Acceptability of teledentistry use among residents and staff in aged residential care facilities in the Otago region of New Zealand.

OBJECTIVES: To assess ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ, and identify end-user-level factors associated with its use. BACKGROUND: Difficulty in accessing oral healthcare services is a key barrier to aged residential care (ARC) residents' oral health and well-being. Teledentistry offers a possible solution, yet studies on its acceptability in ARCs are sparse, especially in New Zealand (NZ). This study assessed ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ and identified end-user-level factors associated with its use. MATERIALS AND METHODS: Rest home-level residents and care staff in ARC facilities in the Otago region of NZ were surveyed to assess their awareness of teledentistry, perceptions of benefit and comfort using teledentistry, and end-user-level factors associated with the feasibility of using it in ARCs. RESULTS: One hundred residents and 77 care staff from 14 facilities participated. Three-quarters of resident participants thought that teledentistry was beneficial. Three in five resident participants were comfortable receiving remote dental consultations and care advice through teledentistry. Acceptability, as measured by perceived benefits and comfort, was lower among older participants. Staff participants were receptive to teledentistry use for residents and were comfortable facilitating remote dental consultations and care through teledentistry. No staff participants disagreed with the potential benefits of teledentistry for ARC residents. CONCLUSION: Teledentistry would likely be acceptable to residents and staff in ARC facilities in NZ, contributing to residents' improved access to oral health care and improved oral health and well-being.

Effectiveness of oral health education methods on oral hygiene in children and adolescents with visual impairment: A systematic review.

BACKGROUND: Conventional methods of oral health education (OHE) are not suitable for children with visual impairment, as these methods usually involve visual demonstration with models or plaque-disclosing dyes. AIM: To systematically review the literature to support the best approach for providing OHE to children and adolescents with visual impairment. DESIGN: A systematic search of five electronic databases and grey literature was conducted. Randomized controlled trials that compared different OHE methods in children and adolescents with visual impairment were included. The Cochrane risk-of-bias tool (RoB 2) was used for the risk-of-bias assessment. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used to determine the certainty of evidence. RESULTS: Nine randomized controlled trials with a total of 804 participants were included in this review. Seven OHE methods were compared. Seven studies were assessed to be at high risk of bias, one study was assessed to have some concerns, and one study was assessed to be at low risk of bias. The overall certainty of evidence was very low according to GRADE. CONCLUSION: There was insufficient evidence to recommend a particular method of OHE as more effective in improving the oral hygiene of children with visual impairment, but combination methods may show similar or better results.

Xerostomia and polypharmacy among dependent older New Zealanders: a national survey.

BACKGROUND: Medication-induced xerostomia is common in older people. We investigated medication use and xerostomia in dependent older New Zealanders. METHODS: Medication and xerostomia data analysed from a nationally representative survey of dependent older people. Automatic interaction detection analysis identified medications combinations most strongly associated with xerostomia, and then xerostomia was modelled. RESULTS: Just over half were taking five to nine different medications; one in five was taking 10+. Xerostomia prevalence (29.4%; 95% confidence interval 26.5, 32.5) was higher among the latter and lowest in psychogeriatric patients. After controlling for age and sex, it was higher among people taking any antidepressant, and higher still with a tricyclic antidepressant and either a steroid or an anticholinergic, or among people taking a bronchodilator without prophylactic aspirin. CONCLUSIONS: Health practitioners should work together to ensure that those with xerostomia are managed in a timely and appropriate manner. Medication review is an important component of that.

Informed consent, dementia and oral health care provision.

Managing patients with dementia requires a practitioner to exercise diverse skills. Communicating with the patient (as their dementia allows), relatives, caregivers and medical personnel are essential elements in the care process. Diagnosis of oral health problems may not be straightforward, clinical examination and treatment planning may be hampered by poor cooperation from the person with dementia. Practitioners must view any treatment from the patient's perspective and balance this with the requirements for sound clinical care. The consent process must be approached in a manner that fulfils the ethical responsibilities that acknowledge patient rights. This can be difficult when managing a patient with dementia. This paper will explore issues surrounding the consent process and the provision of oral health care to people suffering from dementia. It is hoped that readers will be stimulated to review their practice; especially related to informed consent, whether they routinely manage patients with dementia or not. Such practice evaluation should consider the wants and needs of patients and families on a broader than clinical basis and thus enhance the care that is brought to this group of interesting and often challenging patients.