical score in palliative care patients and the optimal timing for predicting mortality using time-dependent receiver operating characteristic (ROC) curves. METHODS AND RESULTS A retrospective observational study was conducted on 176 patients treated by the palliative care team of our medical center between April 2017 and March 2020. Oral health was assessed using the OHAT. Prediction accuracy was evaluated using the area under the curve (AUC) analysis, sensitivity, and specificity, using time-dependent ROC curves. Overall survival (OS) was compared using Kaplan-Meier curves with the log-rank test; hazard ratios (HRs) adjusted for covariates were calculated using a Cox proportional hazard model. A OHAT score of 6 was shown to best predict 21-day OS (AUC 0.681, sensitivity 42.2%, specificity 80.0%). The median OS was significantly shorter in patients with total OHAT scores ≥6 than in patients with scores < 6 (21 days vs. 43 days, p = .017). For individual OHAT items, the unhealthy status of the lips and tongue was associated with decreased OS (HR = 1.91; 95% confidence interval [CI], 1.19-3.05 and adjusted HR = 1.48; 95% CI, 1.00-2.20). CONCLUSION Predicting disease prognosis based on patient oral health can enable clinicians to provide timely treatment.
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Affiliation(s)
- Mifumi Nakao
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Maiko Shimosato
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takeshi Nakashima
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
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Weihermann GA, Bernhardt F, Brix TJ, Baumeister SE, Lenz P. Role and relevance of dentists in a multiprofessional palliative care team: results of a cross-sectional survey study. Support Care Cancer 2024; 32:159. [PMID: 38361035 PMCID: PMC10869371 DOI: 10.1007/s00520-024-08356-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Despite the multiprofessional concept surrounding palliative care patients (PCPs) and their high prevalence of oral issues, licensed dentists (LDs) are often not included in their treatment team. This study aimed to examine the current state of cooperation and to determine whether and how LDs should be included in the care for PCPs. METHODS This single-centre cross-sectional study was conducted at the University Hospital Muenster, Germany. We surveyed three participant groups: PCPs, LDs, and healthcare professionals (HCPs). Questionnaires were tailored for each group, with some questions common for comparison. RESULTS The study encompassed the results of 48 questionnaires from LDs, 50 from PCPs along with 50 from HCPs. Consensus was reached among all parties (LDs: 73% (n = 35/48); HCPs: 94%, n = 47/50; PCPs: 60%, n = 30/50) that involving LDs in the treatment concept is favourable. On the other hand, a significant discrepancy emerged in the perception of the dental treatment effort required by PCPs. While LDs (81%; n = 39/48) and HCPs (64%; n = 32/50) were convinced of increased effort, PCPs (34%; n = 17/50) largely did not share this perspective. To enhance patient care and formulate appropriate treatment plans, LDs consider both training (58%; n = 28/48) and guidebooks (71%; n = 34/48) to be valuable and would attend or use such resources. CONCLUSION This study sheds light on the current gaps in including LDs in palliative care teams and emphasizes the importance of multidisciplinary collaboration to address oral health needs effectively. Development of continuing education options and collaborative models between LDs and HCPs needs to be further expanded in future.
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Affiliation(s)
| | - Florian Bernhardt
- Department of Palliative Care, University Hospital Muenster, 48149, Muenster, Germany
| | - Tobias J Brix
- Institute of Medical Informatics, University of Muenster, 48149, Muenster, Germany
| | | | - Philipp Lenz
- Department of Palliative Care, University Hospital Muenster, 48149, Muenster, Germany.
- Department of Palliative Care, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W 30, D-48149, Muenster, Germany.
