Papers by Gert-Jan van der Putten
Journal of Clinical Medicine, Jun 27, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Special Care in Dentistry, Oct 22, 2016
This paper describes demographic data, risks, causes, and some severe physical consequences of fa... more This paper describes demographic data, risks, causes, and some severe physical consequences of fall accidents of older people and valuable recommendations for prevention of fall accidents of older people in oral healthcare centers.
The oral health of older individuals can be negatively impacted by various systemic health factor... more The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal carers. Regardless of their health status, it is crucial to prioritize the well-being of older people. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.
International Journal of Dental Hygiene, Apr 24, 2023
ObjectivesTranslating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter‐r... more ObjectivesTranslating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter‐rater reliability among community nurses.MethodsThe original version of the OHAT was translated following the five stages of the ‘Guidelines for the Process of Cross‐Cultural Adaptation’. After a forward and backward translation, consensus on the pre‐final version was obtained in an expert panel discussion. This version was pre‐tested on its comprehensibility among 31 nurses and hereafter finalized. Then, inter‐rater reliability of the OHAT‐NL was determined by two trained nurses during oral assessments of 37 care‐dependent community‐dwelling older people. Intraclass correlation coefficient (ICC) and the Cohen's kappa statistic for individual items were estimated.ResultsFeedback from nurses in the pre‐test did lead to minor changes of the OHAT‐NL. Inter‐rater reliability was good (ICC 0.79; 95% CI 0.63–0.89) on the total score. Agreement on item level ranged from fair to very good, the kappa ranged from 0.36–0.89.ConclusionsOHAT is now available in Dutch having good inter‐rater reliability among trained community nurses. Future research can further validate the OHAT‐NL and develop intervention according to total OHAT‐NL scores.
Tijdschrift Voor Gerontologie En Geriatrie, 2015
Journal of Oral Hygiene & Health, 2015
Objectives: To determine nursing staff's current knowledge on providing oral hygiene care to pati... more Objectives: To determine nursing staff's current knowledge on providing oral hygiene care to patients with neurological disorders, to develop a structured basic oral examination guideline and flowchart, to educate and train the nursing staff practically concerning performing a structured basic oral examination, and to compare their perceptions on their knowledge and skills before and after education and practical training. Methods: The study was performed at a hospital's department for patients with neurological disorders in the Netherlands. The study was conducted in two Projects: (1) using a questionnaire, several aspects of providing oral hygiene care by the nursing staff were examined; (2) a guideline for a structured basic oral examination was developed, the nursing staff received training to use the guideline, the potential increase of the nursing staff's knowledge and skills was evaluated using a scoring form before and after the education and practical training and their perception on performing this examination was assessed using 11 questions. Results: (1) The nursing staff experienced some problems during providing oral hygiene care and demonstrated a lack of knowledge on cleansing and handling removable dentures, whereas they considered themselves adequately skilled. (2) Education and practical training did not improve their knowledge and skills, but enhanced their perception of competence significantly. Conclusions: The nursing staff demonstrated a lack of knowledge. Education and practical training enhanced their perception of their knowledge and skills concerning performing a structured basic oral examination.
BMC Oral Health, May 28, 2019
Background: The oral health of community dwelling frail older people is poor, and depends on the ... more Background: The oral health of community dwelling frail older people is poor, and depends on the oral health care provisions available within their own community. The implementation project 'Don't forget the mouth!' (i.e., the intervention) was created with the aim of maintaining and improving the oral health and the general health of community dwelling frail older people, with education and interdisciplinary collaborations of health care professionals and informal caregivers. Critical scientific assessment of the intervention will be described in this study protocol, focused on community dwelling older people with dementia. Methods: This protocol describes a prospective longitudinal single-blind multicentre study, which will take place in 14 towns, each with an intervention and a control group receiving oral health care as usual. Assessment will take place four times during 12 months (i.e., at baseline, after 3, 6, and 12 months). Participants are 65 years and older, community dwelling, and suspected of dementia by their home care worker. The home care organizations will inform, and approach their clients about the study, before the researcher will reach out. The effectiveness of the intervention will be determined with the primary outcome variable 'oral hygiene', assessed through the presence of dental plaque (DP) or dental prosthetic plaque (DPP). The secondary outcome variables are: 'oral health', 'oral health related quality of life', 'oral health care behaviour', 'general health and care dependency', and 'compliance of the health care professionals'. Discussion: This protocol aims to assess the effectiveness of the implementation project 'Don't forget the mouth!' focused on community dwelling older people with dementia. The strengths of the current study are the national roll-out of the intervention, interdisciplinary collaborations and education, and the scientific evaluation over the course of 12 months. The threats and weaknesses are in the recruitment procedure, and the adherence and compliance of the health care professionals to the project. Trial registration: The Netherlands Trail Register NTR6159.
