Oral Health Assessment Tools for Elderly Adults: A Scoping Review

Figures & data

Table 1 Partial Search Strategy and Results

Database	Keywords	Articles	Access Date
CNKI	(SU = “口腔健康”) AND (SU = “工具” + “量表” + “指数”) AND (SU = “评估” + “评价” + “测量”)	206	September 23, 2023
PubMed	#1 “oral health”[MeSH Terms] #2 “oral health”[Title/Abstract] #3 “Tool”[Title/Abstract] OR “Scale”[Title/Abstract] OR “Instrument”[Title/Abstract] OR “Index”[Title/Abstract] #4 “Assessment”[Title/Abstract] OR “Measurement”[Title/Abstract] OR “Evaluation”[Title/Abstract] #1 AND #2 AND #3 AND #4	1296	September 23, 2023

Abbreviations: CNKI, China National Knowledge Infrastructure; SU, Title.

Figure 1 PRISMA flow diagram for the scoping review process.

Notes: Adapted from Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Creative Commons.²³

Table 2 Chronological Overview of Oral Health Assessment Tools

Title	Author	Year	Abbreviations	Tool	Country
An Instrument To Assess the Oral Health Status of Nursing Home Residents^Citation24	Kayser-Jones J, Bird WF, Paul SM, Long L, Schell ES.	1995	BOHSE	Brief Oral Health Status Examination	The United States
Evaluation of a mucosal-plaque index (MPS) designed to assess oral care in groups of elderly^Citation25	Henriksen BM, Ambjørnsen E, Axéll TE.	1999	MPS	Mucosal-plaque Index	Norway
Inter-rater reliability of an oral assessment guide for elderly patients residing in a rehabilitation ward^Citation26	Andersson P, Hallberg IR, Renvert S.	2002	ROAG	The Revised Oral Assessment Guide	Sweden
The Oral Health Assessment Tool – Validity and reliability^Citation27	Chalmers JM, King PL, Spencer AJ, Wright FA, Carter KD.	2005	OHAT	The Oral Health Assessment Tool	Australian
A Single-Item Approach to Screening Elders for Oral Health Assessment^Citation28	Chia-Hui Chen C, Chyun DA, Li CY, McCorkle R.	2007	/	A Single-Item for Oral Health Assessment	Connecticut
Validity and reproducibility of the revised oral assessment guide applied by community health workers^Citation29	Ribeiro, M. T., Ferreira, R. C., Vargas, A. M., Ferreira e Ferreira, E.	2014	ROAG	The Revised Oral Assessment Guide	Brazil
Oral health screening: feasibility and reliability of the oral health assessment tool as used by speech pathologists^Citation30	Simpelaere IS, Van Nuffelen G, Vanderwegen J, Wouters K, De Bodt M.	2016	/	The Modified OHAT Tool	Belgium
Translation and psychometric evaluation of the Kayser-Jones Brief Oral Health Status Examination^Citation31	Zhao CJ, Ding F	2016	/	The Chinese version of Brief Oral Health Status Examination	Chinese
Development of an Oral Assessment Sheet for Evaluating Older Adults in Nursing Homes^Citation32	Yanagisawa S, Nakano M, Goto T, Yoshioka M, Shirayama Y.	2017	OAS	Oral Assessment Sheet	Japan
An oral health and function screening tool for nursing personnel of long-term care facilities to identify the need for dentist referral without preliminary training^Citation33	Tsukada S, Ito K, Stegaroiu R, Shibata S, Ohuchi A.	2017	OHSTNP	Oral Health Screening Tool for Nursing Personnel	Japan
Dental Hygiene Registration (DHR); development, reliability- and validity testing of an assessment scale designed for nurses in institutions^Citation34	Fjeld KG, Eide H, Mowe M, Hove LH, Willumsen T.	2017	DHR	Dental Hygiene Registration	Norway
Reliability and validity test of Chinese version of the Oral Health Assessment Tool^Citation35	Wang JQ, Zhu SZ, Zhan Y, Li J, Liu DN	2019	/	The Chinese version of Oral Health Assessment Tool	Chinese
The oral health‐related section of the interRAI: Evaluation of test content validity by expert rating and assessment of potential reasons for inaccurate assessments based on focus group discussions with caregivers^Citation36	Krausch-Hofmann S, De Almeida Mello J, Declerck D, Declercq A, De Lepeleire J, Tran TD, Lesaffre E, Duyck J.	2019	Ohr‐interRAI	The oral health‐related section of the Resident Assessment Instrument	Belgium
Development of a German version of the Oral Health Assessment Tool^Citation37	Klotz AL, Zajac M, Ehret J, Hassel AJ, Rammelsberg P, Zenthöfer A.	2020	/	German version of the Oral Health Assessment Tool	German
Linguistic-cultural validation of the oral health assessment tool (OHAT) for the Italian context^Citation38	Finotto S, Bertolini G, Camellini R, Fantelli R, Formisano D, Macchioni MG, Mecugni D.	2020	/	Italian version of the Oral Health Assessment Tool	Italian
Assessment of oral health in older adults by non-dental professional caregivers—development and validation of a photograph-supported oral health–related section for the interRAI suite of instruments^Citation39	Krausch-Hofmann S, Tran TD, Janssens B, Declerck D, Lesaffre E, de Almeida Mello J, Declercq A, De Lepeleire J, Duyck J.	2021	/	The optimized ohr-interRAI	Belgium
Development of the European Portuguese version of the oral health assessment tool: Content validity and reliability study in an elderly population^Citation40	Cerveira FR, Matos MAC, Sa-Couto P.	2022	OHAT-EP	European Portuguese version of the OHAT	Portuguese
Development of the Turkish version of the oral health assessment tool: Methodological study^Citation41	Genç FZ, Cingil D, Hisar F.	2023	OHATE	Oral Health Assessment Tool for the Elderly	Turkish
The Dutch version of the Oral Health Assessment Tool: Translation and inter-rater reliability among community nurses^Citation42	van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GH.	2023	OHAT-NL	The Dutch version of the Oral Health Assessment Tool	Dutch

