The effect of oral hygiene education of care-aides combined with periodontal debridement on the gingival health of institutionalized elders

Objective: This randomized controlled trial tested the effectiveness of educational programs for care-aides combined with periodontal debridement of institutionalized elders on the gingival health of the elders. Methods: the UBC Gingival Bleeding Index (UBC GBl) was calculated following an oral examination by a dental hygienist of 113 elderly residents of 14 long-term care facilities. Care-aides in one randomly selected group of seven facilities received instruction and continuous guidance on oral hygiene care from a nurse-supporter in each facility, while the careaides in the other group received similar instruction from a dental hygienist visiting each facility on one occasion without involving a nurse-supporter. The two groups were then randomly assigned to a "treatment" group who received full periodontal debridement, or a "non-treatment" group who did not receive periodontal debridement. Results: No significant difference in the mean UBC GBl of the four groups at baseline and 3-months was found, but gingival bleeding following periodontal debridement in the nurse-supported/treatment group (UBC GBI=23) was significantly lower than in the nurse-supported/non-treatment group (UBC GBI=58, t=3.488, p=0.002), the Care-aide/treatment group (UBC GBI-47, t= 2.274, p=0.031) or the Care-aide/non-treatment group (UBC GBI=76, t=6.547, p=0.000). Conclusions: The gingival health of institutionalized elders can benefit from an oral hygiene nurse-supported educational program offered to care-aides combined with periodontal debridement.