Table 1 Comprehensive geriatric assessment suggested in the treatment planning concepts for geriatric oral care
From: Comprehensive geriatric assessment for oral care in older adults: a focus group study
Model | Studied mention the model | Studies design | Outcomes and conclusion | CGA components for oral treatment planning | |
|---|---|---|---|---|---|
1. | OSCAR model | K. Shay, 1994 (Shay, 1994) [18] | Review article | - Identifying the needs of patients beyond the oral cavity - Provides recommendations for dentists to gather data and work with patients to establish a plan of care that best addresses dental needs and medical and functional limitations, given fiscal realities. | - Systemic conditions - Current medication - Oral health conditions - Socioeconomic factors - Dependency - Communication - Cognitive ability - Life expectancy |
R L Ettinger, 2015 (Ettinger, 2015) [22] | Review article | - Discusses various treatment planning concepts for the ageing patient (OSCAR model, minimal invasive dentistry, and rational dental care) | |||
2. | Rational dental care model | T. E. Johnson, et.al., 1997 (Johnson et al., 1997) [23] | Review article | - Discusses the concept of dental treatment planning for older patients, which can be a complex process due to the influence of multiple age-associated dental, systemic, and psychosocial factors. - Clinicians should focus on the issues of biologic age and life expectancy, rather than relying solely on chronological age, when identifying and weighing factors that can influence treatment planning. | - Oral health conditions - Systemic conditions - Current medication - Socioeconomic factors - Dependency - Communication - Cognitive ability - Life expectancy |
R. L. Ettinger, 2006 (Ettinger, 2006a) [24] | Review article | - Introduce the concept of "rational dental care" as a framework of decision-making that allows a clinician to develop the most appropriate care in the best interests of the patient after weighing all the underlying or modifying factors. | |||
| Â | R. L. Ettinger, 2006 (Ettinger, 2006b) [25] | Review article | - Describes a case history that illustrates the use of a decision tree and a step-wise approach to treatment planning, which is an example of the rational treatment model in clinical use. | ||
I. A. Pretty, 2014 (Pretty, 2014) [17] | Review article | - Emphasizes the significance of considering vulnerability in assessing oral health needs and proposes integrating vulnerability into needs assessments. - Suggests adopting a life course approach and a "rational dental care" approach that considers patients' desires, ability to maintain oral health, positive outcomes, and quality of life. | |||
P. Stein, et.al., 2015 (Stein & Aalboe, 2015) [26] | Review article | - Emphasizing the need for dentists to consider modifying factors and attentively listen to patients to understand their chief complaint and expectations. - Risk assessment plays a critical role in identifying early intervention and implementing preventive strategies to minimize patient suffering. | |||
| Â | R L Ettinger, 2015 (Ettinger, 2015) [22] | Review article | - Discusses various treatment planning concepts for the ageing patient (OSCAR model, minimal invasive dentistry, and rational dental care. | ||
3. | The Seattle Care Pathway and The Lucerne Care Pathway | I. A. Pretty, et.al., 2014 (Pretty et al., 2014) [17] | Review article | - The Seattle Care Pathway is a structured, evidence-based approach to care for older dental patients. - The pathway is presented in tabular form and further illustrated by examples in the form of clinical scenarios. - The paper emphasizes the need for effective prevention and treatment to be linked to levels of dependency and the need for a varied and well-educated workforce. | - Oral health conditions - Systemic conditions - Dependency - Frailty assessment - Communication - Cognitive ability - Socioeconomic factors |
P. Stein, et.al., 2015 (Stein & Aalboe, 2015) [26] | Review article | - Highlights the importance of treatment planning for frail and dependent older adults - Mentions the seattle care pathway as a framework that provides a detailed pathway for oral assessment, prevention, treatment, and communication in this population | |||
| Â | A. Geddis-Regan, et.al., 2018 (Geddis-Regan & Walton, 2018) [27] | Review article | - Highlights the complexity of treatment planning for complex older adults, emphasizing the need for of comprehensive and tailored treatment planning for this population. - Recommends using resources such as the seattle care pathway and fgdp guidance for managing care effectively. | ||
FDI World Dental Federation, 2019 ("FDI World Dental Federation, Managing older adults: Chairside guide. 2019 Sep;07,")Â | Â Clinical guideline | - The Lucerne Care Pathway, derived from the Seattle Care Pathway, aims to identify different levels of dependency in older adults that will guide interventions for securing oral health in this population. - This chairside guide offers recommendations for targeted service delivery, avoiding under- and over-treatment and promoting a life-course approach to oral health. - Emphasizes the link between oral and general health, highlights the vulnerability of older adults to oral diseases, and stresses the need for prevention and dependency-based management. | |||
4. | ROHD concept | L. Marchini, et.al., 2019 (Marchini et al., 2019) [28] | Review article | - Discuss ROHD concept which is a significant concern for older adults, especially those who are frail and dependent. - Risk factors for ROHD can be categorized into general health conditions, social support, and oral health conditions. | - Oral health conditions - factors related to oral health deterioration - Systemic conditions - Medication - socioeconomic factors - cognitive ability - mental health |
Marchini L, et.al., 2017 (Marchini et al., 2017) [29] | a mixed-methods approach, (qualitative and quantitative methods.) | - Introduces ROHD - Discusses the development and evaluation of a learning strategy using critical thinking to teach dental students how to assess this risk. | |||