Comparison of the oral health status of nursing home residents using the current and the newly developed interRAI Oral Health Section (OHS-interRAI): a cross-sectional study

Abstract

Background: Nursing home residents’ oral health is generally poor, which can negatively affect general health and well-being. Regular dental check-ups and good oral hygiene are important, but often challenging for older adults. The interRAI instrument for Long-Term Care Facilities (LTCF) enables caregivers to evaluate residents’ health, including oral health, and to integrate oral care into general care planning. Because the current oral health section in the interRAI instruments does not accurately identify oral care needs, the interRAI Oral Health Section (OHS-interRAI) was developed. The OHS-interRAI differs from the current section by including more items, response options and guidelines, photographs, instruction videos, and Collaborative Action Points to alert caregivers when oral care is needed. This study describes and compares residents’ oral health status assessed by caregivers using the current section and the OHS-interRAI. Methods: This cross-sectional study includes data from baseline assessments of adults aged 65 years or older in Flemish and Dutch nursing homes, collected by caregivers. Assessments with the current section dated from October 2016 to January 2023, and with the OHS-interRAI from October 2020 to January 2023. Results: InterRAI assessments of 12476 residents from 158 nursing homes with the current section were compared with those of 1212 residents from 37 nursing homes with the OHS-interRAI. Missing oral health data were less common with the current section than with the OHS-interRAI. A higher proportion of oral health problems was detected with the OHS-interRAI compared to the current section for chewing function (6.8% vs. 13.7%), dry mouth (7.6% vs. 9.8%), teeth (16.6% vs. 22.1%), and gums (3.1% vs. 7.8%). There was no significant difference in the proportion of residents with discomfort or pain in the mouth. Conclusions: Caregivers identified more oral health problems with the OHS-interRAI, which may be due to its additional features compared to the current section, such as photographs and extensive instructions. The Collaborative Action Points included in the OHS-interRAI support continuity of care and enable integration of oral care into general care. Further research is needed to evaluate whether the OHS-interRAI accurately identifies residents who need help with daily oral hygiene or referral to a dentist.