Revista de Odontologia da UNESP
Revista de Odontologia da UNESP
Original Article

Educational program in oral health for caregivers on the oral hygiene of dependent elders

Programa educacional em saúde bucal para cuidadores sobre a higiene oral de idosos dependentes

Jéssica Damares LAGO, Laiza Maria Grassi FAIS, Andréia Affonso Barretto MONTANDON, Lígia Antunes Pereira PINELLI

Downloads: 1
Views: 358


Objective: Due increased number of elders living in long-term care institutions, actions designs to improve their oral health are essential. Thus, the aim of this study was to evaluate the impact of an educational program for the caregivers through the assessment of the oral hygiene of institutionalized elders. Material and method: The education program consisted in lectures to caregivers about oral health that were performed once a month. The subjects were 40  functionally dependent institutionalized elders and 14 caregivers. Hygiene habits, plaque index, and tongue coating/discoloration of the elders were measured before the educational program (baseline- T0) and after 6 (T1), 12 (T2), 18 (T3) and 24 months (T4). Caregivers answered questions about their knowledge, doubts and implementation of dental care (T0 to T4). Result: After analyzing the data (Friedman, Chi-square and Spearman α = 0.05), a gradual improvement in the oral hygiene of the subjects was observed, with an increased frequency of brushing (p=0.0005), a change in the brush type (p=0.0065) and a reduction in the plaque index (p<0.05) and tongue coating (p<0.05). Caregivers showed a marked improvement in their dental care knowledge. Conclusion: It was concluded that the educational program for caregivers had a positive impact in the oral health of institutionalized elderly observed by the increased in the effectiveness of oral hygiene parameters such as plaque index and tongue coating, contributing to the knowledge gain in hygiene by caregivers.


Caregivers; dental care for aged; education; homes for the aged; old age assistance.


Objetivo: Devido ao aumento do número de idosos que vivem em instituições de longa permanência são essenciais projetos de ações para melhorar a saúde bucal. Assim, o objetivo deste estudo foi avaliar o impacto de um programa educacional para os cuidadores de idosos institucionalizados por meio da avaliação da higiene bucal. Material e método: O programa de educação consistiu em palestras para cuidadores sobre saúde bucal que foram realizadas uma vez por mês. Foram avaliados 40 idosos institucionalizados dependentes funcionalmente e 14 cuidadores. Os hábitos de higiene, o índice de placa e o revestimento/descoloração da língua dos idosos foram avaliados antes do programa educacional (T0) e após 6 (T1), 12 (T2), 18 (T3) e 24 meses (T4). Os cuidadores responderam perguntas sobre seus conhecimentos, suas dúvidas e sobre a implementação de cuidados bucais (T0 a T4). Resultado: Após análise dos dados (Friedman, Qui-quadrado e Spearman, α = 0,05), observou-se melhora gradual na higiene oral dos idosos, com maior freqüência de escovação (p = 0,0005), alteração do tipo de escova (p = 0,0065) e redução do índice de placa (p <0,05) e revestimento da língua (p <0,05). Os cuidadores mostraram uma melhoria acentuada no seu conhecimento sobre saúde bucal. Conclusão: Concluiu-se que o programa educacional para cuidadores teve um impacto positivo na saúde bucal dos idosos institucionalizados observado pelo aumento na eficácia dos parâmetros de higiene bucal, como índice de placa e revestimento da língua, contribuindo para o ganho de conhecimento em higiene pelos cuidadores.


Cuidadores; assistência odontológica para idosos; educação; instituição de longa permanência para idosos; assistência à idosos


1. Junges R, Portella FF, Hugo FN, Padilha DM, Samuel SM. Caregivers’ attitudes regarding oral health in a long-term care institution in Brazil. Gerodontology. 2014 Sep;31(3):178-83. PMid:23134197.

2. Baat C, Kalk W, Schuil GR. The effectiveness of oral hygiene programmes for elderly people-a review. Gerodontology. 1993 Dec;10(2):109-13. PMid:7713526.

3. Wårdh I, Andersson L, Sörensen S. Staff attitudes to oral health care. A comparative study of registered nurses, nursing assistants and home care aides. Gerodontology. 1997 Jul;14(1):28-32. PMid:9610300.

4. Durso SC. Interaction with other health team members in caring for elderly patients. Dent Clin North Am. 2005 Apr;49(2):377-88. PMid:15755411.

5. MacEntee MI, Kazanjian A, Kozak JF, Hornby K, Thorne S, Kettratad-Pruksapong M. A scoping review and research synthesis on financing and regulating oral care in long-term care facilities. Gerodontology. 2012 Jun;29(2):e41-52. PMid:22098091.

