scholarly journals PARE0023 ORAL HEALTH IN RHEUMATOID ARTHRITIS: LISTENING TO PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1297.2-1297
Author(s):  
J. Protudjer ◽  
C. Billedeau ◽  
C. Stavropoulou ◽  
A. Cholakis ◽  
R. Schroth ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Oral Health ◽  
Periodontal Disease ◽  
Oral Care ◽  
Structured Interviews ◽  
Face To Face ◽  
Oral Health Education ◽  
To Receive ◽  
Latent Content

Background:Rates of periodontal disease and tooth loss are increased in rheumatoid arthritis (RA). Periodontal disease may exacerbate RA inflammation and complicate RA care. Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and possibly arthritis outcomes. People with RA may have unique needs and/or barriers to maintain oral health.Objectives:To determine from people with RA what are their experiences and perceptions about their oral health, their most important questions relating to oral health, and how they wish to receive oral health information.Methods:Semi-structured interviews were conducted with RA patients. Recorded interview transcripts underwent iterative content analysis. Transcripts were initially reviewed to develop a coding guide. Latent content, or larger themes, were then applied to the transcripts. Constructs were considered saturated when no new themes were identified with subsequent interviews. We report identified themes with representative quotes.Results:Interviews with 11 RA (10[91%] female; all on RA medication) averaged 19 minutes (range 8-31 minutes) and were mostly conducted face-to-face. Many believed RA medication contributed to dry mouth. Most participants had not previously considered other links between oral health and RA. Themes identified included the need for complicated oral health routines, barriers of cost and access to dental care, and shame relating to oral health (Table 1). Participants preferred to receive oral health education from their rheumatologists or dentists over printed or online resources.Conclusion:RA patients have unique needs relating to oral health and report poor oral quality of life. Strategies to optimize oral health in RA may include educational tools for optimizing oral self-care appropriate for RA, and improved access to oral care professionals who are aware of the needs of arthritis patients.Disclosure of Interests:Jennifer Protudjer: None declared, Corrie Billedeau: None declared, Chrysi Stavropoulou: None declared, Anastasia Cholakis: None declared, Robert Schroth: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

Oral Health in Rheumatoid Arthritis: Listening to Patients

2021 ◽  
pp. 238008442110126
Author(s):  
J.L.P. Protudjer ◽  
C. Billedeau ◽  
K. Hurst ◽  
R. Schroth ◽  
C. Stavropoulou ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Oral Health ◽  
Periodontal Disease ◽  
Health Knowledge ◽  
Care Delivery ◽  
Oral Care ◽  
Oral Health Care ◽  
Personal Hygiene ◽  
Health Maintenance

Introduction: Rates of periodontal disease and tooth loss are increased in individuals with rheumatoid arthritis (RA). Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and arthritis outcomes. Objectives: To determine the perceptions held by people with RA relating to their oral health, to identify patient-centered priorities for oral health research, and to inform optimal strategies for delivering oral health knowledge. Methods: Semistructured interviews were conducted with patients with RA. Recorded interview transcripts were iteratively reviewed to reveal surface and latent meaning and to code for themes. Constructs were considered saturated when no new themes were identified in subsequent interviews. We report themes with representative quotes. Results: Interviews were conducted with 11 individuals with RA (10 women [91%]; mean age, 68 y), all of whom were taking RA medication. Interviews averaged 19 min (range, 8 to 31 min) and were mostly conducted face-to-face. Three overall themes were identified: 1) knowledge about arthritis and oral health links; 2) oral health care in RA is complicated, both in personal hygiene practices and in professional oral care; and 3) poor oral health is a source of shame. Participants preferred to receive oral health education from their rheumatologists or dentists. Conclusions: People with RA have unique oral health perceptions and experience significant challenges with oral health care due to their arthritis. Adapting oral hygiene recommendations and professional oral care delivery to the needs of those with arthritis are patient priorities and are required to improve satisfaction regarding their oral health. Knowledge Translation Statement: Patients living with long-standing rheumatoid arthritis described poor oral health–related quality of life and multiple challenges with maintaining optimal oral health. Study findings indicate a need for educational materials addressing oral health maintenance for patients with rheumatic diseases and their providers.

scholarly journals Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study

2021 ◽  
pp. 238008442110419
Author(s):  
M. Hijryana ◽  
M. MacDougall ◽  
N. Ariani ◽  
L.S. Kusdhany ◽  
A.W.G. Walls
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Environmental Factors ◽  
Periodontal Disease ◽  
Older People ◽  
Structured Interviews ◽  
Research Perspective ◽  
The Impact ◽  
People’S Perceptions

Introduction: The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people. Objectives: To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences. Methods: Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes. Results: Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process. Conclusions: Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences. Knowledge Transfer Statement: This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.