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, Sep 1, 2011
Objectives-To determine the validity and properties of the Summated Xerostomia Inventory-Dutch Ve... more Objectives-To determine the validity and properties of the Summated Xerostomia Inventory-Dutch Version in samples from Australia, The Netherlands, Japan and New Zealand. Study design-Six cross-sectional samples of older people from The Netherlands (N = 50), Australia (N = 637 and N = 245), Japan (N = 401) and New Zealand (N = 167 and N = 86). Data were analysed using the Summated Xerostomia Inventory-Dutch Version. Results-Almost all data-sets revealed a single extracted factor which explained about half of the variance, with Cronbach's alpha values of at least 0.70. When mean scale scores were plotted against a "gold standard" xerostomia question, statistically significant gradients were observed, with the highest score seen in those who always had dry mouth, and the lowest in those who never had it. Conclusion-The Summated Xerostomia Inventory-Dutch Version is valid for measuring xerostomia symptoms in clinical and epidemiological research.
Journal of Clinical Medicine
The oral health of older individuals can be negatively impacted by various systemic health factor... more The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. This paper aims to present an overview of the published evidence on systemic health factors that contribute to rapid oral health deterioration in older individuals, and to explore the implications of these factors for both general healthcare and oral healthcare provision. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral he...
International Journal of Dental Hygiene
Background: Complex dentitions and decline in adequate oral hygiene in elderly may lead to poor o... more Background: Complex dentitions and decline in adequate oral hygiene in elderly may lead to poor oral health. This may have impact on their general health, wellbeing and quality of life. With increased longevity, the problems and needs in oral health of community dwelling elderly lead to changes in oral health care needs. We identified and prioritized problems and needs in oral health of community dwelling elderly. Methods: The problems and needs in oral health of community dwelling elderly were elicited during focus groups and interviews. The list of problems and needs derived thereof was presented to 97 elderly who prioritized these. Results: Overall, older people appeared to be satisfied with their current oral health, and the maintenance and care for their oral health. Cost of care was identified as a major problem in general. There are differences in current perceived problems and needs and problems and needs anticipated for the future. Perceived current problems and needs conce...
Nutrients, 2020
The aim of this study was to gain insight into the nutritional status, dietary intake and muscle ... more The aim of this study was to gain insight into the nutritional status, dietary intake and muscle health of older Dutch hip fracture patients to prevent recurrent fractures and to underpin rehabilitation programs. This cross-sectional study enrolled 40 hip fracture patients (mean ± SD age 82 ± 8.0 years) from geriatric rehabilitation wards of two nursing homes in the Netherlands. Assessments included nutritional status (Mini Nutritional Assessment), dietary intake on three non-consecutive days which were compared with Dietary Reference Intake values, and handgrip strength. Muscle mass was measured using Bioelectrical Impedance Analysis and ultrasound scans of the rectus femoris. Malnutrition or risk of malnutrition was present in 73% of participants. Mean energy, protein, fibre and polyunsaturated fat intakes were significantly below the recommendations, while saturated fat was significantly above the UL. Protein intake was <0.8 in 46% and <1.2 g/(kg·day) in 92%. Regarding micr...
Increasing evidence reveals significant interactions between oral health and general health that ... more Increasing evidence reveals significant interactions between oral health and general health that are unidirectional and often bidirectional, making the challenges of poor oral health considerable. In this chapter, the associations between oral health and (aspiration) pneumonia, diabetes mellitus, cardiovascular diseases, dementia, nutrition, frailty, and other disorders in older people are discussed. A bidirectional association has been shown between periodontitis and diabetes and related guidelines have been developed, addressed to healthcare practitioners. The presence of oral biofilm may increase the risk of respiratory tract infections in frail older people. Poor oral health has been associated with cognitive decline and oral infections with cardiovascular disorders. Poor oral health may also be associated with dietary changes and malnutrition. However, a causal correlation between oral health and most of these disorders has too little scientific evidence. When assessing potenti...