6. Wang TF, Huang CM, Chou C, Yu S. Effect of oral health education programs for caregivers on oral hygiene of the elderly: A systemic review and meta-analysis. Int J Nurs Stud. 2015 Jun;52(6):1090-6. PMid:25724550.

7. Walls A. Developing pathways for oral care in elders: challenges in care for the dentate the subject? Gerodontology. 2014 Feb;31(Suppl 1):25-30. PMid:24446976.

8. Zenthöfer A, Dieke R, Dieke A, Wege KC, Rammelsberg P, Hassel AJ. Improving oral hygiene in the long-term care of the elderly-a RCT. Community Dent Oral Epidemiol. 2013 Jun;41(3):261-8. PMid:23020631.

9. Simons D, Kidd EA, Beighton D. Oral health of elderly occupants in residential homes. Lancet. 1999 May;353(9166):1761. PMid:10347991.

10. Chalmers JM, Hodge C, Fuss JM, Spencer AJ, Carter KD, Mathew R. Opinions of dentists and directors of nursing concerning dental care provision for Adelaide nursing homes. Aust Dent J. 2001 Dec;46(4):277-83. PMid:11838875. tb00292.x.

11. Unfer B, Braun KO, Ferreira AC, Ruat GR, Batista AK. Challenges and barriers to quality oral care as perceived by caregivers in long-stay institutions in Brazil. Gerodontology. 2012 Jun;29(2):e324-30. PMid:21453416.

12. Weening-Verbree L, Huisman-de Waal G, van Dusseldorp L, van Achterberg T, Schoonhoven L. Oral health care in older people in long term care facilities: a systematic review of implementation strategies. Int J Nurs Stud. 2013 Apr;50(4):569-82. PMid:23290098.

13. MacEntee MI, Wyatt CC, Beattie BL, Paterson B, Levy-Milne R, McCandless L, et al. Provision of mouth-care in long-term care facilities: an educational trial.Community Dent Oral Epidemiol. 2007 Feb;35(1):25-34. PMid:17244135.

14. Delgado AM, Prihoda T, Nguyen C, Hicks B, Smiley L, Taverna M. Professional Caregivers’ oral care practices and beliefs for elderly clients aging in place. J Dent Hyg. 2016 Aug;90(4):244-8. PMid:27551145.

15. Simons D, Baker P, Jones B, Kidd EA, Beighton D. An evaluation of an oral health training programme for carers of the elderly in residential homes. Br Dent J. 2000 Feb;188(4):206-10. PMid:10740904.

16. Paulsson G, Söderfeldt B, Fridlund B, Nederfors T. Recall of an oral health education programme by nursing personnel in special housing facilities for the elderly. Gerodontology. 2001 Jul;18(1):7-14. PMid:11813391.

17. Samson H, Berven L, Strand GV. Long-term effect of an oral healthcare programme on oral hygiene in a nursing home. Eur J Oral Sci. 2009 Oct;117(5):575-9. PMid:19758255.

18. McCarney R, Warner J, Iliffe S, van Haselen R, Griffin M, Fisher P. The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol. 2007 Jul;7(1):30. PMid:17608932.

19. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965 Feb;14:61-5. PMid:14258950.

20. Folstein M, Anthony JC, Parhad I, Duffy B, Gruenberg EM. The meaning of cognitive impairment in the elderly. J Am Geriatr Soc. 1985 Apr;33(4):228-35. PMid:3989183.

21. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42(8):703-9. PMid:2760661.

22. Walid EI, Nasir F, Naidoo S. Oral health knowledge, attitudes and behavior among nursing staff in Lesotho. SADJ. 2004 Aug;59(7):288, 290, 292. PMid:15537032.

23. Quigley GA, Hein JW. Comparative cleansing efficiency of manual and power brushing.J Am Dent Assoc. 1962 Jul;65(1):26-9. PMid:14489483.

24. Winkel EG, Roldán S, Van WinkelhoffAJ, Herrera D, Sanz M. Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study. J Clin Periodontol. 2003 Apr;30(4):300-6. PMid:12694427.

25. Munoz N, Touger-Decker R, Byham-Gray L, Maillet JO. Effect of an oral health assessment education program on nurses’ knowledge and patient care practices in skilled nursing facilities. Spec Care Dentist. 2009 Jul-Aug;29(4):179-85. PMid:19573046.

59f859c70e8825135c967cb3 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections