Interventions promoting oral hygiene behaviors among community-dwelling older adults: A review of the literature

Introduction. Though dental diseases are often preventable and reversible, they are one of the most prevalent chronic problems that plague older adults. Community-dwelling older adults are especially vulnerable to dental diseases as they are often hard-to-reach, impoverished, and frail. While it is known that oral health interventions targeting older adults in long-term care (i.e., nursing homes) are effective, little is known about existing oral health interventions for community-dwelling older adults and effective strategies for promoting oral hygiene behaviors. Therefore, a review of oral health interventions targeting non-institutionalized older adults was conducted.

Methods. Literature searches were conducted in five electronic databases. The inclusion criteria were interventions that: 1) aimed to promote oral hygiene behaviors; 2) targeted community-dwell older adults directly (not only targeting health care professionals); and 3) written in English.

Results. Data were extracted from ten peer-reviewed articles. Common theories used were the Health Belief Model and Social Cognitive Theory. All but one of these interventions used pre- and post-intervention evaluation with psychosocial determinants, gingival bleeding, and/or plaque scores as outcomes. The strategies utilized include workshops, song, oral hygiene demonstrations, referrals to dental clinics, and dissemination of brochures.

Conclusion. These articles suggest that oral health interventions that effectively change oral hygiene behaviors among older adults address psychosocial determinants that include knowledge, self-efficacy, attitudes, and beliefs, especially beliefs related to fatalism. This review highlights the need for evidence-based and theory-informed oral health interventions targeting this population and more robust study designs especially those evaluating the long-term effects of behavior change strategies.