Abstract
Background: The Global Burden of Disease Study 2017 estimates that oral diseases affected 3.5 billion people worldwide, with untreated dental caries being among the most prevalent non-communicable diseases. If left untreated, it could lead to pain, swelling, and eventual tooth loss. Tooth loss results in changes in diet, impairment of speech, and reduces one’s quality of life. A 2016 study found that almost 1 in 3 Singaporeans aged 60 and above did not have any teeth. As such, oral health should be part of the comprehensive care for the general well-being of older adults in the community.
Aim: To Increase awareness of oral health knowledge among older adults with chronic diseases from 33% to 83% in 3 months.
Methodology: We recruited the community-dwelling participants who are i) aged 60 years and above, ii) with a minimum of 8 natural teeth, iii) able to comprehend simple instructions, and iv) perform basic activity of daily living. Focused discussions were conducted to explore issues and concerns pertaining to oral health among the participants, followed by individual health coaching with return demonstration. Pre- and post-intervention questionnaires about oral hygiene awareness and Oral-health related Quality of Life (OHRQoL) were conducted. The General Oral Health Assessment Index (GOHAI) questionnaire was used to evaluate the oral health self-perception in older adults.
Results: Seventy-seven participants were included. The educational aid was enhanced with emphasis on oral care and appropriate escalation to seek timely treatment. The post-intervention results showed that there were significant improvements in oral hygiene awareness from 33% to 83% (p<0.05). There was a reduction in the oral pain and discomfort, as reflected by the improvement in the GOHAI score from 47 vs 50 (p<0.05).
Conclusion: The findings highlighted the importance and benefits of increasing oral hygiene awareness through targeted health coaching among older adults in the community. The project team will continue to advocate these enhanced interventions and plan to incorporate oral hygiene assessment and health coaching as standard community nursing practice in the future.
Sustainability: This project is able to achieve the sustainability through incorporating oral frailty assessment and health coaching to community nursing practice, active outreach, and capability building. Singapore General Hospital community nursing team continues to promote Oral Health Movement 8020 in collaboration with National Dental Centre, Singapore at various community engagement platforms.