Paping, L.A.J. (2021) Heeft u gebitsproblemen? In hoeverre is het stellen van de vraag ‘Heeft u gebitsproblemen’ door een huisartsenpraktijk bij kwetsbare ouderen valide om contact en/of eventuele verwijzing naar de mondzorgprofessional te rechtvaardigen? thesis, Dentistry.
Full text available on request.Abstract
Background: The demand for dental care among frail, care-dependent elderly living at home is increasing. Older people visit the dentist less often, making oral health assessment by other professionals more important. In Noord-Limburg general practices the question "Do you have dental problems?" is posed to frail elderly who are still living at home. The aim of this study was to determine to what extent a positive answer to the question "Do you have dental problems?" of a frail elder living at home in a general practice is valid enough to justify contact and/or possible referral to the oral care professional. This paper asks what the validity of this question is for subjective and objective oral health and to what extent does vulnerability or dental situation play a role in this. Method: Questionnaires were administered to the elderly and an oral examination was performed. Two validated instruments were used for oral health namely; the Geriatric Oral Health Assessment Index-NL for subjective oral health and the Oral Health Assessment Tool for objective oral health to determine the validity of the question. The degree of frailty was checked by administering the Groningen Frailty Indicator (GFI). Validity was determined by the sensitivity, specificity, predictive value, likelihood ratios and probability calculated with the corresponding 95% confidence intervals. The question was assessed as sufficiently valid when the sensitivity, specificity, predictive value and probability were 50% or higher. In addition, the positive likelihood ratio must be greater than 1 and the negative likelihood ratio less than 1. Results: Taking the gold standards in account 35% of the participants had subjective and 26% had objective oral health problems. The sensitivity, specificity and probability values of the question were almost all higher than the predetermined 50%. The validity values were different for dentates and edentates, but not for the frail and the non-frail. Conclusion: The question turned out to be valid for frail elderly people with oral health problems to justify contact and/or a referral to the oral care professional. Asking this question was helpful because the study found elderly people with oral health problems that had not yet been resolved. The sensitivity of the question resulted in approximately two thirds of those elderly experiencing subjective, and about half of those experiencing objective oral health problems, to be detected. The specificity of the question resulted in a relatively small group that was incorrectly referred. Where the degree of frailty did not play a role on the validity of the question, the dental situation did. The question was more valid for older people without their own dentition than for older people with their own dentition.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Schuller, Dr. A.A |
| Faculty: | Medical Sciences |
| Date Deposited: | 08 May 2023 11:59 |
| Last Modified: | 08 May 2023 11:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3515 |
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