Evaluating the role of the smartjournal digital intervention in improving oral hygiene among nursing home residents: a cluster randomised trial.

Background: The increasing ageing population has led to increased incidence of chronic conditions, including oral diseases, which are prevalent and overlooked in older adults, especially those in institutional care. Poor oral health is linked to systemic disease, reduced quality of life, and challenges in caregiving, particularly among individuals with dementia who often resist assistance. Barriers related to oral care reported by caregivers include a lack of training, time, and documentation systems. Current interventions largely focus on staff education, with limited and inconsistent outcomes. To support caregivers, a digital tool, the SmartJournal, has been developed to improve oral care through documentation, assessment and education. The aim of the present study was to evaluate the effectiveness of the use of SmartJournal for improving oral hygiene among nursing home residents.

Methods: A pragmatic parallel-group cluster randomised trial was conducted in 12 nursing homes in Rogaland County, Norway. The trial lasted for nine months, with clinical assessments at baseline and at the 3-month and 9-month follow-ups. Randomisation occurred at the nursing home level via simple randomisation. The mucosal-plaque score (MPS) was used as the primary outcome measure. A generalised linear mixed-effects model (GLMM) was used to evaluate the effect of the intervention, adjusted for participant characteristics and clustering, following the intention-to-treat (ITT) approach.

Results: The analysis revealed no significant difference in oral hygiene between the groups at baseline (p = 0.455) or at the second follow-up (p = 0.292). Within-group analysis revealed a significant improvement during the study in the intervention group (p = 0.047).

Conclusions: The SmartJournal intervention led to greater improvement in the oral hygiene score, but the difference between the groups was not statistically significant. A larger-scale study is needed to confirm these findings.

Trial registration: NCT05724043. Date: 2023-01-10.