Gerodontology最新文献

{"title":"Determining the most appropriate socioeconomic status indicator for describing inequalities in dental visits by Japanese older people.","authors":"Hiroo Morohoshi, Yusuke Matsuyama, Takashi Zaitsu, Akiko Oshiro, Katsunori Kondo, Jun Aida","doi":"10.1111/ger.12755","DOIUrl":"https://doi.org/10.1111/ger.12755","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the association between various socioeconomic status (SES) indicators and dental visits among older Japanese.</p><p><strong>Background: </strong>When examining health inequalities, an adequate indicator of SES should be applied. In older adults, wealth and pensions are considered more appropriate indicators of SES than education and income, but few studies have examined.</p><p><strong>Methods: </strong>This cross-sectional study used data from 12 391 individuals aged 65 years or older from the 2016 Japan Gerontological Evaluation Study (JAGES). The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were applied to examine the association of education, income, wealth and pensions with dental visits for treatment and check-up adjusting for covariates.</p><p><strong>Results: </strong>The mean age of the participants was 74.0 ± 6.2 years. In the previous year, 56.3% of participants had visited a dentist for a check-up, and 65.9% had visited for treatment. Inequalities in dental treatment visits were observed for wealth, pensions and income rather than education. Income was not significantly associated with check-up visits. Wealth showed the largest association with dental visits for treatment [(SII 0.09, 95% CI 0.06 to 0.13), (RII 1.14, 95% CI 1.09 to 1.21)] and check-up [(SII 0.08, 95% CI 0.05 to 0.12), (RII 1.16, 95% CI 1.09 to 1.23)].</p><p><strong>Conclusion: </strong>When measuring inequalities in access to dental care among the older population, wealth and pensions could be important indicators of SES.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food insecurity and its relationship to mental health and oral health in older adults.","authors":"Jane J Lee, Lloyd A Mancl, Eunjung Kim, Donald L Chi","doi":"10.1111/ger.12757","DOIUrl":"https://doi.org/10.1111/ger.12757","url":null,"abstract":"<p><strong>Background and objectives: </strong>Poor oral health disproportionately affects low-income older adults, for whom food insecurity and poor mental health may affect dental health. We explored the associations between food insecurity, mental health, and dental health. Furthermore, we examined whether mental health impacted the associations between food insecurity and dental health.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional study with a convenience sample of 226 older adults (aged 50+), employing survey and dental screening data. Participants were recruited from seven community-based organisations in Washington State, USA. We calculated descriptive statistics and conducted Chi-square tests, t tests, and logistic regression analyses to assess the associations between aspects of dental health (untreated decay, gum disease, and unmet dental needs), mental health (depression and cognitive function), and food insecurity.</p><p><strong>Results: </strong>In our sample, food insecurity was observed in 28.4%, 40.6% had untreated decay, 31.6% gum disease, and 42.5% unmet dental needs. Food insecurity was associated with a higher occurrence of untreated decay and unmet dental needs. Participants experiencing food insecurity had higher odds of gum disease (aOR = 2.3; 95% CI: 1.1, 5.2) and unmet dental needs (aOR = 3.2; 95% CI:1.4, 7.6). Greater gum disease due to food insecurity was observed among individuals with lower levels of cognitive impairment.</p><p><strong>Conclusion: </strong>Food insecurity is associated with poorer oral health among older adults and cognitive function may modify this relationship. These findings underscore the importance of addressing both food insecurity and cognitive impairment as integral components of efforts to improve the oral health of older adults.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of teledentistry use among residents and staff in aged residential care facilities in the Otago region of New Zealand.","authors":"Beatrice Ming Ming Ng, Ariyapala Samaranayaka, Graeme Ting, Moira Smith","doi":"10.1111/ger.12752","DOIUrl":"https://doi.org/10.1111/ger.12752","url":null,"abstract":"<p><strong>Objectives: </strong>To assess ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ, and identify end-user-level factors associated with its use.</p><p><strong>Background: </strong>Difficulty in accessing oral healthcare services is a key barrier to aged residential care (ARC) residents' oral health and well-being. Teledentistry offers a possible solution, yet studies on its acceptability in ARCs are sparse, especially in New Zealand (NZ). This study assessed ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ and identified end-user-level factors associated with its use.</p><p><strong>Materials and methods: </strong>Rest home-level residents and care staff in ARC facilities in the Otago region of NZ were surveyed to assess their awareness of teledentistry, perceptions of benefit and comfort using teledentistry, and end-user-level factors associated with the feasibility of using it in ARCs.