Home Telecare Program on Oral Health

Item #
Item
1
I can always trust the videoconferencing equipment to work
2
Video visits are a convenient form of dental healthcare for me
3
There were technical problems that made it difficult for me to hear or see the therapista
4
The therapist can get a good understanding of my oral hygiene condition over the videoconferencing
5
The home telecare helps me to better manage my oral health needs
6
Using videoconferencing the therapist will be able to monitor my oral health condition well
7
The use of the videoconferencing equipment seems difficult to mea
8
I would recommend oral home telecare to a friend
9
I got enough information via oral home telecare to perform oral hygiene
10
I felt comfortable with the videoconferencing equipment used relative to in-person
11
I can explain my mouth and tooth care problems well enough during a video visit
12
I can be as satisfied talking to the therapist over videoconferencing as talking in person
13
The lack of physical contact during a video visit is not a problem
14
Oral home telecare can save my time for visiting the therapist
15
Video visits make it easier for me to contact the therapist
16
I would be willing to use oral home telecare again
17
I feel more control over my oral health care since using oral home telecare
18
I am more involved in my oral health care since using home telecare
19
I have become more active in my oral health care since using oral home telecare
20
My oral health is better than it was before I joined the home telecare
21
Oral home telecare violates my privacya
Note: Each item is rated on a 5-point Likert-type scale, where 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree aItems are worded negatively and need to be recoded
Oral Home Telecare Questionnaire (OHTQ) is adapted from the Telemedicine Satisfaction and Usefulness Questionnaire and the Telemedicine Perception Questionnaire [5, 6]. The internal consistency reliability of the OHTQ estimated by Cronbach’s alpha was .87 [4]
In the area of oral hygiene behaviors, an increase in the frequency of daily toothbrushing, dental flossing and the use of an oral irrigator 6 months from baseline was reported, and the same frequency of oral hygiene was maintained at 12 months. In addition, participants brushed their teeth longer during their toothbrushing demonstration at 6- and 12-month assessments. Yuen [4] concluded that an average of five sessions of videoconferencing across 12 weeks of oral hygiene training in the use of adaptive oral hygiene devices was sufficient to increase participants’ oral hygiene frequency and use of adaptive devices. This resulted in a significant reduction of gingival inflammation and the establishment of long-term oral hygiene habits.
In-depth interviews immediately after the 12-week oral home telecare program indicated that participants felt more aware of their oral health and made a more conscientious effort to perform their oral hygiene. Participants generally accepted the new technology (i.e., videoconferencing) and were enthusiastic about having the opportunity to receive oral home telecare educational services. Participants commented that the oral home telecare service was convenient as it was conducted at their home without traveling to a clinic. Few participants had concerns about loss of privacy via videoconferencing. Participants who never had videoconferencing experience felt a little embarrassed or strange during the first encounter with the therapist, but they quickly became used to the therapist looking and talking to them on the screen.

4.3 Types of Clients Who May Benefit from Oral Home Telecare

Based on the literature [14], clients who may benefit most from the oral home telecare are those who demonstrate cognitive impairment and/or physical disabilities, especially upper extremity dysfunction with manual dexterity impairment. For example, clients with brain damage who exhibit hemiparesis and cognitive impairment, and clients with an incomplete injury of the cervical spinal cord segments (i.e., quadriplegia) who have difficulty manipulating a manual toothbrush or dental floss to perform oral hygiene but do not totally depend on others to complete the task. Other vulnerable populations that may benefit from the oral home telecare services include patients with chronic medical conditions such as systemic sclerosis, in which manual dexterity impairments and orofacial dysfunction (e.g., microstomia/small mouth and xerostomia/dry mouth) may complicate oral hygiene and lead to oral health problems [79]. Hand deformity and limited oral aperture may affect oral hygiene performance as well as willingness to perform oral hygiene [7, 10]. Patients may require an adaptive oral hygiene device due to small mouth opening, and need to perform mouth stretching exercises to increase the size of their oral aperture.
The goal of the oral home telecare program is to improve oral hygiene so as to prevent severe oral diseases such as caries and periodontal disease. The program cannot reverse any existing oral disease condition. Therefore, patients who are likely to benefit most from the program are those who have recently received comprehensive dental cleaning and treatment, or those who were recently injured or diagnosed, and need to learn a new set of skills to maintain their oral hygiene, including exercises that can improve their orofacial and manual dexterity function. Some of these patients are home-bound, have limited mobility, and/or use a wheelchair which may impose physical barriers to accessing dental care. Oral home telecare provides an avenue to decrease physical barriers and improve access to oral health care.
Due to the nature of their impairments and disabilities, these patients may require special adaptation of commercially available oral hygiene devices, labor-intensive training in the use of adaptive oral hygiene devices, training on correct performance of mouth stretching exercises, and repeated positive reinforcement to assist in establishing regular mouth stretching exercises and oral hygiene habits. For patients without upper extremity impairment, orofacial dysfunction, or cognitive impairment, this kind of intensive training (i.e., oral home telecare services) is not required. Instead, other avenues for receiving oral health information and training via the Internet, as reported in the literature [11, 12], may be sufficient.
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Sep 17, 2015 | Posted by in General Dentistry | Comments Off on Home Telecare Program on Oral Health
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