Table 3 Reliability and Validity of Included Studies

Abbreviations	Inter-Rater Reliability	Test–Retest Reliability	Intra-Rater Reliability	Validity
BOHSE	√	√	×	√
MPS	√	×	√	×
ROAG (Andersson et al, 2002)	√	×	×	×
OHAT	√	×	√	√
A Single-Item for Oral Health Assessment	×	×	×	√
ROAG (Ribeiro et al, 2014)	√	×	×	√
The Modified OHAT tool	√	√	√	×
The Chinese version of Brief Oral Health Status Examination	√	√	×	√
OAS	√	×	√	√
OHSTNP	√	×	×	√
DHR	√	×	√	√
The Chinese version of Oral Health Assessment Tool	√	√	×	√
Ohr‐interRAI	×	×	×	√
German version of the Oral Health Assessment Tool	√	√	×	×
Italian version of the Oral Health Assessment Tool	√	√	×	√
The optimized ohr-interRAI	√	×	√	×
OHAT-EP	√	×	√	√
OHATE	√	√	×	√
OHAT-NL	√	×	×	×

Notes: √: Reliability was tested in the article; ×: Validity was not tested in the article.

Abbreviations: BOHSE, Brief Oral Health Status Examination; MPS, Mucosal-plaque Index; ROAG, The Revised Oral Assessment Guide; OHAT, The Oral Health Assessment Tool; OAS, Oral Assessment Sheet; OHSTNP, Oral Health Screening Tool for Nursing Personnel; DHR, Dental Hygiene Registration; ohr‐interRAI, the oral health‐related section of the Resident Assessment Instrument; OHAT-EP, European Portuguese version of the OHAT; OHATE, Oral Health Assessment Tool for the Elderly; OHAT-NL, The Dutch version of the Oral Health Assessment Tool.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021:372:n71. doi:10.1136/bmj.n71

 Web of Science ®Google Scholar

Kayser-Jones J, Bird WF, Paul SM, Long L, Schell ES. An instrument to assess the oral health status of nursing home residents. Gerontologist. 1995;35(6):814–824. doi:10.1093/geront/35.6.814

 PubMed Web of Science ®Google Scholar

Henriksen BM, Ambjørnsen E, Axéll TE. Evaluation of a mucosal-plaque index (MPS) designed to assess oral care in groups of elderly. Spec Care Dentist. 1999;19(4):154–157. doi:10.1111/j.1754-4505.1999.tb01378.x

 PubMedGoogle Scholar

Andersson P, Hallberg IR, Renvert S. Inter-rater reliability of an oral assessment guide for elderly patients residing in a rehabilitation ward. Spec Care Dentist. 2002;22(5):181–186. doi:10.1111/j.1754-4505.2002.tb00268.x

 PubMedGoogle Scholar

Chalmers JM, King PL, Spencer AJ, Wright FA, Carter KD. The oral health assessment tool--validity and reliability. Aust Dent J. 2005;50(3):191–199. doi:10.1111/j.1834-7819.2005.tb00360.x

