Background
Methods
Data extraction
Results
Study selection
Oral health parameters
Assessment | Number of unique studies | Studies | Description of assessment |
---|---|---|---|
Dental status
|
63
| ||
DMFT – decayed, missed, filled teeth | 38 | 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 | 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] - 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 | 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 | - 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 | - Plaque index grades 0–2 [5] - Modified plaque index [82] - 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] - Presence of bleeding after probing [45] - Sulcus bleeding index [55] | |
Gingival/gingivitis index | 12 | ||
Oral hygiene
|
23
| ||
Oral Hygiene Index (OHI) | 10 | - 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 | - 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 | 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 | ||
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 |
Assessment | Number of unique studies | Studies | Description of assessment |
---|---|---|---|
Dry mouth
|
5
| ||
(Summated) Xerostomia Inventory ((S)XI) | 2 | Eleven or 5 items are scored by the patient, grades 1–3 (my mouth feels dry, difficulty eating dry foods, difficulty swallowing foods, lips feel dry) | |
Xerostomic VAS | 1 | [86] | Visual Analogue Scale to quantify dry mouth, ranges 0–10 |
Dry mouth symptoms and oral motor function | 1 | [105] | Likert scales to rate dry mouth and motor function |
Dry mouth scale | 1 | [94] | Four questions on dry mouth, answered yes or no |
Oral health
|
13
| ||
Oral symptoms | 1 | [78] | Chewing and swallowing problems, dry mouth |
Assessment of oral health | 1 | [108] | Standardized questionnaire on problems with eating, chewing and xerostomia |
Oral function scale and oral problems self-report and oral hygiene | 1 | [94] | Degree of satisfaction with oral functioning, rated 1–5, and questionnaires regarding oral problems and oral hygiene |
Oral symptoms questionnaire | 1 | [57] | Oral symptoms: sensitive teeth, toothache, broken teeth, missing teeth, bleeding gums, dry mouth, burning mouth, dry lips |
Oral conditions | 1 | [88] | Questions concerning: pain in the mouth, bleeding gums, tooth mobility, bad breath, burning mucosa, excess saliva, or dryness, swallowing difficulties, pain in the temporomandibular joint |
Oral health | 2 | Questionnaire on subjective oral health conditions: teeth problems, gum problems, opinion on oral status | |
OHIP and/or GOHAI | 7 | OHIP: Oral Health Impact Profile: a 14-items questionnaire to measure self-reported functional limitation, discomfort and disability to oral conditions GOHAI: Geriatric Oral Health Assessment Index: a 12-items questionnaire to evaluate self-perceived oral health | |
Dental visit checklist | 1 | [97] | Checklist including number of dental visits in the last 2 years and reason of last dental visit |
Oral pain
|
5
| ||
Presence of oral pain in the last 4 weeks | 1 | [49] | Presence of oral pain |
Orofacial-pain scale for non-verbal individuals | 1 | [40] | Orofacial-pain scale for non-verbal individuals |
Tooth/ jaw pain | 1 | [109] | Presence of tooth or jaw pain |
Oral pain | 1 | [46] | Oral pain experienced in past year |
Dental complaints | 1 | [84] | Presence of dental complaints |
Masticatory function
|
1
| ||
Masticatory difficulties (VAS 0–10) | 1 | [59] | Visual Analog Scale to measure masticatory difficulties |
Assessment name | Number of unique studies | Studies | Description of assessment | Validation |
---|---|---|---|---|
OHAT | 8 | Oral Health Assessment Tool Eight categories (lips, tongue, gums and tissues, saliva, natural teeth, dentures, oral cleanliness and dental pain) scored as 0 – healthy, 1 – changes or 2 – unhealthy | Yes [114] | |
ROAG(J) | 5 | Revised Oral Assessment Guide – Jonkoping Evaluation oral health by assessing the condition of voice, lips, oral mucosa, tongue, gums teeth, saliva, swallowing, protheses/implants (grades 0–3) | ROAG: yes [117] | |
ADS | 1 | [118] | Asymptotic Dental Score – sum of oral pathologies: dental caries or one edentulous jaw (grades 0–3), gingivitis (grades 0–1), root remnants (grades 0–2), number of teeth with pockets (grades 0–3). Low ADS 0–2, moderate ADS 3–4 and high ADS 5–9 | No |
Oral health examination instrument | 1 | [109] | An instrument based on OHAT and Oral Health Module. Questions concerning lip health, breath odour, saliva appearance, natural teeth count, gingival inflammation, toot hand jaw pain, presence of dentures, denture fit and hygiene, mucosal status and oral health abnormalities | No |
RAI MDS | 3 | Resident Assessment Instrument – Minimum Data Set. Oral health problems concerning chewing, swallowing, pain, debris, dentures, teeth lost, broken teeth, inflamed gums, daily oral health care | Inconclusive [121] | |
BOHSE | 1 | [122] | Brief Oral Health Status Examination: 10 items reflecting the status of oral health (lips, tongue, tissue inside cheek, floor, roof of the mouth, gums between teeth, saliva, condition of natural teeth, condition of artificial teeth, occluding pairs, oral cleanliness), rated on 3-point scale | Yes [123] |
Dental status
Oral health status
Periodontal parameters
Periodontal screening instruments
-
National Institute of Dental Research Criteria; examination of 6 teeth on 6 sides and assessing presence or absence of dental plaque, gingival bleeding, supra- and subgingival calculus, as well as probing pocket depth [53].
-
Periodontal Screening Index [26]: screening 6 points per tooth and per sextant ranging from 0–4 based on probing depth, bleeding on probing and calculus.
-
Extent and Severity Index [52]: periodontal score based on the extent of periodontitis (clinical attachment loss categorized slight (1–2 mm), moderate (3–4 mm) or severe (5 mm).
-
Dutch Periodontal Screening index [71]: each sextant is scored based on pocket depth (score ranges 0 to 4). The highest score per sextant is recorded.
-
The Miller index score; assessment of tooth mobility (grade 0–3). This measure is used as a marker for severe periodontal problems [45, 76]. One study did not use the Miller index score to assess tooth mobility, but mainly reported horizontal mobility less than 1 mm (score 1), between 1 and 2 mm (score 2) or more than 2 mm (score 3) [76]. The Miller index score was also combined with other parameters such as presence of calculus and bleeding on probing [45].