</p><p><strong>Results: </strong>One hundred residents and 77 care staff from 14 facilities participated. Three-quarters of resident participants thought that teledentistry was beneficial. Three in five resident participants were comfortable receiving remote dental consultations and care advice through teledentistry. Acceptability, as measured by perceived benefits and comfort, was lower among older participants. Staff participants were receptive to teledentistry use for residents and were comfortable facilitating remote dental consultations and care through teledentistry. No staff participants disagreed with the potential benefits of teledentistry for ARC residents.</p><p><strong>Conclusion: </strong>Teledentistry would likely be acceptable to residents and staff in ARC facilities in NZ, contributing to residents' improved access to oral health care and improved oral health and well-being.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired oral status is associated with sarcopenic obesity in post-stroke patients.","authors":"A. Shiraishi, Yoshihiro Yoshimura, H. Wakabayashi, F. Nagano, A. Matsumoto, S. Shimazu, Y. Kido, T. Bise, Aomi Kuzuhara, Kota Hori, Takenori Hamada, Kouki Yoneda, Kenichiro Maekawa","doi":"10.1111/ger.12756","DOIUrl":"https://doi.org/10.1111/ger.12756","url":null,"abstract":"PURPOSE\u0000Oral problems and muscle health are indeed significant concerns in ageing populations. However, there is limited evidence concerning the association between these issues. The study's focus was to investigate the association between oral problems and sarcopenic obesity, wherein sarcopenia and obesity coexist concurrently, in post-stroke patients.\u0000\u0000\u0000METHODS\u0000This retrospective, observational, cross-sectional study included patients hospitalised for post-stroke rehabilitation. Oral problems were assessed using the Revised Oral Assessment Guide (ROAG). Sarcopenic obesity was diagnosed according to the European Society of Clinical Nutrition and Metabolism/European Association for the Study of Obesity criteria. Multiple linear regression analysis was used to examine the association between the ROAG and sarcopenic obesity after adjusting for confounding factors.\u0000\u0000\u0000RESULTS\u0000A total of 760 patients were included, with a mean (SD) age of 71 (9) years, of whom 408 (54.7%) were male. The median (interquartile range, 25th and 75th percentiles) ROAG was 11 [9, 13]. Sarcopenic obesity was diagnosed in 16 (3.9%) men, 18 (5.1%) women, and 34 (4.5%) patients overall. Multivariate linear analysis showed that ROAG was significantly and positively associated with sarcopenic obesity (β = .091, P = .023), followed by obesity alone (β = .084, P = .044), and sarcopenia alone (β = .081, P = .037).\u0000\u0000\u0000CONCLUSION\u0000Oral problems were associated with sarcopenic obesity in post-stroke. Oral assessment and intervention may have a positive impact on ADL and QOL in post-stroke patients with sarcopenic obesity.","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"104 16","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health self‐management barriers among rural older adults in Guangxi, China: A qualitative study","authors":"Li‐Juan Wei, Chun‐Xi Chen, Ke Wei, Xiao‐Yuan Mo, Shu‐Yu Lu, De‐Jing Fan, Min Wang, Hui‐Qiao Huang, Pin‐Yue Tao","doi":"10.1111/ger.12754","DOIUrl":"https://doi.org/10.1111/ger.12754","url":null,"abstract":"BackgroundObjective: To understand the barriers associated with self‐management of oral health among rural older adults in Guangxi, and to explore the high incidence of oral problems. This information will assist in the formulation of relevant strategies to solve the oral health problems in this population.MethodsTaking a phenomenological approach, the current status of, and barriers to, oral health self‐management in rural older adults from different regions of Guangxi were explored. Participants were purposively selected and interviewed face‐to‐face.ResultsThe interviews yielded four overarching themes and six corresponding sub‐themes pertaining to barriers in oral health self‐management. These included: (1) Older adults' understanding of oral health and disease, perceptions of oral health and their oral health behaviours; (2) Problems in accessing oral health information; (3) Role of family support; and (4) Barriers to healthcare that included access to dental services, oral treatment experience and financial burden of access to dental care.ConclusionRural older adults in Guangxi face oral health self‐management barriers. Improving access to oral healthcare services and changing existing oral health perceptions and habits may assist them in overcoming self‐management challenges.","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":"72 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140603165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health status, care dependency and oral care utilization among older adults: a register-based study.","authors":"Ina Tapager, Caroline Louise Westergaard, Esben Boeskov Øzhayat","doi":"10.1111/ger.12748","DOIUrl":"https://doi.org/10.1111/ger.12748","url":null,"abstract":"<p><strong>Background and objectives: </strong>The aim of the study was to examine oral care utilisation among older Danes and to describe the extent to which oral care use is associated with the co-existence of challenges relating to general health and care dependency.