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Suzuki H, Furuya J, Nakagawa K, Hidaka R, Nakane A, Yoshimi K, Shimizu Y, Saito K, Itsui Y, Tohara H, Minakuchi S. Factors influencing the selection of oral healthcare providers in multidisciplinary Nutrition Support Team for malnourished inpatients: A cross-sectional study. J Oral Rehabil 2023; 50:1446-1455. [PMID: 37574822 DOI: 10.1111/joor.13565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Oral health management involving dental professionals in a multidisciplinary Nutritional Support Team (NST) is effective collaborative care. However, the indicators for the triage of oral health management requirements and selection of oral healthcare providers remain unclear. OBJECTIVE This cross-sectional study included inpatients with malnutrition and aimed to investigate the factors associated with determining the need for oral health management involving dental professionals and selecting primary oral healthcare providers when needed. METHODS Participants included 255 inpatients (154 males and 101 females, mean age 69.7 ± 14.4 years) aged ≥20 years who underwent oral assessment by the NST between April 2016 and July 2019. Participants were assigned to the following groups: good oral health group, oral health management by nurses under the supervision of dental professionals group, and oral health management by dental professionals group. The comprehensive oral health status was investigated using the Oral Health Assessment Tool (OHAT). The total OHAT score ranges from 0 to 16, with a higher score indicating a poorer oral environment. RESULTS The total OHAT score had a significant correlation with the need for oral health management by dental professionals. Inpatients with denture problems required oral health management from dental professionals. The optimal cutoff value of the total OHAT score for determining the need for oral health management was four. CONCLUSION The need for oral health management by dental professionals increased with worsening oral health status, especially denture problems. The OHAT score could be used to triage inpatients who require oral health management collaborated with dental professionals.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Junichi Furuya
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Ota-ku, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
- Clinical Department of Dentistry, Japan Community Health-care Organization Tokyo Shinjuku Medical Center, Shinzyuku-ku, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Yukue Shimizu
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Japan
| | - Keiko Saito
- Department of Nutrition Service, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Japan
| | - Yasuhiro Itsui
- Medical Education Research and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
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11
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Malik Z, Wright F. Dental and nursing collaboration in oral healthcare research in palliative care inpatient settings. Int J Palliat Nurs 2023; 29:318-320. [PMID: 37478068 DOI: 10.12968/ijpn.2023.29.7.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Collaboration between palliative care nurses and oral health professionals has been frequently recommended to ensure optimal oral healthcare. However, the importance of this collaboration to the success of evidence-based protocols, involving oral healthcare interventions in the inpatient palliative care setting, is less discussed. Feasibility requires consideration during the planning, intervention and implementation phases of any clinical trial; all of which typically rely on good collaboration with nursing staff. Therefore, it is imperative that nursing staff appreciate the need for oral healthcare at the end of a person's life. Nursing and dental collaboration is critical to the feasibility of running research trials in this group and can help overcome some of the logistical and ethical challenges in this vulnerable population.
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Affiliation(s)
- Zanab Malik
- Specialist Special Needs Dentistry, School of Health Sciences, Faculty of Health and Medicine, Campbelltown Hospital Dental Centre Specialist Clinic, Sydney, Australia
| | - Fac Wright
- Clinical Professor, Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Sydney, Australia
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12
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Silva ARP, Bodanezi AV, Chrun ES, Lisboa ML, de Camargo AR, Munhoz EA. Palliative oral care in terminal cancer patients: Integrated review. World J Clin Cases 2023; 11:2966-2980. [PMID: 37215429 PMCID: PMC10198072 DOI: 10.12998/wjcc.v11.i13.2966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/07/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Palliative care (PC) aims to improve quality of life in patients and its families against life threatening diseases, through suffering's prevention and relief. It is the duty of the dental surgeon to possess the knowledge needed to treat a patient with little life span, in order to establish an adequate treatment plan for each situation. AIM To synthesize the published evidence on oral conditions, impact, management and challenges in managing