A Randomized Controlled Trial of a Care Partner-Assisted Oral Hygiene Intervention for Persons With Mild Dementia

TL;DR

This study tests if care partners can help people with mild dementia improve their oral hygiene using smart toothbrushes and coaching.

Contribution

A novel care partner-assisted oral hygiene intervention with smart toothbrushes and personalized coaching is evaluated for mild dementia patients.

Findings

All groups showed significant reductions in plaque and gingival inflammation over time.

Personalized coaching added to smart toothbrush use (TG2) showed the largest improvements in plaque and gingival inflammation.

Improvements were more sustained in TG2 compared to other groups at 6 months.

Abstract

Oral hygiene contributes to oral health outcomes and quality of life. This study evaluates a care partner-assisted intervention to improve oral hygiene in community-dwelling older adults with mild dementia. We conducted a three-arm randomized controlled trial involving 60 participants with mild dementia and their care partners. Participants were randomized into three arms: (1) control (educational booklet only), (2) Treatment Group 1 (TG1: smart electronic toothbrush without coaching), and (3) Treatment Group 2 (TG2: smart electronic toothbrush plus personalized coaching). Plaque and gingival inflammation were assessed at baseline, 3 months, and 6 months using linear mixed models. All groups showed significant reductions in mean plaque and gingival inflammation from baseline. For plaque, significant reductions were observed at both 3 [β=-0.10 (95% CI, -0.15, -0.06)] and 6 months [β=-0.07 (95% CI, -0.12, -0.03)]. For gingival inflammation, significant reductions were observed at 3 months [β=-0.12 (95% CI, -0.19, -0.05)] but not at 6 months [β= -0.05 (95% CI, -0.12 to 0.02)]. In terms of absolute reduction at study follow up, TG2 showed the largest reduction from baseline in mean plaque [3 months: -0.19 TG2, -0.07 TG1, -0.06 control; 6 months -0.15 TG2, -0.07 TG1, -0.01 control] and gingival inflammation [3 months: -0.22 TG2, -0.07 TG1, -0.05 control; 6 months -0.16 TG2, -0.10 TG1, +0.11 control]. A care partner-assisted intervention may support oral health improvements in individuals with mild dementia, with potential sustained benefits. Larger studies with longer follow-up are needed to fully evaluate the efficacy of the intervention.