Dental and nursing collaboration in oral healthcare research in palliative care inpatient settings.

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.

Does social support predict increased use of dental services in older men?

BACKGROUND: Past research on social support and dental visits in older people has been limited by cross-sectional design, limited social support dimensions and non-representative samples. METHODS: Data came from men with natural teeth completing Waves 3 and 4 of the Concord Health and Ageing in Men Project in Sydney, Australia. The relationship between social support at Wave 3 (2011-2012) and at least one dental visit per year at Wave 4 (2014-2016) was examined by Poisson regression. Social support was measured by structural (marital status, living arrangements, family support and social interaction) and functional (social support satisfaction) domains. RESULTS: About 673 men were analysed. Structural and functional social support were not associated with the pattern of usual dental visits 5 years later in univariable or multivariable analyses. The only consistent significant factor was income source, with older men who had other sources of income more likely to regularly visit the dentist than older men solely reliant on the pension for income (prevalence ratio: 1.31, 95% CI: 1.13-1.52). CONCLUSIONS: We found no differences in the pattern of usual dental visits between older men with different levels and types of social support. For older Australian men, income source seems to be the most important determinant of regular dental visits. © 2022 Australian Dental Association.

Oral health status of newly admitted residents living in residential aged care.

BACKGROUND: It is important to understand whether older people are admitted into residential care with existing dental diseases or their oral health deteriorates while residing in residential care. There is, however, little research available exploring the oral health status of people newly admitted into residential care. Understanding this disease trend would lead to effective prevention and treatment strategies to be trialled and implemented prior to admission. In this cross-sectional study, we hypothesize that older people with one or more natural teeth might have poor oral health prior to admission to residential care. METHOD: The study was carried out using the de-identified oral health assessment database of an established domiciliary oral health care program in metropolitan New South Wales, Australia. Four hundred and nine participants with mean participant age of 85.56 years from 13 facilities from 2015 to 2018 fulfilled the inclusion criteria for this study. CONCLUSION: This study confirmed that dentate, newly admitted residents to residential care had pre-existing dental problems and oral health concerns. Almost half of the newly admitted residents had an unsatisfactory oral cleanliness score when examined in their residential care setting.

Oral health behaviours of older Australian men: the Concord Health and Ageing in Men Project.

BACKGROUND: The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of older Australian men. The aim of this paper is to describe the oral health behaviours and dental service use of CHAMP participants and explore associations between oral health behaviours with and general health status. METHOD: Information collected related to socio-demographics, general health, oral health service-use and oral health behaviours. Key general health conditions were ascertained from the health questionnaire and included physical capacity and cognitive status. RESULTS: Fifty-seven percent of the men reported visiting a dental provider at least once or more a year and 56.7% did so for a "dental check-up". Of those with some natural teeth, 59.3% claimed to brush their teeth at least twice or more a day. Most men (96%) used a standard fluoride toothpaste. Few participants used dental floss, tooth picks or mouth-rinses to supplement oral hygiene. Cognitive status and self-rated general health were associated with dental visiting patterns and toothbrushing behaviour. CONCLUSIONS: Most older men in CHAMP perform favourable oral health behaviours. Smoking behaviour is associated with less favourable dental visiting patterns, and cognitive status with toothbrushing behaviour.

A longitudinal workforce analysis of a Rural Clinical Placement Program for final year dental students.

BACKGROUND: There is little longitudinal evaluation of rural dental education outreach programs. This longitudinal research investigates the influence of a Rural Clinical Placement Program (RCPP) on workforce outcomes in terms of practice locations for five graduate years from the University of Sydney. METHODS: Work locations for the graduates from 2009-2013 were identified in 2015 and 2017 by rurality, using faculty contact lists, phone calls and online methods. A total of 397 graduate locations were identified out of 404 (98.2%) (267 RCPP participants and 137 non-RCPP participants). Semi-structured questionnaires were used to report on demographic and characteristic data. Univariate and multivariate statistical analyses were utilised to explore associations. RESULTS: Rural Clinical Placement Program participation in 2015 was significantly associated with an increased likelihood of working rurally (PR = 2.16), and almost two times the likelihood of rural retention in the period from 2015 to 2017 (PR = 1.93). In the multivariate analyses, both rural experience prior to the RCPP and pre-placement rural intentions were significant independent predictors of an increased likelihood for rural employment and rural retention. CONCLUSIONS: Participation in the RCPP was associated with increased rural employment and retention. Prior rural experience and pre-placement rural intentions were identified as significant independent predictors of rural employment.

Oral health of community-dwelling older Australian men: the Concord Health and Ageing in Men Project (CHAMP).

