Gerodontology. 2026 May 25. doi: 10.1111/ger.70093. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate caregiver-dentist agreement and inter-rater reliability of the Oral Health Screener (OHS) following its optimisation for use in long-term care and to examine the effect of different caregiver OHS training modalities.
METHODS: This prospective reliability and agreement study was nested within a 2-year cluster-randomised controlled trial in Flemish nursing homes (Belgium). Professional caregivers and dentists independently assessed residents’ oral health using the OHS every 6 months across five timepoints, blinded to each other’s assessments. Caregivers received either e-learning only (IG1) or e-learning combined with on-site training (IG2). Agreement was analysed using percent agreement, Cohen’s kappa, prevalence-adjusted bias-adjusted kappa (PABAK) and logistic generalised linear mixed models (GLMM).
RESULTS: Fifty-one caregivers from six facilities and eight dentists assessed 193 residents. Within groups, IG1 showed higher agreement with dentists for self-reported items (GLMM 0.46-0.58) than for inspection-based OHS items (GLMM 0.10-0.48), whereas this difference was less pronounced in IG2 (self-reported items: GLMM 0.45-0.95, inspection-based items: GLMM 0.35-0.92). Comparing groups, GLMM analyses indicated overall higher reliability in IG2 for most items, except for chewing difficulty. Exploratory analyses suggested that longitudinal patterns varied across items. Inter-caregiver reliability analyses were exploratory due to the limited number of paired assessments.
CONCLUSION: Non-dental professional caregivers showed acceptable agreement with dentists when assessing residents’ oral health using the OHS. Although agreement varied across items due to prevalence and marginal imbalances, the findings suggest the potential added value of training and support when using the OHS as a first-line screening tool in care-dependent older adults.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06536322 (July 23, 2024).
PMID:42179168 | DOI:10.1111/ger.70093