scholarly journals Dental care course and oral quality of life in patients with X-linked hypophosphatemia: a qualitative exploration

2021 ◽  
Author(s):  
Lisa Friedlander ◽  
Caroline Nguyen ◽  
Elisabeth Celestin ◽  
Delphine Chambolle ◽  
Agnès Linglart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Health Professionals ◽  
Care Pathway ◽  
Oral Care ◽  
Clinical Signs ◽  
Structured Interviews ◽  
Fgf 23 ◽  
Qualitative Exploration

Abstract Background. X-linked hypophosphatemia (XLH) is a rare, hereditary, progressive, and lifelong phosphate wasting disorder characterized by pathological elevations in fibroblast growth factor (FGF) 23 serum concentration and activity. In the oral cavity, spontaneous abscesses can occur often without any clinical signs of alteration of the causal tooth. The objective of our study was to evaluate the readability of the oral care pathway and the oral quality of life of patients followed in an expert oral medicine department located within a Parisian hospital and working in close collaboration with an endocrinology department expert in this pathology. Methods. This study employed a qualitative descriptive design including semi-structured interviews using guiding themes. Results. Twenty-one patients were included in the study, with an average age of 28 years. The topics discussed exceeded the initial objectives as the patients largely addressed the alteration of their oral and general quality of life, a very chaotic oral health care pathway with oral health professionals not aware of their pathology, consequences on their social, professional, and school integration and access to care complicated by financial factors. Patients reported the importance of having a multidisciplinary team around them, including medical and dental professionals.Conclusions. The variety of manifestations in patients with XLH necessitates a high coordination of multidisciplinary patient care to optimize quality of life and reduce disease burden. Education of oral health professionals on this disease is essential to enable patients to receive the best possible care as early as possible.

scholarly journals POS0581 PERIODONTAL DISEASE IN RHEUMATOID ARTHRITIS: RESULTS FROM A COHORT AT TREATMENT WITH BIOLOGICAL, CLASSICAL AND TARGETED SYNTHETIC DMARDs

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 524.1-524
Author(s):  
R. Dos-Santos ◽  
F. Otero ◽  
E. Perez-Pampín ◽  
A. Mera Varela
Keyword(s):  
Rheumatoid Arthritis ◽  
Oral Health ◽  
Periodontal Disease ◽  
Disease Activity ◽  
Health Problem ◽  
Multivariable Analysis ◽  
Testing Time ◽  
Univariable Analysis ◽  
Clinical Attachment Loss ◽  
Attachment Loss

Background:Periodontal disease (PD) has been widely studied in the pathogenesis of rheumatoid arthritis (RA). As well, its relationship with severity and disease activity, has also been investigated with ambiguous results. It has been suggested that the improvement of oral health could enhance disease activity scores.1 PD prevalence worldwide stands around 60% in older adults (>65 years) and its frequency increases with aging.2Objectives:To asses oral health in RA patients and to identify predictors of PD in this population.Methods:Patients diagnosed of RA at treatment with biological, classical or targeted synthetic disease modifying anti-rheumatic drugs (b/cs/tsDMARDs) in the aforementioned hospital during 2020 performed a dental review with a specialized periodontal odontologist. Oral health patterns were given for all patients, following criteria of American Academy of Periodontology, and reevaluation of disease activity was made 2 months later.Clinical, demographic and treatment data were collected from participants.Univariable logistic regression was performed to identify predictors of PD. Variables with p<0.20 were selected for multivariable analysis.Stata 15.1 was used to perform statistical analysis.Results:81 patients were recruited. 82.72% were female. Mean age was 56.17 years (SD 14.15) and mean time since diagnosis was 15.58 years (SD 8.17). 25% were current or past smokers. 21 patients had comorbidities (arterial hypertension the most frequent). 66.67% were rheumatoid factor (RF) positive and 72.73% anti-citrullinated peptide autoantibody (ACPA) positive. Median erythrocyte sedimentation rate (ESR) was 12 mm (IQR 6;23) and mean C-reactive protein (CRP) was 0.48 mg/dl (SD 1.18). Mean disease activity score (DAS28-VSG) at the testing time was 2.62 (SD 1.21) and after 2 months was 2.39 (SD 0.97). 96.30% of patients were at treatment with csDMARDs, 64.20% with glucocorticoids, 96.30% with bDMARDs and 6 patients with tsDMARDs.Univariable analysis identified higher age, at least one autoantibody positive and ESR/CRP as potential predictors of medium/severe PD (p<0.20). Multivariable testing including these variables pointed out higher age, lower ESR and at least one autoantibody positive (OR 1.09 [CI95% 1.04-1.14] p=0.001, OR 0.18 [CI95% 0.04-0.95] p=0.044 and OR 0.94 [CI95% 0.88-1.00] p=0.042, respectively) as predictors of medium or severe PD (≥3 mm interdental clinical attachment loss).Univariable analysis identified higher age, the presence of any comorbidity and anti tumour-necrosis factor alpha treatment (anti-TNF) as potential predictors of severe PD (p<0.20). Multivariable testing including these variables pointed out higher age (OR 1.15 [CI95%1.02-1.30] p=0.026) as predictor of severe PD (≥5 mm interdental clinical attachment loss).Conclusion:Periodontal disease is still an extended health problem among the entire population. Its prevalence in RA is increased, therefore higher age and RF or ACPA positive are risk factors for developing severe PD. This analysis might suggest that an aggressive management of PD could implement better responses in DAS28. Also anti-TNF treatment could delimit a “penumbra” group of patients at risk of developing severe PD, where intensive manage could modify the final outcome.References:[1]C O Bingham, M Moni. Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol. 2013;25(3):345-353.[2]P Carvajal. Periodontal disease as a public health problem: the challenge for primary health care. Rev Clin Periodoncia inplantol. 2016;9(2):177-183.Disclosure of Interests:None declared