BMC Oral Health, 2019
Background: The oral health of community dwelling frail older people is poor, and depends on the ... more Background: The oral health of community dwelling frail older people is poor, and depends on the oral health care provisions available within their own community. The implementation project 'Don't forget the mouth!' (i.e., the intervention) was created with the aim of maintaining and improving the oral health and the general health of community dwelling frail older people, with education and interdisciplinary collaborations of health care professionals and informal caregivers. Critical scientific assessment of the intervention will be described in this study protocol, focused on community dwelling older people with dementia. Methods: This protocol describes a prospective longitudinal single-blind multicentre study, which will take place in 14 towns, each with an intervention and a control group receiving oral health care as usual. Assessment will take place four times during 12 months (i.e., at baseline, after 3, 6, and 12 months). Participants are 65 years and older, community dwelling, and suspected of dementia by their home care worker. The home care organizations will inform, and approach their clients about the study, before the researcher will reach out. The effectiveness of the intervention will be determined with the primary outcome variable 'oral hygiene', assessed through the presence of dental plaque (DP) or dental prosthetic plaque (DPP). The secondary outcome variables are: 'oral health', 'oral health related quality of life', 'oral health care behaviour', 'general health and care dependency', and 'compliance of the health care professionals'. Discussion: This protocol aims to assess the effectiveness of the implementation project 'Don't forget the mouth!' focused on community dwelling older people with dementia. The strengths of the current study are the national roll-out of the intervention, interdisciplinary collaborations and education, and the scientific evaluation over the course of 12 months. The threats and weaknesses are in the recruitment procedure, and the adherence and compliance of the health care professionals to the project. Trial registration: The Netherlands Trail Register NTR6159.
Journal of the American Medical Directors Association, 2018
Good oral health in old age is particularly important for maintaining adequate oral function, pre... more Good oral health in old age is particularly important for maintaining adequate oral function, preventing pain and discomfort, controlling localized or systemic inflammation, sustaining social interaction and preserving quality of life. Given that oral health is an integral part of general health and well-being, and that major chronic systemic and oral diseases share common risk factors, oral health prevention and promotion should be embedded within routine medical assessment and care provision. The role of medical physicians, particularly primary care physicians, geriatricians and elderly care physicians, in community and long-term care facilities in assessing and promoting oral health in frail older adults is critical and has been emphasized in recent European recommendations. All physicians should appreciate the importance of oral health and incorporate an initial oral health screening into routine medical assessment and care. A short interview with patients and carers on current oral health practices may help to assess the risk for rapid oral health deterioration. The interview should be followed by an oral health assessment, using validated tools, for non-dental health care providers. Based on these findings the physician should decide on necessary follow-up procedures which may include oral health counseling and/or dental referral. Oral health counseling should include advice on daily oral, mucosal and denture hygiene, denture maintenance, dietary advice, smoking cessation, limitation of harmful alcohol consumption, management of xerostomia and frequent dental review. To enable physicians to perform the tasks recommended in this publication appropriate teaching at both undergraduate and postgraduate levels must be delivered in addition to provision of appropriate continuing education courses.
International journal of health services : planning, administration, evaluation, 2018
Retaining natural teeth for longer, together with increasing care dependency in the elderly, has ... more Retaining natural teeth for longer, together with increasing care dependency in the elderly, has the potential to hamper adequate oral self-care and service provision. The aim of this qualitative study was to compare and contrast views from a multi-stakeholder perspective on the future priorities for oral health care services of older people in the United Kingdom and the Netherlands. A participatory setting partnership was undertaken with 4 key stakeholder groups in the United Kingdom and the Netherlands. A final consensus group considered collective responses. The views of the different groups were recorded, transcribed verbatim, and analyzed thematically. Two main themes derived: "individual well-being" and "underlying principles of service provision." Codes relating to principles of service provision focused on the importance of developing quality criteria, improving access, prevention and screening, awareness raising, education and training, together with mul...
Journal of clinical periodontology, 2017
Over the last two decades, progress in prevention and treatment of caries and periodontal disease... more Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed ...
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Papers by Gert-Jan van der Putten