Short Communication
Survey for nursing home caregivers on the effectiveness of denture marking
2024 年 2 巻 1 号 p. 16-19
詳細
2024 年 2 巻 1 号 p. 16-19
This study aimed to elucidate the situations in which denture misplacement occurs in nursing homes and to investigate the effectiveness of denture marking, in which a plate with the user’s name is placed into a removable denture and filled with a clear resin. The participants were 68 caregivers from 3 nursing homes. Pre- and post-surveys were collected 1 year after the implementation of denture marking. Among the participants, 30.9% experienced misplaced dentures, and 94.1% responded in the post-survey that denture marking would reduce the incidence of denture misplacement for other residents. These results indicate the usefulness of denture marking in nursing home residents.
The participants were 80 caregivers from three nursing homes for older adults where we provide home-visit dental treatment. These nursing homes provide comprehensive care for older adults who require constant nursing care and have difficulty living at home. Pre- and post-surveys were conducted with a 1-year interval following denture marking. The survey period was from May 2023. Because the questionnaires were filled out without names to protect personal information, we explained that the submission of questionnaire indicates their willingness to participate in this study. Therefore, we did not determine whether the respondents to the pre- and post-surveys were the same individuals. The same number of individuals (n = 68) responded to the post- and pre-surveys. Therefore, the survey response rate for each was 85%. This study was approved by the ethics review committee of Ohu University (Approval No. 329).
Pre- and post-surveysThe pre-survey items were as follows: 1. Experience with misplaced dentures? (yes/no). If yes, who (resident/caregiver) and when (upon waking/at mealtime/cleaning dentures after meals/bedtime/others). 2. Shortage of caregivers? (yes/no). 3. Identification of full dentures (clearly distinguishable/administratively, yes). 4. Identification of partial dentures (clearly distinguishable/administratively, yes). 5. If denture marking is implemented, destruction/breakage of dentures will decrease/misplacement of dentures will decrease.
However, the post-survey items were as follows: 1. With denture marking, caregivers can confidently hand out dentures to residents? (yes/no). 2. Has denture marking decreased denture misplacement? (yes/no). 3. Denture marking has made residents more careful in handling their dentures/a little more careful in handling their dentures/not change the way they handled their dentures. 4. Denture marking has made caregivers more careful in handling their dentures/a little more careful in handling their dentures/not change the way they handled their dentures. 5. Denture marking is effective when identified in disasters/during simultaneous cleaning for multiple residents/when misplaced dentures/increase the user’s affinity for the denture/increase the caregiver’s affinity for the denture).
Statistical methodsAll survey items were categorical variables. Statistical analysis was conducted using IBM Statistical Package for the Social Sciences version 29 for Windows (IBM, Armonk, NY, USA). Comparisons between facilities were made using chi-squared tests and Bonferroni correction. The significance level was set to 5%.
Table 1 presents the results of the pre-survey. The incidence of denture misplacements was significantly higher at Facility B than at Facility A (p < 0.05) and Facility C (p < 0.05). Regarding denture identification, the proportion of caregivers at Facility C who answered “clearly distinguishable” was significantly higher than that at Facility A (p < 0.05). Meanwhile, no significant differences were observed in the identification of partial dentures between facilities.
| Total (n = 68) |
Facility |
p-value* (multiple comparisons§) |
|||
|---|---|---|---|---|---|
| A (n = 24) | B (n = 24) | C (n = 20) | |||
| n (%) | n (%) | n (%) | n (%) | ||
| Experience with misplaced dentures | 21 (30.9) | 12 (50.0) | 24 (100.0) | 9 (45.0) | <0.001 (A vs. B, B vs. C) |
| Who: resident | 7 (10.3) | 6 (25.0) | 24 (100.0) | 1 (5.0) | 0.061 |
| Who: caregiver | 19 (27.9) | 10 (41.7) | 24 (100.0) | 9 (45.0) | 0.198 |
| When: upon waking | 12 (17.6) | 8 (33.3) | 24 (100.0) | 4 (20.0) | — |
| When: at mealtime | 6 (8.8) | 2 (8.3) | 24 (100.0) | 4 (20.0) | — |
| When: cleaning dentures after meals | 4 (5.9) | 2 (8.3) | 24 (100.0) | 2 (10.0) | — |
| When: bedtime | 2 (2.9) | 2 (8.3) | 24 (100.0) | 0 (0.0) | — |
| When: others | 1 (1.5) | 1 (4.2) | 24 (100.0) | 0 (0.0) | — |
| Shortage of caregivers? | 6 (8.8) | 5 (20.8) | 24 (100.0) | 1 (5.0) | 0.069 |
| Full denture | 0.015 (A vs. C) |
||||
| Clearly distinguishable | 16 (23.5) | 1 (4.2) | 7 (29.2) | 8 (40.0) | |
| Administratively, yes | 52 (76.5) | 23 (95.8) | 17 (70.8) | 12 (60.0) | |
| Partial denture | 0.348 | ||||
| Clearly distinguishable | 33 (48.5) | 9 (37.5) | 14 (58.3) | 10 (50.0) | |
| Administratively, yes | 35 (51.5) | 15 (62.5) | 10 (41.7) | 10 (50.0) | |
| If denture marking is implemented | |||||
| Destruction/breakage of dentures will decrease | 41 (60.3) | 15 (62.5) | 13 (54.2) | 13 (65.0) | 0.737 |
| Misplacement of dentures will decrease | 63 (92.6) | 24 (100.0) | 20 (83.3) | 19 (95.0) | 0.077 |
*: Chi-squared test, §: Multiple comparisons using Bonferroni correction (p < 0.05).
