Table 1 Objective parameters
From: Oral health assessment in institutionalized elderly: a scoping review
Assessment | Number of unique studies | Studies | Description of assessment |
|---|---|---|---|
Dental status | 63 | ||
DMFT – decayed, missed, filled teeth | 38 | [29, 35, 38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73] | Decayed Missed Filled Teeth Index - Based on the presence of teeth and use of dentures, elders were classified as CD: complete dentures, edentulous without CD, partially dentate with prosthesis and partially dentate without prosthesis [38] - Including root caries [52] |
DMF(R)S – decayed, missed, filled (root) surfaces | 3 | Decayed filled (root) surfaces | |
Dental status (presence and number of teeth) | 21 | [5, 27, 40, 45, 57, 71, 76,77,78,79,80,81,82,83,84,85,86,87,88,89,90] | Presence (0 or 1) of own teeth and/or the number of teeth |
Number of occluding pairs | 6 | Number of functional occluding pairs with static contacts | |
Dental treatment need | 6 | - Grades 0: no treatment needed, 1: treatment needed [27] - Restorative/prosthodontic/extractions/urgent care [56] - Need for treatment: filling/extraction/denture/other [29, 92] - Treatment need: presence of retained roots, decayed teeth, suspicious changes mucosa or swelling [46] - Dental treatment need: preventive, routine, non-urgent, urgent or immediate emergency [72] - Simple/complex treatment, dental treatment, extractions [84] | |
Dental risk assessment | 1 | [63] | Individual dental risk assessment was graded from 1 to 4 according to: general risk (general health, compliance), technical risk (previous dental work), dental caries risk and/or periodontitis risk |
Root caries index | 5 | Grades 1–5 on buccal side of teeth | |
Root and/or coronal caries | 12 | Number of teeth with root caries and/or coronal caries | |
Clinical dental functionality score | 1 | [96] | Score based on the number of occluding contacts and whether they are evenly distributed between jaws |
Oral health status | 4 | ||
Oral health status, oral care status, oral status | 3 | - Oral health status scored as poor/medium/good, based on several clinical aspects (dental visits/oral mucosa condition/presence of teeth) [97] - Oral care status of teeth, mucous membranes and dentures scored as good/fair/poor [92] - Presence of oral status problems: gingivitis, caries, tooth fracture [87] | |
Oral health index | 1 | [71] | Oral health index was created: ranging from 0–9, the sum of all parameters. OHI score of less than 3 was acceptable, higher score than 6 was high need for oral care. Parameters: caries/root remnants, periodontium, oral hygiene and denture |
Periodontal parameters | 42 | ||
Periodontal status CPITN or CPI | 15 | [32, 39, 46, 48, 51, 56, 61, 62, 64, 65, 67, 74, 85, 86, 98] | Community Periodontal Index of Treatment Needs: a screening tool to assess presence or absence of periodontal pockets, calculus and gingival bleeding Community Periodontal Index (CPI) is the modified version of CPITN |
Periodontal parameters according to National Institute of Dental Research Criteria | 1 | [53] | Presence of dental plaque, bleeding, calculus, gingival recession, pocketing, level of attachment |
Periodontal screening (and recording) index | 3 | Score 0–4 for each sextant based on measuring periodontal pockets and the extend of the resulting bleeding | |
Measuring pocket depth | 1 | [55] | Measured mesially and distally of all elements, scores clustered in < 4 mm, = 4 mm and > 4 mm |
Assessment of periodontal status | 1 | [45] | Periodontal status described by presence of calculus and bleeding on probing |
Dutch Periodontal Screening Index | 1 | [71] | Each sextant is scored based on pocket depth (range 0–4). Highest score is the patient’s DPSI score |
Extent and severity index score | 1 | [52] | Periodontal score based on the extent (< 30% is localized, > 30% is generalized) and severity (clinical attachment level slightly (1–2 mm), moderately (3–4 mm) or severely (5 mm) |
Periodontal disease / tooth mobility | 2 | Miller’s classification on tooth mobility | |
Tooth mobility | 1 | [55] | Tooth mobility graded in 1: horizontal mobility less than 1 mm, 2: between 1 and 2 mm mobility, 3: horizontal mobility > 2 mm |
Calculus index | 5 | - Volpe-Manhold Index [39, 86] - Calculus index; ranging 0–3 [43] - Presence/absence calculus [45] - Average calculus score [94] | |
Gingivitis/periodontitis assessment | 1 | [95] | Pocket depth > 5.5 mm, bleeding, suppuration and / or tooth mobility class III |
Plaque index | 21 | [5, 32, 39, 41, 50, 55, 58,59,60, 71, 72, 80,81,82, 86, 88, 93, 94, 99,100,101] | - Plaque index grades 0–3 [39, 41, 50, 60, 71, 80, 86, 88, 94, 99, 101] - Plaque index grades 0–2 [5] - Modified plaque index [82] - Quigly-Hein index grades 0–5 [58, 86] - Mucosal plaque index (MPS) – dentate + edentulous, grades 1–4 [93, 100] - Plaque control record or full mouth plaque score (using plaque indicator, calculated percentage) [32, 41, 59] - Approximal plaque index determined in percentages [55] |
Bleeding index | 7 | - Modified sulcus bleeding index, grades 0–3 [93] - Papilla bleeding index [86] - Gingival bleeding index [32, 35, 98] - Presence of bleeding after probing [45] - Sulcus bleeding index [55] | |
Gingival/gingivitis index | 12 | - Visual appearance of inflammation grades 0–2/0–3 [39, 50, 60, 62, 72, 73, 80, 86, 88, 99, 102] | |
Oral hygiene | 23 | ||