BACKGROUND: The Concord Health and Ageing in Men Project (CHAMP) is a cohort study of the health of a representative sample of Australian men aged 70 years and older. The aim of this report is to describe the oral health of these men. METHODS: Oral health was assessed when the men were all aged 78 years or older. Two calibrated examiners conducted a standardized intraoral assessment. Descriptive data were analysed by statistical association tests. Participants were excluded from the collection of some periodontal assessments if they had a medical contraindication. RESULTS: Dental assessments of 614 participants revealed 90 (14.6%) were edentate. Men had a mean of 13.8 missing teeth and 10.3 filled teeth. Dentate participants had a mean of 1.1 teeth with active coronal decay. Those in the low-income group had a higher rate of decayed teeth and lower rate of filled teeth. Thirty-four participants (5.5%) had one or more dental implants, and 66.3% relied on substitute natural teeth for functional occlusion. Of those with full periodontal assessments; 90.9% had sites with pocket depths of 3 mm or more, 96.6% had sites with CAL of 5 mm or more, and 79.7% had three or more sites with GI scores of 2 or more. CONCLUSIONS: There was a high prevalence of periodontal diseases and restorative burden of dentitions, which suggests that greater attention needs to be given to prevention and health maintenance in older Australian men.

Characteristics of undergraduate dental students in Japan: English competency and willingness to study abroad.

OBJECTIVE: This study was conducted to acquire a deeper understanding of Japanese students' motivation to study abroad and to provide baseline information for nurturing globally-minding dental students. MATERIALS AND METHODS: Students from the first to the sixth year (n = 332), at the Faculty of Dentistry, Tokyo Medical and Dental University, were invited to participate in the study and were asked to complete a self-administered questionnaire, written in Japanese. Self-reported English competency was assessed in four areas: reading; writing; speaking; and listening. Students were asked to score their competencies in these areas using a 10-point visual analogue scale (VAS). Of the total eligible students, 312 (94%) participated. RESULTS: The results of the study suggest that competency and confidence in the English language could be one of the biggest obstacles for students to study abroad. Students with an interest in studying abroad were highly motivated and studied English independently. DISCUSSION AND CONCLUSIONS: Japanese educational authorities and dental schools may need to consider a range of incentives and motivational strategies to nurture clinicians, educators and researchers who can function confidently in an increasingly borderless world. These could include increasing exposure to English language skills through mandatory lectures and seminars in English, increasing the range of inbound international students through student exchange programmes and encouraging students to develop and communicate with international colleagues. The Faculty of Dentistry at Tokyo Medical and Dental University has begun to increase exposure of students to English through the regular curriculum. Outcomes will be followed and evaluated.

Social implications and workforce issues in the oral health of an ageing population.

A functional and socially acceptable level of oral health is an integral part of healthy ageing! More teeth, more sophisticated dental technology and increasing co-morbidities of an ageing Australian society will have significant impacts on oral health professionals and their capacities to work within expanded teams of health, education and social organizations. Society is adapting its perspective on the social role of older citizens; replacing its perception of the elderly as an economic social burden, to one of senior citizens as being a respected and active source of social and economic benefit. Maintaining general and oral health for older Australians will bring into sharp focus the need for recognizing and managing not only the biological markers associated with ageing and frailty, but also the potential mediators on health outcomes associated with changing health and social behaviours. Increasing social capital of older Australians through national policy initiatives such as the Living Longer Living Better reforms, and greater involvement of allied health and carers' organizations in oral health education and health promotion will set a new scene for the roles of dental professionals. Issues of equity will drive the service delivery agenda, and a socio-cultural shift to 'consumer-directed' health outcomes will shape the range of services, quality of care and support required by an older Australian population. Formal education and training modules for aged care workers, allied health practitioners and geriatricians will develop. The challenge for the dental profession is the coordination and integration of these changes into new models of dental and general health care.

Geriatric dentistry, teaching and future directions.

BACKGROUND: Many nations are facing a demographic shift in the age profile of their population, leading the World Health Organization to a 'Call for Public Health Action' on the oral health of older people. METHODS: A search of the literature relevant to geriatric dentistry teaching was undertaken using MEDLINE, Web of Science, Eric and Psychlit. A search of dental professional school websites in Australia and policy and international practice documents was undertaken. RESULTS: The international literature describes requirements for geriatric dentistry courses and various approaches to teaching, including didactic teaching, practical experiences and external placements. Challenges are identified in the area of geriatric dental education. Educational institutions (with others) have an obligation to lead change, yet there appears to be little formal recognition in Australian dental curricula of the need to develop quality education and research programmes in geriatric dentistry. CONCLUSIONS: Internationally, the inclusion of geriatrics within dental curricula has been the subject of consideration since the 1970s. The current evidence indicates that geriatrics/gerodontology is not a significant component of dental curricula. Given the projected age distribution in many countries, the need for implementation of dental curriculum content in the area of geriatrics/gerodontology is evident.