</p><p><strong>Materials and methods: </strong>The study used registry data covering the entire population of older adults (≥65 years) in seven municipalities in Denmark (N = 178 787 individuals). Oral care services utilisation was computed from administrative data on oral care contacts up to and including 2019, including both private oral care and a municipal oral care programme (MOCP). Various registry data sources were used to compute risk factors to describe oral care utilisation across indicators of general health and care dependency.</p><p><strong>Results: </strong>Indicators for poorer health were associated with larger proportions of individuals enrolled in the MOCPs and larger proportions of non-users of any type of oral care. Higher degrees of care dependency were associated with larger proportions of individuals enrolled in MOCPs and individuals with no use of any oral care services, with the exception of nursing home residents, who comprised a lower proportion of non-users than individuals receiving at-home care. Municipal oral care mainly enrolled older adults who were nursing home residents (60% of nursing home residents were enrolled).</p><p><strong>Conclusion: </strong>Our findings support existing evidence on the link between oral care utilisation and general health and frailty. While the municipal care programmes assisted in covering oral care for those with the highest level of care dependency, future preventive strategies for ensuring care continuity for older adults that are increasing in frailty may want to focus on the earlier stages of frailty and of general health deterioration.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of new complete dentures on the touch perception threshold and quality of life of edentulous patients.","authors":"Paulo Augusto Penitente, Victoria Tiyemi Lopes Onuki, Júlio César Vieira Goiato, Emily Vivianne Freitas da Silva, Clóvis Lamartine de Moraes Melo Neto, Karina Helga Leal Turcio, André Pinheiro de Magalhães Bertoz, Daniela Micheline Dos Santos, Marcelo Coelho Goiato","doi":"10.1111/ger.12753","DOIUrl":"https://doi.org/10.1111/ger.12753","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the touch perception threshold of the alveolar mucosa and quality of life of edentulous patients before (T0) and 30 days after (T1) the insertion of new complete dentures.</p><p><strong>Background: </strong>Touch perception is important so that edentulous patients can detect the position of complete dentures in their mouth.</p><p><strong>Materials and methods: </strong>This study included 32 complete denture wearers with good oral and systemic health and no temporomandibular disorders for at least 5 years. At each time point (T0 and T1), two tests were performed (touch perception threshold and quality-of-life scale). The touch perception threshold (Von Frey or Semmes-Weinstein test) was assessed using nylon monofilaments on the regions of the alveolar mucosa of the maxilla and mandible. The Oral Health Impact Profile for edentulous individuals (OHIP-EDENT) was administered to evaluate oral health-related quality of life.</p><p><strong>Results: </strong>In the maxilla and mandible, the touch perception thresholds for all regions of the alveolar mucosa were significantly lower at T1 than at T0. The OHIP-EDENT mean scores showed that the overall quality of life was significantly better at T1 (3.6) than at T0 (4.7), and a significant improvement in quality of life was observed in all domains of the OHIP-EDENT at T1. For touch perception threshold, effect sizes ranged from 0.4 to 0.8; and for quality of life, effect sizes ranged from 0.4 to 1.0.</p><p><strong>Conclusions: </strong>New complete dentures reduced the touch perception threshold of the alveolar mucosa of both edentulous arches and improved individuals' quality of life.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete denture palatal rugae design impact on satisfaction and quality of life.","authors":"Motasum Abu-Awwad, Mohammad Bustani, Mohammad Alkababji, Farah Majdalawi, Nesreen A Salim, Mahmoud K Al-Omiri","doi":"10.1111/ger.12746","DOIUrl":"https://doi.org/10.1111/ger.12746","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the impact of three complete denture palatal rugae designs on participants' satisfaction and oral-health-related quality of life.</p><p><strong>Background: </strong>Complete dentures palatal rugea are usually polished to a smooth finish, which can affect the patient's adaptation. Roughening or keeping an opening in the rugae area to replicate the natural sensation of the palatal rugae has been suggested but lacks clinical evidence.</p><p><strong>Methods: </strong>This randomised crossover trial included participants with complete dentures randomly allocated to six sequences. Each sequence alternated between polished, roughened, and open rugae designs. Participants evaluated general and domain-specific satisfaction (eating, taste, speaking, phonetics, and ease of cleaning) on a 100-mm visual analogue scale. They also completed the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) and indicated their preferred design at the end. Repeated-measure ANOVA compared satisfaction, and one-way ANOVA with Tukey's test compared OHIP-EDENT scores.</p><p><strong>Results: </strong>Forty-two participants were randomised. Seven dropped out. General satisfaction ratings were comparable for the polished (Mean = 80.2, SD = 19.7) and roughened designs (Mean = 79.5, SD = 20.2). However, the open design had a significantly lower satisfaction rating (Mean = 41.1, SD = 32.2). OHIP-EDENT scores for the open design (Mean = 44.9, SD = 17.5) were significantly worse than those for the polished (Mean = 36.1, SD = 12.7) and roughened designs (Mean = 36.2, SD = 13.3). Two-thirds of the participants chose the polished design. One-third chose the roughened design; of those, 83% were first-time denture wearers.</p><p><strong>Conclusions: </strong>Complete dentures with polished and roughened rugae designs were perceived similarly. Both designs could be recommended based on the patient's preference. However, the open design should be avoided due to negative perception.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between measured masticatory function and cognitive status: A systematic review.","authors":"Kenji Maekawa, Yoshiko Motohashi, Kentaro Igarashi, Takuya Mino, Yasuhiko Kawai, Youngnam Kang, Toshihiro Hirai, Takuo Kuboki","doi":"10.1111/ger.12751","DOIUrl":"https://doi.org/10.1111/ger.12751","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to provide an overview of the most recent evidence on the association between measured masticatory function and cognitive status.</p><p><strong>Materials and methods: </strong>Literature and manual searches were conducted using three electronic databases (PubMed, Web of Science and CINAHL). Observational studies published between 2011 and 2021 investigating the association between masticatory function, dementia and cognitive status in adult humans were abstracted and reviewed by three reviewers. Studies that assessed participants' masticatory function using objective and subjective measurements and that individually examined its association with cognitive function were included. The included studies were divided into cross-sectional and cohort studies, and the quality of each study was analysed using critical appraisal skills checklists. Additionally, the main conclusions and strength of the evidence were assessed for each article.</p><p><strong>Results: </strong>A total of 21 studies (11 cross-sectional studies that objectively evaluated masticatory function, 9 cross-sectional studies that subjectively evaluated masticatory function and 1 prospective cohort study) were evaluated. The poorer masticatory function was associated with lower cognitive status even after adjusting for potential risk factors of dementia in four of 11 and six of nine cross-sectional studies where the masticatory function was respectively evaluated objectively and subjectively. One prospective cohort study also demonstrated that masticatory function, as evaluated based on measurements of occlusal force, predicted cognitive decline during the follow-up period.</p><p><strong>Conclusion: </strong>Several studies demonstrated a positive association between masticatory function and cognitive status. However, further studies, particularly longitudinal studies, are required to determine whether the association is causal.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Setting the context for a complex dental intervention of role substitution in care homes: Initial process evaluation findings.","authors":"Annie Hendry, Sarah R Baker, Gerry McKenna, Georgios Tsakos, Ivor Chestnutt, Craig Smith, Vicki Jones, Ciaran O'Neill, Alison Jenkins, Rachel Evans, Saif Sayeed Syed, Afshan Mirza, Michelle Harvey, Anup Karki, Kirstie Moons, Fiona Sandom, Michael Donaldson, Caroline Lappin, Karen Shepherd, Paul R Brocklehurst","doi":"10.1111/ger.12749","DOIUrl":"https://doi.org/10.1111/ger.12749","url":null,"abstract":"<p><strong>Objectives: </strong>SENIOR (uSing rolE-substitutioN In care homes to improve oRal health) is a randomised controlled trial designed to determine whether role substitution could improve oral health for this population. A parallel process evaluation was undertaken to understand context. This paper reports on the first phase of the process evaluation.</p><p><strong>Background: </strong>The oral health and quality-of-life of older adults residing in care homes is poorer than those in the community. Oral health care provision is often unavailable and a concern and challenge for managers. The use of Dental Therapists and Dental Nurses rather than dentists could potentially meet these needs.</p><p><strong>Materials and methods: </strong>Semi-structured interviews were conducted with 21 key stakeholders who either worked or had experience of dependent care settings. Questions were theoretically informed by the: Promoting Action on Research Implementation in Health Services (PAHRIS) framework. The focus was on contextual factors that could influence adoption in practice and the pathway-to-impact. Interviews were fully transcribed and analysed thematically.</p><p><strong>Results: </strong>Three themes (receptive context, culture, and leadership) and 11 codes were generated. Data show the complexity of the setting and contextual factors that may work as barriers and facilitators to intervention delivery. Managers are aware of the issues regarding oral health and seek to provide best care, but face many challenges including staff turnover, time pressures, competing needs, access to services, and financial constraints. Dental professionals recognise the need for improvement and view role substitution as a viable alternative to current practice.</p><p><strong>Conclusion: </strong>Although role substitution could potentially meet the needs of this population, an in-depth understanding of contextual factors appeared important in understanding intervention delivery and implementation.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}