Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 2;7(1):138.
doi: 10.1186/s40814-021-00872-6.

Improving the oral health of older people in care homes (TOPIC): a protocol for a feasibility study

Georgios Tsakos  1 , Paul R Brocklehurst  2 , Sinead Watson  3 , Anna Verey  1 , Nia Goulden  2 , Alison Jenkins  2 , Zoe Hoare  2 , Kirstie Pye  2 , Rebecca R Wassall  4 , Andrea Sherriff  5 , Anja Heilmann  1 , Ciaran O'Neill  6 , Craig J Smith  7   8 , Joe Langley  9 , Renato Venturelli  1 , Peter Cairns  6   10 , Nat Lievesley  6   11 , Richard G Watt  1 , Frank Kee  6 , Gerald McKenna  6
Affiliations

Improving the oral health of older people in care homes (TOPIC): a protocol for a feasibility study

Georgios Tsakos et al. Pilot Feasibility Stud. .

Abstract

Background: Evidence for interventions promoting oral health amongst care home residents is weak. The National Institute for Health and Care Excellence (NICE) guideline NG48 aims to maintain and improve the oral health of care home residents. A co-design process that worked with residents and care home staff to understand how the NG48 guideline could be best implemented in practice has been undertaken to refine a complex intervention. The aim of this study is to assess the feasibility of the intervention to inform a future larger scale definitive trial.

Methods: This is a protocol for a pragmatic cluster randomised controlled trial with a 12-month follow-up that will be undertaken in 12 care homes across two sites (six in London, six in Northern Ireland). Care homes randomised to the intervention arm (n = 6) will receive the complex intervention based on the NG48 guideline, whilst care homes randomised to the control arm (n = 6) will continue with routine practice. The intervention will include a training package for care home staff to promote knowledge and skills in oral health promotion, the use of the Oral Health Assessment Tool on residents by trained care home staff, and a 'support worker assisted' daily tooth-brushing regime with toothpaste containing 1500 ppm fluoride. An average of ten residents, aged 65 years or over who have at least one natural tooth, will be recruited in each care home resulting in a recruited sample of 120 participants. Assessments will be undertaken at baseline, 6 months and 12 months, and will include a dental examination and questionnaires on general health and oral health administered by a research assistant. A parallel process evaluation involving semi-structured interviews will be undertaken to explore how the intervention could be embedded in standard practice. Rates of recruitment and retention, and intervention fidelity will also be recorded. A cost-consequence model will determine the relevance of different outcome measures in the decision-making context.

Discussion: The study will provide valuable information for trialists, policymakers, clinicians and care home staff on the feasibility and associated costs of oral health promotion in UK care homes.

Trial registration: ISRCTN10276613. Registered on 17th April 2020. http://www.isrctn.com/ISRCTN10276613 .

Keywords: Care homes; Cluster randomised controlled trial; Complex intervention; Feasibility study; Older adults; Oral health.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of recruitment, allocation, consent, intervention and analysis
Fig. 2
Fig. 2
Time schedule of enrolment, interventions, assessments, and visits for participants. t, timepoint; t−2, allocation to study group; t−1, enrolment of participants; t0, baseline assessments; t1, 6-month assessments; t2, 12-month assessments
See this image and copyright information in PMC

References

    1. Office for National Statistics. Adult Dental Health Survey 2009. Summary report and thematic series. 2011. https://digital.nhs.uk/data-and-information/publications/statistical/adu.... Accessed January 2020.
    1. Porter J, Ntouva A, Read A, Murdoch M, Ola D, Tsakos G. The impact of oral health on the quality of life of nursing home residents. Health Qual Life Outcomes. 2015;13(1):102. doi: 10.1186/s12955-015-0300-y. - DOI - PMC - PubMed
    1. Gerritsen A, Allen P, Witter D, Bronkhorst E, Creugers N. Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 2010;8(1):126. doi: 10.1186/1477-7525-8-126. - DOI - PMC - PubMed
    1. Walls A, Steele J. The relationship between oral health and nutrition in older people. Mech Ageing Dev. 2004;125(12):853–857. doi: 10.1016/j.mad.2004.07.011. - DOI - PubMed
    1. Moynihan P. The relationship between nutrition and systematic and oral well-being in older people. J Am Dent Assoc. 2007;138(4):493–497. doi: 10.14219/jada.archive.2007.0201. - DOI - PubMed

LinkOut - more resources