 PubMed Web of Science ®Google Scholar

Chia-Hui Chen C, Chyun DA, Li CY, McCorkle R. A single-item approach to screening elders for oral health assessment. Nurs Res. 2007;56(5):332–338. doi:10.1097/01.NNR.0000289504.30037.d8

 PubMed Web of Science ®Google Scholar

Ribeiro MT, Ferreira RC, Vargas AM. Validity and reproducibility of the revised oral assessment guide applied by community health workers. Gerodontology. 2014;31(2):101–110. doi:10.1111/ger.12014

 PubMed Web of Science ®Google Scholar

Simpelaere IS, Van Nuffelen G, Vanderwegen J, Wouters K, De Bodt M. Oral health screening: feasibility and reliability of the oral health assessment tool as used by speech pathologists. Int Dent J. 2016;66(3):178–189. doi:10.1111/idj.12220

 PubMed Web of Science ®Google Scholar

Zhao CJ, Ding F. Translation and psychometric evaluation of the Kayser-Jones Brief Oral Health Status Examination. Chin Nurs Manage. 2016;16(1):38–41. doi:10.3969/j.issn.1672-1756.2016.01.011

 Google Scholar

Yanagisawa S, Nakano M, Goto T, Yoshioka M, Shirayama Y. Development of an Oral Assessment Sheet for Evaluating Older Adults in Nursing Homes. Res Gerontol Nurs. 2017;10(5):234–239. doi:10.3928/19404921-20170621-04

 PubMed Web of Science ®Google Scholar

Tsukada S, Ito K, Stegaroiu R, Shibata S, Ohuchi A. An oral health and function screening tool for nursing personnel of long-term care facilities to identify the need for dentist referral without preliminary training. Gerodontology. 2017;34(2):232–239. doi:10.1111/ger.12255

 PubMed Web of Science ®Google Scholar

Fjeld KG, Eide H, Mowe M, Hove LH, Willumsen T. Dental hygiene registration: development, and reliability and validity testing of an assessment scale designed for nurses in institutions. J Clin Nurs. 2017;26(13–14):1845–1853. doi:10.1111/jocn.13452

 PubMed Web of Science ®Google Scholar

Wang JQ, Zhu SZ, Zhan Y, Li J. Reliability and validity test of Chinese version of the Oral Health Assessment Tool. Chin J Mod Nurs. 2019;25(28):3607–3610. doi:10.3760/cma.j.issn.1674-2907.2019.28.010

 Google Scholar

Krausch-Hofmann S, De Almeida Mello J, Declerck D, et al. The oral health-related section of the interRAI: evaluation of test content validity by expert rating and assessment of potential reasons for inaccurate assessments based on focus group discussions with caregivers. Gerodontology. 2019;36(4):382–394. doi:10.1111/ger.12421

 PubMed Web of Science ®Google Scholar

Klotz AL, Zajac M, Ehret J, Hassel AJ, Rammelsberg P, Zenthöfer A. Development of a German version of the Oral Health Assessment Tool. Aging Clin Exp Res. 2020;32(1):165–172. doi:10.1007/s40520-019-01158-x

 PubMed Web of Science ®Google Scholar

Finotto S, Bertolini G, Camellini R, et al. Linguistic-cultural validation of the oral health assessment tool (OHAT) for the Italian context. BMC Nurs. 2020;19:7. doi:10.1186/s12912-020-0399-y

 PubMed Web of Science ®Google Scholar

Krausch-Hofmann S, Tran TD, Janssens B, et al. Assessment of oral health in older adults by non-dental professional caregivers-development and validation of a photograph-supported oral health-related section for the interRAI suite of instruments. Clin Oral Investig. 2021;25(6):3475–3486. doi:10.1007/s00784-020-03669-8

 PubMed Web of Science ®Google Scholar

Cerveira FR, Matos MAC, Sa-Couto P. Development of the European Portuguese version of the oral health assessment tool: content validity and reliability study in an elderly population. Spec Care Dentist. 2022;42(6):623–629. doi:10.1111/scd.12724

 PubMed Web of Science ®Google Scholar

Genç FZ, Cingil D, Hisar F. Development of the Turkish version of the oral health assessment tool: methodological study. Spec Care Dentist. 2023;43(4):416–424. doi:10.1111/scd.12775

 PubMed Web of Science ®Google Scholar

van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GH. The Dutch version of the Oral Health Assessment Tool: translation and inter-rater reliability among community nurses. Int J Dent Hyg. 2023. doi:10.1111/idh.12678

 PubMed Web of Science ®Google Scholar