Clinical Oral Investigations

, Volume 23, Issue 2, pp 707–713 | Cite as

Efficacy and acceptance of professional dental cleaning among nursing home residents

  • Anna Greta BarbeEmail author
  • Hannah Elisa Kottmann
  • Stefanie Hamacher
  • Sonja Henny Maria Derman
  • Michael Johannes Noack
Original Article



To determine the impact of general and oral health status of nursing home residents in Germany on efficacy and acceptance of professional dental cleaning performed by a dental nurse.

Materials and methods

Participants (N = 41; mean age 83 ± 8 years) living in a nursing home were included. Personal and general health, oral health, oral hygiene habits, and needs were investigated. Individual acceptance regarding professional dental cleaning via different devices (scaler, interdental brushes, ultrasonic cleaning) was assessed, as was the efficacy of this method using after-cleaning indices.


Oral health among nursing home residents was impaired and independent from dementia status. Most residents (33/41) performed oral hygiene procedures independently and showed better index values than those in need of external help. Residents requiring help with oral hygiene showed increased risk profiles (higher age, more often immobile, demented, more xerostomia). The dental cleaning procedure required a mean time of 37 ± 11 min, was widely accepted (36/41), and achieved clean results (plaque index 0.1 ± 0.5, oral hygiene index 0.2 ± 1.6, Volpe-Manhold index 0.4 ± 1.6); food residues were reduced to 0 independent from cognitive status. Regarding the cleaning methods, scalers were accepted best without difference between demented and non-demented residents.


Professional dental cleaning in nursing homes is an accepted and efficacious oral hygiene procedure among nursing home residents.

Clinical relevance

Professional dental cleaning is an efficacious and accepted method as a first step in line with strategies to improve oral health and should be considered in nursing home residents.


Nursing home Oral hygiene Gerodontology Dentistry nursing 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study or their legal guardians.


