Oral Health Status of Older Adults in Sweden Receiving Elder Care: Findings From Nursing Assessments

Nurs Res. May-Jun 2016;65(3):215-23. doi: 10.1097/NNR.0000000000000158.


Background: Frail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life.

Objective: The aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care.

Methods: Data were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care.

Results: Individuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p < .01); at the subsequent assessment, gender differences in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006) were observed.

Discussion: Most participants had good oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Deglutition Disorders / diagnosis
  • Female
  • Geriatric Assessment / methods
  • Gingivitis / diagnosis
  • Humans
  • Lip Diseases / diagnosis
  • Male
  • Mouth Diseases / diagnosis*
  • Mouth Diseases / nursing
  • Nurse's Role
  • Nursing Assessment / methods*
  • Nursing Homes*
  • Oral Health / statistics & numerical data*
  • Oral Hygiene
  • Saliva / metabolism
  • Sweden
  • Tongue Diseases / diagnosis