Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.01922
Revista de Odontologia da UNESP
Original Article

Intra- and interobserver reliability of nurses and dentists in the assessment and screening of oral conditions of institutionalized older adults

Confiabilidade intra e interobservador de enfermeiro e cirurgião-dentista na avaliação e triagem das condições bucais de idosos institucionalizados

Larissa Gregório SILVA; Jessica THOMAZ; Ana Lúcia Schaefer Ferreira MELLO; Betina FANTUZZI; Sissiane MARGREITER; Daniela de Rossi FIGUEIREDO

http://dx.doi.org/10.1590/1807-2577.01922 Rev. odontol. UNESP, vol.51, e20220019, 2022
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Abstract

Abstract: Introduction: older persons in Long-Term Care (LTC) facilities have functional impairments and a higher disease prevalence. Nurses’ comprehensive assessment of older persons’ health is highlighted, including using tools for screening dental treatment needs.

Objective: to report the intra- and inter-observer reliability of older adults’ oral health assessment in LTC facilities by video.

Material and method: descriptive study, in three LTC facilities, in the Florianópolis region, Southern Brazil. Data were collected according to Oral Health Assessment Tool (OHAT), which presents 8 categories (“lips, tongue, gums/tissues, saliva, natural teeth, dentures, dental hygiene, and toothache”), and the scores 0=healthy, 1=presence of changes (could be a need for care), 2=unhealthy (need for dental service); final score from 0 to 16. In each LTC facility, a Nurse assessed oral conditions and made a video of each older adult using a smartphone. The dentist performed the oral health assessment through the videos. Estimated Kappa test, p<0.05.

Result: the sample was 34 older adults, 71% were female. Interobserver reliability between Nurses 1 and 2 and Dentist for “lips” and “natural teeth” was classified as poor and excellent/very good for toothache and denture conditions. The nurse’s intraobserver reliability was classified as weak for the “natural teeth” assessment.

Conclusion: the OHAT showed reliability for assessing denture conditions and pain. However, nurses’ training for recognizing oral conditions that require dental care is suggested, as well as the management of this action by the dentist and LTC facilities.

Keywords

Oral health, teledentistry, long term assistance

Resumo

Resumo: Introdução: idosos em Instituições de Longa Permanência (ILPIs) possuem comprometimento da capacidade funcional e maior prevalência de agravos bucais. Destaca-se o papel do profissional enfermeiro na avaliação integral do idoso inclusive com instrumentos para identificação e encaminhamento para tratamento odontológico.

Objetivo: descrever a confiabilidade intra e interobservador, na avaliação da saúde bucal de idosos em ILPIs por vídeo.

Material e método: estudo metodológico, em três ILPIs da Grande Florianópolis, Sul do Brasil. Foi utilizado o instrumento Avaliação da Saúde Bucal para Triagem Odontológica (ASBTO), que possui oito categorias (“lábios”, “língua”, “gengivas/tecidos”, “saliva”, “dentes naturais”, “dentadura”, “higiene” e “dor de dente”), segundo escores 0=saudável, 1=presença de alterações (podendo haver necessidade de atendimento), 2=não saudável (necessidade de atendimento) e escore final de 0 a 16. Um Enfermeiro, em cada ILPI, avaliou as condições bucais presencialmente e realizou vídeo com smartphone de cada idoso. Um cirurgião-dentista avaliou as condições bucais à partir desses vídeos. Foi estimado o teste de Kappa, p<0,05.

Resultado: amostra de 34 idosos, 71% do sexo feminino. Confiabilidade interobservador entre os enfermeiros 1 e 2 e cirurgião-dentista para “lábios” e “dentes naturais” foi classificada como fraca e excelente/muito boa para dor de dente e condição das dentaduras segundo dois enfermeiros. Confiabilidade intraobservador dos enfermeiros foi classificada como fraca para avaliação dos “dentes naturais”.

Conclusão: o ASBTO mostrou-se confiável na avaliação das condições de prótese e dor, entretanto sugere-se maior capacitação dos Enfermeiros para o reconhecimento de condições bucais que requerem atendimento odontológico, assim como, a gestão deste processo pelo cirurgião-dentista e ILPIs.
 

Palavras-chave

Saúde bucal, teleodontologia, assistência de longa duração

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Submitted date:
05/06/2022

Accepted date:
07/01/2022

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