  1. 1.
    Zenthofer A, Dieke R, Dieke A, Wege KC, Rammelsberg P, Hassel AJ (2013) Improving oral hygiene in the long-term care of the elderly—a RCT. Community Dent Oral Epidemiol 41:261–268. CrossRefGoogle Scholar
  2. 2.
    Montal S, Tramini P, Triay JA, Valcarcel J (2006) Oral hygiene and the need for treatment of the dependent institutionalised elderly. Gerodontology 23:67–72. CrossRefGoogle Scholar
  3. 3.
    Wyatt CC (2002) Elderly Canadians residing in long-term care hospitals: part I. Medical and dental status. J Can Dent Assoc 68:353–358Google Scholar
  4. 4.
    Hoad-Reddick G, Grant AA, Griffiths CS (1990) Investigation into the cleanliness of dentures in an elderly population. J Prosthet Dent 64:48–52CrossRefGoogle Scholar
  5. 5.
    Adams R (1996) Qualified nurses lack adequate knowledge related to oral health, resulting in inadequate oral care of patients on medical wards. J Adv Nurs 24:552–560CrossRefGoogle Scholar
  6. 6.
    Zenthofer A, Baumgart D, Cabrera T, Rammelsberg P, Schroder J, Corcodel N, Hassel AJ (2017) Poor dental hygiene and periodontal health in nursing home residents with dementia: an observational study. Odontology 105:208–213. CrossRefGoogle Scholar
  7. 7.
    Zenthofer A, Schroder J, Cabrera T, Rammelsberg P, Hassel AJ (2014) Comparison of oral health among older people with and without dementia. Community Dent Health 31:27–31Google Scholar
  8. 8.
    De Visschere LM, Grooten L, Theuniers G, Vanobbergen JN (2006) Oral hygiene of elderly people in long-term care institutions—a cross-sectional study. Gerodontology 23:195–204. CrossRefGoogle Scholar
  9. 9.
    Weeks JC, Fiske J (1994) Oral care of people with disability: a qualitative exploration of the views of nursing staff. Gerodontology 11:13–17CrossRefGoogle Scholar
  10. 10.
    MacEntee MI, Thorne S, Kazanjian A (1999) Conflicting priorities: oral health in long-term care. Spec Care Dentist 19:164–172CrossRefGoogle Scholar
  11. 11.
    Vanobbergen JN, De Visschere LM (2005) Factors contributing to the variation in oral hygiene practices and facilities in long-term care institutions for the elderly. Community Dent Health 22:260–265Google Scholar
  12. 12.
    Ainamo J, Barmes D, Beagrie G, Cutress T, Martin J, Sardo-Infirri J (1982) Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int Dent J 32:281–291Google Scholar
  13. 13.
    Baelum V, Manji F, Wanzala P, Fejerskov O (1995) Relationship between CPITN and periodontal attachment loss findings in an adult population. J Clin Periodontol 22:146–152CrossRefGoogle Scholar
  14. 14.
    Loe H, Silness J (1963) Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 21:533–551CrossRefGoogle Scholar
  15. 15.
    Saxer UP, Muhlemann HR (1975) Motivation and education. SSO Schweiz Monatsschr Zahnheilkd 85:905–919Google Scholar
  16. 16.
    Beighton D, Lynch E, Heath MR (1993) A microbiological study of primary root-caries lesions with different treatment needs. J Dent Res 72:623–629. CrossRefGoogle Scholar
  17. 17.
    Greene JC (1960) Nutrition in a collegiate basic nursing curriculum. Nurs Outlook 8:314–315Google Scholar
  18. 18.
    Volpe AR, Manhold JH, Hazen SP (1965) In vivo calculus assessment. I. A method and its examiner reproducibility. J Periodontol 36:292–298CrossRefGoogle Scholar
  19. 19.
    Dirix P, Nuyts S, Vander Poorten V, Delaere P, Van den Bogaert W (2007) Efficacy of the BioXtra dry mouth care system in the treatment of radiotherapy-induced xerostomia. Support Care Cancer 15:1429–1436. CrossRefGoogle Scholar
  20. 20.
    Zenthofer A, Navratil SD, Rammelsberg P, Cabrera T, Gorenc L, Urbanowitsch N, Wetzel P, Schroder J, Hassel AJ (2015) Oral health and apraxia among institutionalized elderly people—a pilot study. Acta Odontol Scand 73:150–155. CrossRefGoogle Scholar
  21. 21.
    Ziebolz D, Werner C, Schmalz G, Nitschke I, Haak R, Mausberg RF, Chenot JF (2017) Oral health and nutritional status in nursing home residents-results of an explorative cross-sectional pilot study. BMC Geriatr 17:39. CrossRefGoogle Scholar
  22. 22.
    Caplan DJ, Ghazal TS, Cowen HJ, Oliveira DC (2017) Dental status as a predictor of mortality among nursing facility residents in eastern Iowa. Gerodontology 34:257–263. CrossRefGoogle Scholar
  23. 23.
    Janssens B, Vanobbergen J, Lambert M, Schols JM, De Visschere L (2017) Effect of an oral healthcare programme on care staff knowledge and attitude regarding oral health: a non-randomised intervention trial. Clin Oral Investig 22:281–292. CrossRefGoogle Scholar
  24. 24.
    Nicol R, Petrina Sweeney M, McHugh S, Bagg J (2005) Effectiveness of health care worker training on the oral health of elderly residents of nursing homes. Community Dent Oral Epidemiol 33:115–124. CrossRefGoogle Scholar
  25. 25.
    Zenthofer A, Cabrera T, Rammelsberg P, Hassel AJ (2016a) Improving oral health of institutionalized older people with diagnosed dementia. Aging Ment Health 20:303–308. CrossRefGoogle Scholar
  26. 26.
    Zenthofer A, Meyer-Kuhling I, Hufeland AL, Schroder J, Cabrera T, Baumgart D, Rammelsberg P, Hassel AJ (2016b) Carers' education improves oral health of older people suffering from dementia—results of an intervention study. Clin Interv Aging 11:1755–1762. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre of Dental Medicine, Department of Operative Dentistry and PeriodontologyUniversity of CologneCologneGermany
  2. 2.Institute of Medical Statistics and Computational BiologyUniversity of CologneCologneGermany

Personalised recommendations