oral conditions among palliative patients. METHODS Articles were selected from PubMed and Scopus electronic platforms, using a research strategy with diverse descriptors related to "palliative care", "cancer" and "oral health". The article's selection was done in two phases. The first one was performed by the main researcher through the reading of the abstracts. In the second phase two researchers selected eligible articles after reading in full those previous selected. Data was tabulated and analyzed, obtaining information about what is found in literature related to this subject and what is necessary to be approached in future researches about PC. RESULTS As results, the total of 15 articles were eligible, being one a qualitative analysis, 13 (92.8%) clinical trials and one observational study. Of the 15 articles, 8 (53.4%) involved questionnaires, while the rest involved: one systematic review about oral care in a hospital environment, 2 oral exams and oral sample collection, one investigation of terminal patient's (TP) oral assessment records, 2 collection of oral samples and their respective analysis and one treatment of the observed oral complications. CONCLUSION It can be concluded that the oral manifestations in oncologic patients in terminal stage are, oral candidiasis, dry mouth, dysphagia, dysgeusia, oral mucositis and orofacial pain. Determining a protocol for the care of these and other complications of cancer - or cancer therapy - based on scientific evidence with the latest cutting-edge research results is of fundamental importance for the multidisciplinary team that works in the care of patients in PC. To prevent complications and its needed to initial the dentist as early as possible as a multidisciplinary member. It has been suggested palliative care protocol based on the up to date literature available for some frequent oral complications in TP with cancer. Other complications in terminal patients and their treatments still need to have further studying.
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Affiliation(s)
- Ana Rute Preis Silva
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Augusto Vanni Bodanezi
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Emanuely Silva Chrun
- Department of Pathology, Federal University of Santa Catarina, Florianopolis 88040900, Brazil
| | - Mariah Luz Lisboa
- Professor Polydoro São Thiago Ernani Hospital, Federal University of Santa Catarina, Florianopolis 88040900, Brazil
| | - Alessandra R de Camargo
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Etiene Andrade Munhoz
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
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13
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Choi YS, Lee YJ, Hwang IC, Ahn HY. Oral care and survival time in terminally ill patients with cancer: nested case-control pilot study. BMJ Support Palliat Care 2023:spcare-2023-004200. [PMID: 36918258 DOI: 10.1136/spcare-2023-004200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023]
Affiliation(s)
- Youn Seon Choi
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea (the Republic of)
| | - Yoo Jeong Lee
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea (the Republic of)
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea (the Republic of)
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, Korea (the Republic of)
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14
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Suzuki H, Furuya J, Matsubara C, Aoyagi M, Shirobe M, Sato Y, Tohara H, Minakuchi S. Comparison of the Amount of Used and the Ease of Oral Care between Liquid and Gel-Type Oral Moisturizers Used with an Oral Care Simulators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138158. [PMID: 35805817 PMCID: PMC9266061 DOI: 10.3390/ijerph19138158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022]
Abstract
Oral care involving the removal of dry sputum is effective for older patients who require nursing care or hospitalization. However, safe and efficient oral care methods for such patients remain unclear. We aimed to simulate the oral cavity of older adults with dry mouth and elucidate the differences between two moisturization agents, water and gel-like oral moisturizer, and investigate the effect of occupation and experience on the amount of use and the ease of oral care. Using an oral care simulator (MANABOT®, Nissin Dental Products Inc., Kyoto, Japan), 42 students and 48 dental professionals (13 dentists and 35 dental hygienists) performed oral care using moisturization agents to facilitate dry sputum removal. The time required for oral care, amount of water or gel used, amount of pharyngeal inflow, and ease of oral care when using water or gel were compared. The simulations revealed that the amount of use and pharyngeal inflow for gel (2.9 ± 1.6 and 0.3 ± 0.3, respectively) were significantly lower than those for water (6.8 ± 4.1 and 1.2 ± 1.5, respectively) in all participants. Using a gel-like moisturizer might reduce the aspiration risk in older patients requiring nursing care or hospitalization, regardless of occupation and experience.
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Affiliation(s)
- Hiroyuki Suzuki
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.S.); (S.M.)