The Influence of Peridontal Screening upon Dental Hygienist Practice in the Royal Navy

1988 ◽  
Vol 74 (3) ◽  
pp. 165-172
Author(s):  
A. J. Woodman
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Treatment Time ◽  
Intensive Therapy ◽  
Treatment Patterns ◽  
Dental Hygienist ◽  
Royal Navy ◽  
Initial Examination ◽  
Oral Health Education ◽  
Periodontal Index

AbstractTreatment patterns and times were observed for 616 Royal Naval personnel following routine referral to a Dental Hygienist. Results were then related to the patient’s periodontal status recorded at their initial examination, using the Periodontal Index for Treatment, to determine whether the Index would allow prediction of the treatment necessary for such patients and whether the Index was being used, as intended, for prioritisation of resources for periodontal care. Results indicated that both the treatment time and oral health education time for each patient were related to the Index and thus to disease severity. However, the results failed to show that the Index was used for prioritising periodontal care and suggested that Dental Hygienist practice is dominated by the treatment of patients with little or no periodontal disease to the disadvantage of a minority of patients requiring intensive therapy for destructive periodontal disease.

scholarly journals Organizing Psycho-Oncological Care for Cancer Patients: The Patient’s Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Anouk S. Schuit ◽  
Karen Holtmaat ◽  
Valesca van Zwieten ◽  
Eline J. Aukema ◽  
Lotte Gransier ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Oncological Treatment ◽  
Face To Face ◽  
Patient’S Perspective ◽  
Oncological Care ◽  
After Cancer ◽  
To Receive

BackgroundCancer patients often suffer from psychological distress during or after cancer treatment, but the use of psycho-oncological care among cancer patients is limited. One of the reasons might be that the way psycho-oncological care is organized, does not fit patients’ preferences. This study aimed to obtain detailed insight into cancer patients’ preferences regarding the organization of psycho-oncological care.Methods18 semi-structured interviews were conducted among cancer patients. Patients completed psycho-oncological treatment between 2015 and 2020 at the psychology department in a general hospital or a center specialized in psychological cancer care in the Netherlands. The interview comprised questions related to preferences regarding the institute where to receive treatment, the psychologist who provides treatment, and the type of treatment, as well as questions related to experienced barriers and facilitators to receive psycho-oncological care. Interviews were digitally recorded and transcribed verbatim. Data were analyzed individually by two coders into key issues and themes.ResultsRegarding the institute, easy accessibility and prompt availability of psychol-oncological care were considered important. Regarding the psychologist, most participants had a strong preference to be treated by a psychologist specialized in cancer or other somatic diseases. Individual face-to-face therapy was preferred above other types of treatment. Several barriers were mentioned to receive psycho-oncological treatment, among which poor accessibility to psycho-oncological care, lack of knowledge on the possibilities for psycho-oncological treatment, and stigma. Most frequently mentioned facilitators were being assertive to ask for help, having a good relationship with the healthcare professional, and the integration of psycho-oncological support within medical cancer care.ConclusionFrom the patient’s perspective, the organization of psycho-oncological care for cancer patients should focus on easy accessibility and availability, delivered by specialized psychologists, and integration in medical cancer care. Online and group therapy are acceptable, but individual face-to-face therapy is preferred. It is warranted to increase awareness on psycho-oncological care targeting both patients and healthcare providers.

scholarly journals Restoration of oral health as one of the important factors improving the quality of life

