Factors Affecting Older Persons' Ability to Manage Oral Hygiene

Objectives: This study is a step in the development of a new index assessing ability to manage oral hygiene. The aim of the study is to elucidate what factors affect an elderly person's ability to perform self-care oral hygiene.
A great challenge for dental professionals is to support the growing group of elderly in preserving a good oral health. Limitations in ability to manage oral hygiene and an increased number of risk factors is often reflected in poor oral health. Instruments present today assessing ability to manage oral hygiene mainly focus on motor skills. An instrument that includes more factors would be important in preventive work. Such an instrument could be valuable also in other patient-groups like disabled or medically compromised individuals of different ages.
Methods: Data was collected and categorized from four focus group interviews with a total of 23 informants. Three groups consisted respectively of dental hygienists, occupational therapists and assistant nurses, all working with elderly persons. The fourth group consisted of elderly people (72-89 years). The design of the study was qualitative, using content analysis.
Results: The latent content was formulated into the core category ‘Oral hygiene – a complex activity’. Three main thematic categories emerged: ‘Psychological’, ‘Environmental’ and ‘Functional’ dimensions. The psychological dimension described attitude/motivation (e.g. experience, knowledge), emotions (e.g. fear, disgust) and cognitive factors (e.g. impaired memory). The environmental category contained practical conditions and social context. The functional category dealt with bodily and oral function as well as senses (e.g. eyesight).
Conclusions: The study shows that ability to manage oral hygiene is a complex activity consisting of a large number of factors. The identified factors need to be taken into account when developing a future "oral hygiene ability index".