Abstract
As the Government of Canada develops a new national dental plan for high-risk groups, it is timely to assess how non-invasive preventive dental care can be integrated into our overall healthcare system.Many older adults with chronic disease receiving home healthcare services experience poor oral health; A first-of-its-kind study is examining the use and delivery of Prevora (DIN 02046245) to avoid compounding health problems and costly care visits, while evaluating improvements in oral health, general health, and quality of life for patients in home care.The St. Joseph Health Systems Center for Integrated Care (The Centre) and St. Joseph Home Care are integrating preventive oral healthcare into the home healthcare programs of high-risk adult patients. The study is co-sponsored by CHX Technologies and Innovation Factory Southern Ontario Pharmaceutical and Health Innovation Ecosystem (SOPHIE) program, funded through FedDev, and is being facilitated through The Research Institute of St. Joe Hamilton. The study team is observing improvements in oral health, blood markers of inflammation, cholesterol and glucose, improvements in respiratory conditions, additional costs of care, and quality of life over five months of home care visits. Prevora is applied during a routine home care visit and patients are assessed on their oral health status during subsequent visits. Patients were involved in the design of the study and enrolled patients are providing feedback on overall experience after every interaction with study team members.Several factors have limited the delivery of preventive dental services in the hospital and home. Conventional delivery of dental hygiene services requires both significant equipment and time, and hence are expensive and difficult to deliver in home care settings and some procedures are technique sensitive and beyond the scope of skills, competencies and procedures of homecare providers. Specifically, the Centre is evaluating Prevora (DIN 02046245) as an additional homecare service to improve the health and recovery of patients. Prevora is approved to reduce root caries in high-risk adults and has for many years been shown to treat all stages of periodontal disease. The provision of treatment using Prevora is non-invasive and can be done rapidly (applied in minutes) without special equipment. The procedure can be performed readily by a nurse or PSW during a routine homecare visit. Importantly, at a point in time when the spread of respiratory airborne pathogens has become a major issue, this treatment emits no aerosols.The study full results are expected in the second quarter of 2024..To evaluate Prevora ability to improve oral health in adults with COPD or CHF or on dialysis or with chronic metabolic conditions (e.g., hypertension and diabetes) correlated with chronic oral inflammation and who are receiving home healthcare services.2. To evaluate Prevora ability to change blood-based markers of inflammation, serum cholesterol, serum glucose and glycated hemoglobin (HbAC) between the study start and end. An evaluation of Prevora effect on self-reported wheezing events will also be conducted.3.To evaluate qualitative measures of treatment effect in terms of a survey of participants for tolerability to treatment, general well-being, and willingness to continue treatment.4. To evaluate the feasibility of integrating preventive oral health services into a home healthcare program, including provider response to a survey, logistics, costs, training requirements, and revenues so as to define best practices for integration.Link between poor oral health and chronic disease.Opportunity to incorporate preventative healthcare into 'reactive' publicly funded health systems.Importance of and opportunity associated with integrated home and community services.Secure funding to support incorporation of preventive oral healthcare into standardized care paths for patients with chronic disease.