4.2. Evaluation of Oral Hygiene Status before and after Autonomous Tooth Brushing and Denture Cleaning (T1a-T1b)
bleeding, loose teeth, cognitive impairment, periodontitis, gingivitis, pain, denture
BLEEDING, PERIODONTITIS, TOOTH DECAY, GINGIVITIS, DENTAL PLAQUE, DISORDERS, PLAQUE
Between T1a and T1b, geriatric inpatients in both groups effectively removed plaque on the teeth and dentures. This suggests that the mere presence of a quietly observing caregiver may lead to improved plaque removal. Supervision clearly places the focus at that moment on the performance of oral hygiene. The more effective plaque removal on natural teeth in the IG could be explained by the received IndOHCT. Inpatients were able to perform more effective cleaning techniques that they were taught using their personal toothbrushing products and for which training was given. Geriatric inpatients who received IndOHCT achieved increased plaque reduction, achieving a significantly lower TmQHI score. Thus, oral and denture hygiene is improvable through supervision and implementation of IndOHCT. These findings are consistent with those of other studies [Inpatients with 1–9 residual teeth benefited significantly more from IndOHCT, succeeding in removing more dental plaque than those with more residual teeth. Single or gap-bounded teeth are usually more difficult to clean than complete dentition, especially on approximal surfaces. A dentition with gaps requires the learning of new techniques whereas for an almost complete dentition, lifelong routine techniques can be maintained. Therefore, during IndOHCT, special attention was given to inpatients with reduced numbers of teeth to exercise individualized cleaning techniques.Geriatric inpatients with healthy periodontal tissues or gingivitis also benefited more from IndOHCT than those with periodontitis. Presumably, inpatients with periodontitis would not have practiced effective oral hygiene for a long time. They were invited to learn fundamentally new techniques that could be perceived as very difficult. In addition, pain, loose teeth, and bleeding may have hampered the brushing process. In contrast, inpatients who already had good oral hygiene only had to change their habits slightly. Often, only small changes in brushing techniques were sufficient to improve plaque reduction.The MMSE score demonstrated a medium effect on denture hygiene. Inpatients with lower MMSE scores removed more plaque on dentures than did those with higher MMSE scores. They almost halved the DHI scores of the baseline examinations. Due to the very limited inclusion criteria, which excluded inpatients with an MMSE score < 24 from the study, conclusions regarding the relationship between MMSE and plaque scores cannot be reliably drawn. Mental disorders are a risk indicator for poor oral health. Tooth decay, edentulism, and poor denture and oral hygiene are more prevalent in older adults with cognitive impairment than in those who are cognitively healthy [Nevertheless, programs to improve oral health should also be implemented in hospitals. Many multimorbid individuals or older people requiring care take advantage of dental assistance irregularly and complaint-based [Comprehensive medical and dental preventive strategies for older people aiming to increase their quality of life should include individualized oral healthcare training. This study clearly revealed that the oral hygiene of geriatric inpatients can be improved by individualized supervised hands-on training on teeth and denture cleaning. Thus, both hypotheses could be partially confirmed: (1) First, the findings confirmed the effectiveness of IndOHCT in geriatric inpatients. IndOHCT improved the oral hygiene status of geriatric inpatients, and this is in line with the findings of other studies, showing that IndOHCT programs can be successful [In comparison with the present study, an intervention study by Frenkel et al. also clearly demonstrated that oral health education of non-dental staff can improve the oral health of institutionalized elders [