2021 ◽  
Vol 105 (1) ◽  
pp. 78-81
Author(s):  
N. Zhachko ◽  
◽  
T. Nespriad’ko-Monborgne ◽  
I. Skrypnyk ◽  
M. Zhachko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Periodontal Disease ◽  
Dental Health ◽  
Adult Population ◽  
Communication Process ◽  
Complete Analysis ◽  
Comprehensive Treatment ◽  
The Impact

Summary: The search for and development of methods for determining the quality of life is an urgent problem of foreign and domestic medicine, and the state of dental health plays a very important role. An important role in human communication plays the maxillofacial area. Therefore, the most important areas and defects associated with the communication process – defects in the frontal area, smile, change of pronunciation, spitting during the conversation – all these signs accompany a number of anomalous processes. Objective: to assess the impact of dental status on the quality of life of the adult population in the presence of the disease periodontal disease in combination with musculoskeletal dysfunction in patients with dental anomalies and deformities. Materials and methods. To study this goal, a survey of 283 patients who applied was conducte with complaints of aesthetic defect of the dentition, combined with the presence of joint pain and periodontal disease of varying severity. Results. A complete analysis of factors that significantly affected the quality of life of patients with a number of diseases was obtained oral cavity. Conclusions. Deficiencies related to oral health reduce the quality of life of our patients, and the treatment significantly changes its quality depending on age, sex and method. But for the best results positive changes in the quality of life of the patient dentists can expect only by conducting a comprehensive treatment. Key words: quality of life, dental health correction.

scholarly journals Caregivers’ attitudes, knowledge and practices of oral care at nursing homes in Serbia

2016 ◽  
Vol 73 (7) ◽  
pp. 668-673 ◽  
Author(s):  
Ivica Stancic ◽  
Milos Petrovic ◽  
Aleksandra Popovac ◽  
Miroslav Vasovic ◽  
Nebojsa Despotovic
Keyword(s):  
Oral Health ◽  
Nursing Homes ◽  
Periodontal Disease ◽  
Oral Hygiene ◽  
Oral Care ◽  
The Elderly ◽  
Oral Diseases ◽  
Closed Type ◽  
Work Shifts ◽  
Self Administered Questionnaire

Background/Aim. Within the elderly population, residents in nursing homes, there is a greather risk of caries, periodontal disease and teeth loss. Assistance of caregivers in maintaininig good oral hygiene besides improving oral health can improve of residents general health and the qulity of their lives. The aim of this study was to examine the attitudes of caregivers and knowledge about oral health, as well as the practice regarding oral care they apply at nursing homes in Serbia. Methods. The survey was conducted at the Gerontology Center Belgrade, consisting of four nursing homes located in the urban area. The study included 58 caregivers. They were contacted on working days, in all work shifts, during January, February and March of 2013. They were asked to fill in a self-administered questionnaire consisting of 26 closed-type questions. Results. The caregivers mostly considered that it was very important to take care of oral health of the residents, but 69% responded that the level of their oral health was low or very low. As the main barriers to oral hygiene maintenance, the caregivers indicated lack of time. The caregivers had more knowledge about periodontal disease than about the main cause of caries and its prevention. Formal medical education had the influence on the knowledge about oral diseases. Oral hygiene procedures carried out by the mayority of caregivers were denture cleaning and tooth brushing. Conclusion. The caregivers were aware of the limitations in everyday oral care of nursing homes residents in Serbia, although solving these problems requires the involvement of the entire public health service.

scholarly journals Improving Dental Access and Oral Health of Older Adults Living in Residential Care: A Qualitative Research

2021 ◽  
Vol 10 (02) ◽  
pp. 84-90
Author(s):  
Samantha Glover ◽  
Russell Kabir
Keyword(s):  
Oral Health ◽  
Residential Care ◽  
Care Home ◽  
Oral Care ◽  
Local Area ◽  
Communication Training ◽  
Structured Interviews ◽  
Dental Services ◽  
Care Home Staff ◽  
Residential Care Home

Abstract Objectives To explore the access to daily oral care and access to dentistry for those living in a residential care home. Materials and Methods For this research, a residential care home and a dental practice within the local area to the care home was approached. A total of 45 participants were interviewed. Statistical Analysis Semi-structured interviews with three separate cohorts were performed, the patients or their friends and families, care home staff, and the dental teams. The data were analyzed using thematic analysis. Results The three cohorts of patients had similar concerns in accessing the dentists including transport, communication, training, and the need for raised awareness of the importance of oral health. The access to daily oral care was impacted upon by apathy and lack of education or training. Conclusion Better training is required for care home staff and older people living in care on the importance of oral health. The provision of dental services for this community could be delivered differently with a focus on preventing and maintaining independence as long as possible.

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