Oral Hygiene Index (OHI) | 10 | - OHI: combination of debris index and calculus index for 12 tooth surfaces—grades 0–3 [49, 86] - s-OHI: uses only 6 tooth surfaces [40, 43, 54, 73, 83, 102] - m-OHI: summation of average debris index and calculus index [46] - UM-OHI: using disclosing agent, determines plaque in 12 regions [47] | |
Denture Hygiene Index | 8 | - Grades excellent, fair, poor [40, 83] - Percentage 0–100% [32, 41, 81, 98] - Scoring dentate/mucosal surface of the denture, maximum score 10 [55] | |
Denture cleanliness | 1 | [90] | Denture cleanliness was defined as good, medium, poor |
Biofilm index for dentures | 1 | [101] | Score 0–4 for presence of biofilm on the denture in 5 areas |
Food debris / debris index | 5 | - Food debris after rinsing, 6-point scale [86] | |
Tongue coating index | 2 | - Tongue coating coverage, grades 0–4 [99] - Using the classification by Miyazaki [76] | |
Oral hygiene assessment based on dependency | 1 | [92] | The extent to which the patient can independently practice oral hygiene |
Independence of oral care | 1 | [76] | The ability to independently perform oral selfcare |
Oral hygiene status | 2 | - Presence of calculus, plaque and gingival bleeding used for a subjective assessment based on the dentists’ judgement to evaluate oral hygiene status [35] - Oral hygiene status scored based on the presence and amount of calculus [87] | |
Denture related parameters | 35 | ||
Presence of dentures | 23 | [27, 29, 38, 40, 42, 45, 48, 51, 60, 64, 65, 67, 70, 73, 77, 78, 81, 85,86,87, 90, 91, 103] | Presence or absence of removable denture |
Denture fit or condition | 10 | Fit of the removable denture | |
Presence and retention/stability | 2 | Presence and retention / stability of removable denture | |
Type, fit and condition of denture | 1 | [49] | Type, fit and condition of the removable denture by the classification of Vigild |
Denture quality | 1 | [85] | Quality of the removable denture was scored on a gravity scale |
Prosthetic need | 1 | [72] | Prosthetic need was defined as: no prosthesis needed (0), full denture (1) or partial denture needed (2), denture realignment (3) |
Oral function | 9 | ||
Masticatory performance / chewing efficiency | 3 | Twenty chewing cycles with two-color chewing gum. After flattening, the gum was scanned and colorimetric assessment was performed [38, 59] or a score was given, grades 1–5 [27] | |
Clinical dental functionality (CDF) score | 1 | [96] | CDF score is based on the even distribution of functional contacts in the upper and lower jaw |
Swallowing threshold | 1 | [38] | The number of chewing cycles performed by the patient to chew a portion of unsalted roasted peanuts |
Swallowing test | 1 | [76] | Water swallowing test with 3 mL cold water, than swallow twice, grades 1–5 |
Oral dryness | 1 | [93] | Mirror-sliding friction test |
Dry mouth (wetness tester) | 1 | [76] | Measuring dry mouth by a new wetness tester, grades 0–3 |
Salivary secretion/salivary IgA, pH/halitosis and mouth opening | 1 | [105] | All parameters were measured according to guidelines |
Salivary gland flow rates | 1 | [53] | Unstimulated and stimulated salivary flow was collected using a modified Carlson-Crittenden cup |
Krogh-Poulsen test | 1 | [46] | Test using a flat, thin wedge to determine cracked teeth, damaged dentures, occlusive surfaced and joint pain |
Oral pathology | 16 | ||
Stomatitis, presence of denture-related stomatitis | 3 | Denture stomatitis grading I – III [48] | |
Prevalence of oral lesions | 1 | [87] | Presence or mixture of the following lesions: Candidiasis, aphthous ulcer, cheilitis, fistula, abscess, red or white lesion, dry mouth |
Presence of oral lesions | 1 | [49] | Presence or absence of oral pathology, such as swellings, sinus tracts, ulceration and stomatitis |
Mucosal lesions | 1 | [85] | Presence of mucosal lesions: generalized stomatitis, denture-induces ulcers or various |
Presence of oral pathology | 1 | [50] | Presence of denture stomatitis, angular cheilitis, oral ulceration, fissured tongue, red or white lesions |
Presence of mucosal pathology | 1 | [51] | Presence of ulceration, leukoplakia, angular cheilitis, fibrous lesions, denture stomatitis |
Oral mucosal lesions | 1 | [56] | Presence of oral mucosal lesions, tooth defects, bone disorder |
Oral soft tissue | 1 | [90] | The oral soft tissues were examined for the presence of erythema, mucosal plaques, atrophic glossitis, pseudomembranous candidosis, stomatitis, gingivitis, denture induced hyperplasia and denture-induced ulceration |
Soft tissue lesions | 1 | [104] | Presence of soft tissue lesions |
Mucosal rating scale | 1 | [53] | Presence of erythemic or leukoplakic lesions, ulcerations and erosions |
Oral mucosa condition | 1 | [97] | Presence of denture-induced stomatitis, inflammatory papillary hyperplasia, chronic atrophic candidiasis |
Alterations of oral mucosa | 1 | [55] | Alterations of oral mucosa (not further specified) |
Treatment need oral mucosa or gingiva | 1 | [92] | Assessment of care status of mucous membrane (good, medium, poor) |
Oral tissue anomalies scale | 1 | [94] | Based on Roed Peterson and Renstrup [106]; an examiner rates the presence of tissue anomalies. The number of anomalies was summed to create oral tissue anomalies score |
Halitosis | 2 | ||
Oral odour Halitosis | 2 | [107] [76] | Oral odour was examined by opening the mouth and make an ‘ah’ sound for 5 s, grades 0–4 Halitosis was categorized by 6 stages, scores from 3 to 5 indicated the presence of halitosis |