***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aim The aim of this study was to evaluate the effectiveness of carers ’ education on improvements in oral health and denture hygiene of care-dependent and cognitively impaired older people in nursing homes compared to those without intervention . Methods A total of 219 seniors living in 14 nursing homes in southwest Germany ( intervention : n=144 ; control : n=75 ) were enrolled in this study . For each participant , Plaque Control Record ( PCR ) , Gingival Bleeding Index ( GBI ) , Denture Hygiene Index ( DHI ) and Community Periodontal Index of Treatment Needs ( CPITN ) were assessed at baseline and six months following the interventions . In addition , demographic parameters such as age , sex , chronic diseases , permanent medications , level of dependency and cognitive state were recorded . In the intervention homes , education for caregivers was provided and ultrasound baths for denture cleaning were implemented . Changes in the dental target variables PCR , GBI , CPITN and DHI during the six-month study period were compared between subjects in the intervention and the control groups as well as between subjects with and without dementia . Additionally , multivariate models were compiled for each dental index to evaluate possible confounders . Results In the intervention group , PCR and DHI significantly improved during the study period ( P<0.001 ) . Oral health and denture hygiene improved likewise in subjects with and without dementia . In the control group , no significant improvements were observed ( P>0.05 ) . Conclusion Carers ’ education improves oral health of people in nursing homes over a clinical ly relevant period of time . Implementation of ultrasound baths is a simple and effective measure to improve denture hygiene of both institutionalized elderly people and seniors with dementia and in severe need of care . From a clinical st and point , it is noteworthy that the respective interventions can be easily implemented in everyday care routine OBJECTIVES This cluster-r and omised controlled trial assessed whether oral health care education ( OHCE ) for nursing home caregivers would achieve improvements in clients ' oral health . METHODS Twenty-two nursing homes were r and omly allocated to intervention or control group . Clients were examined at baseline and at follow-up visits 1- and 6-months after caregivers received OHCE . Main outcome measures were denture plaque , denture-induced stomatitis , dental plaque and gingivitis . Differences in group means/medians were compared with adjustment for cluster r and omisation . RESULTS Clients ' baseline oral health was poor . After OHCE , the intervention group 's oral health scores improved significantly . Reductions in denture plaque scores ( 0 - 4 scale ) exceeded those of the control group by 1.15 ( 95%CI=0.83 , 1.47 ) at 1 month and by 1.47 ( 95%CI=1.13 , 1.80 ) at 6 months . Denture-induced stomatitis prevalence reduced significantly over 6 months compared to the control group ( P<0.0001 ) . Group differences in favour of the intervention group were 0.41 ( 95%CI=0.18 , 0.65 ) at 1 month and 0.34 ( 95%CI=0.14 , 0.53 ) at 6 months for dental plaque ( 0 - 3 scale ) , and 0.17 ( 95%CI= -0.01 , 0.35 ) at 1 month and 0.28 ( 95%CI 0.15 , 0.42 ) at 6 months for gingivitis ( 0 - 2 scale ) . Key differences remained significant after adjustment for clustering effects . The provider 's costs would currently be approximately pounds 6700 per year to deliver the intervention to a Health Authority with 100 homes . CONCLUSIONS Although final levels of residents ' oral health were still short of ideal , this study clearly shows that , for a modest cost , OHCE can improve caregivers '  knowledge , attitudes and oral health care performance for elderly , functionally dependent clients BACKGROUND : Family caregivers are an essential part of health care services for elderly with dementia disorders , because of providing care for such patients is a big burden for their families . This study aim ed to assess the effects of family education program in reducing the burden of families of elderly with dementia . METHODS : This was a clinical trial , in which 50 family caregivers of the elderly patients with dementia who had referred to two referral centers for dementia in the city of Isfahan were selected with convenient sampling method and were r and omized to experimental and control groups . The experimental group participated in a family education program but the control group did not . Data were collected by Zarit ’s caregiver burden scale completed by caregivers of both groups before , right after , and one month after family education program . Also , Mini-Mental Status Examination was conducted for elderly before the program . Finally , data were analyzed in SPSS software . RESULTS : Caregivers ’ burden was gradually increased in the controls , but decreased in the experimental group during the study . The means of caregivers ’ burden before , right after , and one month after family education program were 42 , 35.44 , and 33.56 in the experimental group , respectively , while they were 43.28 , 46.8 and 50.64 in the control group , respectively . Also , there was a significant difference between caregivers ’ burden of the two groups immediately after intervention , but one month after intervention no significant difference was seen between the two groups . CONCLUSIONS : Since conducting this program could reduce caregivers ’ burden of families of elderly with dementia , developing such programs and evaluating them within research projects are recommended BACKGROUND Oral hygiene and health of the institutionalized elderly are frequently described as inadequate . OBJECTIVES This r and omized and single-blinded ( outcome evaluation ) study compared three types of intervention for improving oral hygiene  with a control . The purpose was to investigate whether there were any significant differences between the intervention and control groups . METHODS One hundred and six participants living in long-term care homes in South-West Germany were recruited and r and omly divided into four groups-three therapy groups and one control group . For all three therapy groups , teeth and dentures were cleaned professionally and individual instruction was given . One of these groups was also re-instructed and remotivated by a dentist ( n = 27 ) . One also received help from , and was remotivation by , staff educated in dental hygiene ( n = 26 ) . The third therapy group was not remotivated after professional cleaning of teeth and dentures ( n = 26 ) . For the control group , there was no intervention ( n = 23 ) . The main target clinical data were mean plaque ( plaque-control record , O'Leary ) , gingival bleeding ( Ainamo/Bay ) , and denture hygiene indices . For assessment of the difference between being in an