Tanaka Kumi, Kikutani Takeshi, Takahashi Noriaki, Tohara Takashi, Furuya Hiroyasu, Ichikawa Yoko, Komagata Yuka, Mizukoshi Arato, Ozeki Maiko, Tamura Fumiyo, Tominaga Tomokazu
The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan.
Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan.
Odontology. 2025 Apr;113(2):776-787. doi: 10.1007/s10266-024-00984-4. Epub 2024 Aug 14.
Information on the effects of dental treatment must be identified and factors that hinder the continuation of dental treatment must be identified to provide appropriate domiciliary dental care (DDC). This study aimed to clarify the treatment outcomes of DDC for older adults and the factors that impede the continuation of such care. This prospective study was conducted at a Japanese clinic specializing in dental care for older adults. The functional status, nutritional status, oral assessment, details of the dental treatment, and outcomes after 6 months of older adults receiving DDC were surveyed. The Oral Health Assessment Tool (OHAT) was used for oral assessment. Cox proportional hazards analysis was used to analyze the factors at the first visit that were associated with treatment continuation. A total of 72 participants (mean age, 85.8 ± 6.9) were included. Twenty-three participants (31.9%) could not continue treatment after 6 months. The most frequently performed procedures were oral care and dysphagia rehabilitation, followed by prosthetic treatment, then tooth extraction. The percentage of participants with teeth that required extraction after 6 months and the total OHAT score decreased significantly. The Barthel Index, Mini Nutritional Assessment Short-Form, and rinsing ability were significantly associated with treatment continuation. Furthermore, instrumental activities of daily living (ADL) and the OHAT "tongue" sub-item were correlated with treatment continuation. In conclusion, DDC improved the oral health status of older adults after 6 months. Factors that impeded treatment continuation were decreased ADL, decreased nutritional status, difficulty in rinsing, and changes in the tongue such as tongue coating.
必须明确牙科治疗的效果信息，并找出阻碍牙科治疗持续进行的因素，以提供适当的居家牙科护理（DDC）。本研究旨在阐明老年人居家牙科护理的治疗结果以及阻碍此类护理持续进行的因素。这项前瞻性研究在一家日本专门为老年人提供牙科护理的诊所进行。对接受居家牙科护理的老年人的功能状态、营养状况、口腔评估、牙科治疗细节以及6个月后的治疗结果进行了调查。使用口腔健康评估工具（OHAT）进行口腔评估。采用Cox比例风险分析来分析首次就诊时与治疗持续相关的因素。总共纳入了72名参与者（平均年龄85.8±6.9岁）。23名参与者（31.9%）在6个月后无法继续治疗。最常进行的治疗程序是口腔护理和吞咽困难康复，其次是修复治疗，然后是拔牙。6个月后需要拔牙的参与者百分比和OHAT总分显著下降。巴氏指数、简易营养评估简表和漱口能力与治疗持续显著相关。此外，日常生活活动能力（ADL）和OHAT“舌头”子项目与治疗持续相关。总之，居家牙科护理在6个月后改善了老年人的口腔健康状况。阻碍治疗持续的因素包括ADL下降、营养状况下降、漱口困难以及舌头的变化，如舌苔。