—: cannot be analyzed.
Table 2 presents the results of the post-survey. Among the caregivers, 83.8% answered “with denture marking, caregivers can confidently hand out dentures to residents,” and 94.1% answered “denture marking decreased denture misplacement.” Regarding the effectiveness of denture marking, 91.2% of caregivers answered “when misplaced dentures,” and 85.3% answered “when identified in disasters.” No significant differences were observed between facilities, as most respondents indicated that denture marking was effective.
| Total (n = 68) |
Facility |
p-value* (multiple comparisons§) |
|||
|---|---|---|---|---|---|
| A (n = 31) | B (n = 18) | C (n = 19) | |||
| n (%) | n (%) | n (%) | n (%) | ||
| With denture marking, caregivers can confidently hand out dentures to residents. | 57 (83.8) | 26 (83.9) | 13 (72.2) | 18 (94.7) | 0.178 |
| Has denture marking decreased denture misplacement? | 64 (94.1) | 30 (96.8) | 15 (83.3) | 19 (100.0) | 0.068 |
| Denture marking has made residents | 0.883 | ||||
| more careful in handling their dentures | 15 (22.1) | 8 (25.8) | 4 (22.2) | 3 (15.8) | |
| a little more careful in handling their dentures | 20 (29.4) | 9 (29.0) | 6 (33.3) | 5 (26.3) | |
| not change the way they handled their dentures | 33 (48.5) | 14 (45.2) | 8 (44.4) | 11 (57.9) | |
| Denture marking has made caregivers | 0.457 | ||||
| more careful in handling their dentures | 23 (33.8) | 12 (38.7) | 3 (16.7) | 8 (42.1) | |
| a little more careful in handling their dentures | 14 (20.6) | 5 (16.1) | 5 (27.8) | 4 (21.1) | |
| not change the way they handled their dentures | 31 (45.6) | 14 (45.2) | 10 (55.6) | 7 (36.8) | |
| Denture marking is effective | |||||
| when identified in disasters | 58 (85.3) | 26 (83.9) | 16 (88.9) | 16 (84.2) | 0.881 |
| when simultaneous cleaning for multiple residents | 22 (32.4) | 10 (32.3) | 3 (16.7) | 9 (47.4) | 0.137 |
| when misplaced dentures | 62 (91.2) | 30 (96.8) | 15 (83.3) | 17 (89.5) | 0.266 |
| increase the user’s affinity for the denture | 18 (26.5) | 9 (29.0) | 7 (38.9) | 2 (10.5) | 0.135 |
| increase the caregiver’s affinity for the denture | 18 (26.5) | 9 (29.0) | 7 (38.9) | 2 (10.5) | 0.135 |
*: Chi-squared test, §: Multiple comparisons using Bonferroni correction (p < 0.05).
Although denture marking has been said to be effective in preventing denture misplacement1,2), reports on when exactly misplacement or loss occurs are scarce. Denture marking is information about a user of removable denture placed on the surface of or embedded in the denture to help identify the user1,2). The methods of denture marking utilize the patient’s initials, name, bar code, or microchip2). Another approach is to use a face photo3,4), a metal plate with a face photo and ID number5), or a memory card6). In nursing homes, bar codes and microchips are not suitable due to the need to identify individuals in a group setting. We performed a procedure in which the printed name on a tape made of polyethylene terephthalate was embedded in the denture and covered with a clear resin.
Our pre-survey results showed that all respondents at Facility B reported experiencing denture misplacement, suggesting that Facility B had a significantly higher percentage than at Facility A or C. At Facility B, after dentures were cleaned in the common washing area, dentures of residents who could not manage their dentures due to dementia were kept in a denture case. In this situation, it is possible for the dentures to be put into another resident’s denture case. In fact, on more than one occasion during a dental visit, the facility caregivers gave the denture case with the name of the resident scheduled for treatment containing another resident’s denture. The environment in which the dentures were mistakenly stored in another resident’s denture case may have been the reason for the high rate of denture misplacements. Because our results indicated that most cases of denture misplacement occurred “upon waking” (17.6%) and “at mealtime” (8.8%), we speculate that checking the names of both the denture and the case when the denture is stored may reduce the misplacement rate.
Although denture marking has been said to be effective in preventing denture misplacement, reports on when exactly misplacement or loss occurs are scarce. Endo et al.7) reported a 1.01% rate of lost dentures in geriatric facilities in Japan 1 year, with two cases possibly due to accidental discarding during bed making and excrement disposal or loss while organizing luggage at the time of admission. The novelty of our findings is that we investigated the specific timing of denture replacement. Our post-survey results indicated that 94.1% of the caregivers across all facilities answered that denture marking prevents denture misplacement, with no differences between facilities. Furthermore, for the question of “effectiveness of denture marking,” 91.2% answered “when misplaced dentures,” and 85.3% answered “when identified in disasters,” confirming that denture marking is effective for caregivers for the same reasons as those proposed in the field of dentistry1,2). The limitations of this study ought to be addressed. First, age and sex of the caregivers are unknown because of the anonymous survey. Secondly, because the items in the pre- and post-denture marking surveys are not identical, it may not be an objective assessment.
In conclusion, the results indicated that about 30% of caregivers at nursing homes had experienced denture misplacement and that the most common occurrence was when handing over dentures upon waking or at mealtime.
The authors thank all the staff of Hikari no mori no oka, Mihota, and Ile village for their cooperation during the survey.
The authors declare no conflicts of interest.
