Oral health promotion among older persons and their care providers in a nursing home facility.

OBJECTIVES: To assess oral health status and oral health-related quality of life (OHRQoL) of residents in an extended care facility and to assess the care providers' oral health attitudes and knowledge. METHODS: Participants included 137 residents (58.1% female, age range 32-94 years, 91% African-American) and 22 care providers. Residents received an oral examination and completed the Oral Health Impact Profile (OHIP-14), an OHRQoL questionnaire. Care providers completed an oral health knowledge (OHK) questionnaire before and after the on-site geriatric oral health education and training programme. RESULTS: Oral examinations showed that 58% of the residents had extensive oral health needs. On the OHIP-14, the mean severity was 9.2 (SD=12.0), extent (number of items rated as 'fairly often' or 'often') was 1.2 (SD=2.6) and prevalence (participants rating at least one item at least 'fairly often') was 37.8%. Most prevalent negative impact items were about 'oral pain', 'appearance' and 'self-consciousness'. Regarding OHK, caregivers' knowledge improved following instruction from 65% correct on the pre-test to 90% correct on the post-test (p<0.05). Subsequent to the eight in-service workshops, providers reported that physical limitations, fear of getting bitten and time constraints were barriers to providing oral hygiene to their residents. CONCLUSION: Examination data showed a high level of dental needs among the majority of residents, accompanied by significantly reduced OHRQoL. Although care providers' OHK improved following the geriatric service programme, they reported specific barriers regarding their provision of oral hygiene care to the residents.