intervention group and in a control group , mixed-model analysis for repeated measurements was performed for each main target variable . In addition , target clinical data were evaluated in long-term follow-up after 3 years . RESULTS Compared with controls , denture hygiene , plaque , and gingival bleeding indices were significantly lower in the intervention groups over a twelve-week period ( mixed model for repeated measurements ; P < 0.023 ) . Estimates of effects between control and each treatment group were comparable among the three therapy groups ; however , even though two of the groups received further help and instruction . Long-term follow-up showed that all indices were significantly worse than at the last study recall ( P < 0.001 ) . CONCLUSIONS Professional cleaning of teeth and dentures , with individual instruction , can be recommended to improve oral hygiene . However , the effect decreases over time and renewal of the intervention is necessary OBJECTIVES The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index , as well as denture hygiene of patients provided with removable partial denture ( RPD ) during a 12-month follow-up . MATERIAL AND METHODS A total of 53 partially edentulous patients were recruited for this study . The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit . The plaque and gingival indexes were measured using the Löe index . Following treatment , the patients were r and omly divided into three groups . In Control Group I , subjects were instructed to continue their personal oral hygiene routine . In Group II , participants were given verbal instructions and a self-educational manual on oral hygiene without illustrations . In Group III , oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual . To evaluate the effect of the different modes of instruction , the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces ( day zero examination ) and re-examined 7 , 15 and 30 days , 3 , 6 and 12 months following RPD placement . The state of denture hygiene was evaluated 7 , 15 and 30 days and 3 , 6 and 12 months following rehabilitation . Parametric statistics was applied to dental plaque and gingival indexes . For accumulation of plaque and calculus on the RPD , non-parametric statistic was applied . RESULTS The frequency of plaque found during the preliminary visit was higher than that found in the other periods . With regard to gingival index , significant difference was found between the preliminary visit examination and other periods . There was a significant difference in the plaque accumulation on the denture surface between groups I and III . CONCLUSION The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance PURPOSE To investigate the effects of oral care education on knowledge , attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes . METHODS In this quasi-experimental study , the intervention group ( n=27 ) of residents received oral care from intervention group caregivers ( n=28 ) who had received 6 weeks of oral care education . The control group ( n=27 ) of residents received usual oral care from control group caregivers ( n=26 ) . Data on knowledge , attitude , and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected . Data were analyzed using SPSS WIN 16.0 . RESULTS 1 ) Scores on caregivers ' knowledge ( p<.001 ) and behavior ( p<.001 ) for oral care were higher in the intervention group 6 and 12 weeks . The caregivers ' attitude ( p<.001 ) score for oral care was higher in the intervention group 12 weeks . 2 ) The plaque index ( p=.004 ) and halitosis ( p=.002 ) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks . CONCLUSION Oral care education programs for caregivers are effective in improving the oral hygiene  of elderly residents in nursing homes through enhancement of caregivers ' knowledge , attitude , and behavioral change Background : The population of older people as well as the number of dependent older people is steadily increasing . Those unable to live independently at home are being cared for in a range of setting s. Practical training for nurses and auxiliary care staff has frequently been recommended as a way of improving oral health care for functionally dependent elderly . Aim : To evaluate an oral health education program for the caretakers of institutionalized elderly . Material s and Methods : The study was a cluster r and omized intervention trial with an elderly home as the unit of r and omization . Seven out of 65 elderly homes accommodating a total of 78 caretakers and 462 elderly residents were selected in Bangalore city , India , out of which 3 elderly homes were assigned to the  intervention group and 4 to the  control group .  Oral health knowledge of caretakers was assessed using a pre-tested proforma ; later , oral health education was provided to the caretakers of the intervention group . Oral health  education was given at the end of 6 months to the caretakers of the control group . Chi-square test , Fisher exact test , and paired proportion test were used for statistical analysis . Results : There was significant improvement in the oral health knowledge of the caretakers from baseline in the interventional group . Conclusion : The results of the present study showed that there was a significant improvement in the oral health knowledge among the caretakers . Educating the caretakers for assisting or enabling residents for maintaining oral hygiene is essential OBJECTIVE We evaluated the effectiveness of professional oral health care ( POHC ) given by dental hygienists once a week for 24 months to 141 elderly persons needing daily care and living in 2 nursing homes . STUDY DESIGN Elderly subjects with POHC and without POHC living in 2 nursing homes were examined for 24 months to detect any fevers of 37.8 degrees C or more and the prevalence of fatal aspiration pneumonia . The numbers of Staphylococcus species and C and ida albicans in swab sample s from oral cavities were compared between the POHC group and the non-POHC group . The amounts of methylmercaptan exhaled in the POHC group were determined and compared with those in the non-POHC group . RESULTS The prevalence of fevers of 37.8 degrees C or more in the subjects receiving POHC was significantly lower than in the non-POHC group ( P < .05 ) . We found that the ratio of fatal aspiration pneumonia in the POHC group during the 24 months was significantly lower than in the non-POHC group ( P < .05 ) . Numbers of C albicans species in sample s obtained from the oral cavity after 6 months of POHC were significantly lower than those in the non-POHC group ( P < .01 ) . POHC result ed in the reduction of the presence of Staphylococcus but not to a statistically significant extent . The amounts of 
    Output:
    
This review identifies limited evidence for a carer oral health education as an efficient means to improve oral health in dementia elderly .