TY - JOUR

T1 - uSing rolE-substitutioN In care homes to improve ORal health (SENIOR)

T2 - a study protocol

AU - McKenna, Gerald

AU - Tsakos, Georgios

AU - Watson, Sinead

AU - Jenkins, Alison

AU - Masterson Algar, Patricia

AU - Evans, Rachel

AU - Baker, Sarah R

AU - Chestnutt, Ivor G

AU - Smith, Craig J

AU - O'Neill, Ciaran

AU - Hoare, Zoe

AU - Williams, Lynne

AU - Jones, Vicki

AU - Donaldson, Michael

AU - Karki, Anup

AU - Lappin, Caroline

AU - Moons, Kirstie

AU - Sandom, Fiona

AU - Wimbury, Mary

AU - Morgan, Lorraine

AU - Shepherd, Karen

AU - Brocklehurst, Paul

N1 - © 2022. The Author(s).

PY - 2022/8/18

Y1 - 2022/8/18

N2 - BACKGROUND: Dental service provision in the care home sector is poor, with little emphasis on prevention. Emerging evidence suggests that the use of Dental Care Professionals (dental therapists and dental nurses) as an alternative to dentists has the potential to improve preventive advice, the provision of care and access to services within care homes. However, robust empirical evidence from definitive trials on how to successfully implement and sustain these interventions within care homes is currently lacking. The aim of the study is to determine whether Dental Care Professionals could reduce plaque levels of dentate older adults (65 + years) residing in care homes.METHODS: This protocol describes a two-arm cluster-randomised controlled trial that will be undertaken in care homes across Wales, Northern Ireland and England. In the intervention arm, the dental therapists will visit the care homes every 6 months to assess and then treat eligible residents, where necessary. All treatment will be conducted within their Scope of Practice. Dental nurses will visit the care homes every month for the first 3 months and then three-monthly afterwards to promulgate advice to improve the day-to-day prevention offered to residents by carers. The control arm will be 'treatment as usual'. Eligible care homes (n = 40) will be randomised based on a 1:1 ratio (20 intervention and 20 control), with an average of seven residents recruited in each home resulting in an estimated sample of 280. Assessments will be undertaken at baseline, 6 months and 12 months and will include a dental examination and quality of life questionnaires. Care home staff will collect weekly information on the residents' oral health (e.g. episodes of pain and unscheduled care). The primary outcome will be a binary classification of the mean reduction in Silness-Löe Plaque Index at 6 months. A parallel process evaluation will be undertaken to explore the intervention's acceptability and how it could be embedded in standard practice (described in a separate paper), whilst a cost-effectiveness analysis will examine the potential long-term costs and benefits of the intervention.DISCUSSION: This trial will provide evidence on how to successfully implement and sustain a Dental Care Professional-led intervention within care homes to promote access and prevention.TRIAL REGISTRATION: ISRCTN16332897 . Registered on 3 December 2021.

AB - BACKGROUND: Dental service provision in the care home sector is poor, with little emphasis on prevention. Emerging evidence suggests that the use of Dental Care Professionals (dental therapists and dental nurses) as an alternative to dentists has the potential to improve preventive advice, the provision of care and access to services within care homes. However, robust empirical evidence from definitive trials on how to successfully implement and sustain these interventions within care homes is currently lacking. The aim of the study is to determine whether Dental Care Professionals could reduce plaque levels of dentate older adults (65 + years) residing in care homes.METHODS: This protocol describes a two-arm cluster-randomised controlled trial that will be undertaken in care homes across Wales, Northern Ireland and England. In the intervention arm, the dental therapists will visit the care homes every 6 months to assess and then treat eligible residents, where necessary. All treatment will be conducted within their Scope of Practice. Dental nurses will visit the care homes every month for the first 3 months and then three-monthly afterwards to promulgate advice to improve the day-to-day prevention offered to residents by carers. The control arm will be 'treatment as usual'. Eligible care homes (n = 40) will be randomised based on a 1:1 ratio (20 intervention and 20 control), with an average of seven residents recruited in each home resulting in an estimated sample of 280. Assessments will be undertaken at baseline, 6 months and 12 months and will include a dental examination and quality of life questionnaires. Care home staff will collect weekly information on the residents' oral health (e.g. episodes of pain and unscheduled care). The primary outcome will be a binary classification of the mean reduction in Silness-Löe Plaque Index at 6 months. A parallel process evaluation will be undertaken to explore the intervention's acceptability and how it could be embedded in standard practice (described in a separate paper), whilst a cost-effectiveness analysis will examine the potential long-term costs and benefits of the intervention.DISCUSSION: This trial will provide evidence on how to successfully implement and sustain a Dental Care Professional-led intervention within care homes to promote access and prevention.TRIAL REGISTRATION: ISRCTN16332897 . Registered on 3 December 2021.

KW - Aged

KW - Caregivers

KW - Cost-Benefit Analysis

KW - Humans

KW - Oral Health

KW - Quality of Life

KW - Randomized Controlled Trials as Topic

KW - Surveys and Questionnaires

U2 - 10.1186/s13063-022-06487-3

DO - 10.1186/s13063-022-06487-3

M3 - Article

C2 - 35982457

VL - 23

JO - Trials

JF - Trials

SN - 1745-6215

IS - 1

M1 - 679

ER -