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan; sato-@dent.showa-u.ac.jp
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
- Correspondence: ; Tel.: +81-3-3783-3971
| | - Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, 2-2-1 Oshika, Suruga-ku, Shizuoka 422-8021, Japan;
| | - Michiyo Aoyagi
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan;
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan; sato-@dent.showa-u.ac.jp
| | - Haruka Tohara
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.S.); (S.M.)
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15
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Furuya J, Suzuki H, Hidaka R, Matsubara C, Motomatsu Y, Kabasawa Y, Tohara H, Sato Y, Miyake S, Minakuchi S. Association between oral health and advisability of oral feeding in advanced cancer patients receiving palliative care: a cross-sectional study. Support Care Cancer 2022; 30:5779-5788. [PMID: 35344101 PMCID: PMC9135851 DOI: 10.1007/s00520-022-06984-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/11/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Maintenance of oral feeding is important in terms of maintaining and improving the quality of life in terminal cancer patients receiving palliative care. Although adequate oral health status is essential for oral feeding in hospitalized patients, the relationship between oral health and oral feeding in patients receiving palliative care remains unclear. This cross-sectional study aimed to examine how the general condition and oral health status of these patients relate to decisions regarding their nutritional intake methods. METHODS This retrospective cross-sectional study included 103 terminal cancer patients (59 men and 44 women; mean age, 73.8 ± 10.9 years) who received palliative care between April 2017 and August 2019. The nutritional method was assessed using the Functional Oral Intake Scale (FOIS). We assessed two types of nutritional methods: (1) the method advised by the attending physician until the initial dental examination (FOIS-I) and (2) the recommended method based on consultation with a palliative care doctor and dentist after the initial oral examination (FOIS-R). Furthermore, the participants' basic information and Dysphagia Severity Scale (DSS) and Oral Health Assessment Tool (OHAT) scores were assessed. RESULTS There was a divergence between FOIS-I and FOIS-R. FOIS-R was significantly higher than FOIS-I (p < 0.001). Multiple regression analysis revealed that the time until death, DSS score, and OHAT score had a significant impact on determining the food form for oral feeding. CONCLUSIONS Appropriate oral health assessment is important in determining the food form and indication for oral feeding among patients receiving palliative care.
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Affiliation(s)
- Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo, 145-8515, Japan.,Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroyuki Suzuki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Chiaki Matsubara
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuko Motomatsu
- Department of Nursing, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuji Kabasawa
- Department of Oral Care for Systemic Health Support, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo, 145-8515, Japan
| | - Satoshi Miyake
- Center for Innovative Cancer Treatment, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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16
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Regular Oral Health Management Improved Oral Function of Outpatients with Oral Hypofunction in Dental Hospital: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042154. [PMID: 35206345 PMCID: PMC8871729 DOI: 10.3390/ijerph19042154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023]
Abstract
This longitudinal study aimed to clarify the impact of regular oral health management for oral hypofunction on the oral function of older dental outpatients. The 68 participants enrolled in this study were older dental outpatients (mean age 78.5 ± 8.1 years). According to the number of declined oral examinations after the first exam, participants were assigned to the oral hypofunction group (Hypo group, ≥3), receiving regular oral health management with a leaflet at the dental clinic, or the pre-oral hypofunction group (Pre-hypo group, ≤2), which served as a control. At the second oral examination, after approximately 6 months to 1 year, the Hypo group showed significant improvement in the tongue-lip motor function (Oral diadochokinesis, ODK) /pa/, /ta/, and masticatory function, while the Pre-hypo group showed significant worsening in oral hygiene and oral wetness. Temporal changes in ODK /pa/, /ta/, and the number of declined examination items were significantly different between the groups. Multiple analysis revealed that the number of improved oral examination items were associated with presence of regular oral health management after adjusting for age, sex, number of visits, measuring period, and dental treatment. Regular comprehensive oral health management for oral hypofunction improves and maintains oral function among older dental outpatients.
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