Screening oral health in older adults: accuracy of the Oral Health Screener for use within the interRAI

Regular assessment is essential to maintain oral health in nursing home residents, but access to professional dental care is often limited. The Oral Health Screener within the interRAI instruments (OHS) allows caregivers without dental background to identify potential oral problems. This study evaluated the accuracy of the OHS items Oral hygiene, Teeth, and Gums against established dental indices. Dental professionals assessed 458 residents (mean age 82.7 ± 7.8 years, 70.3% female; 53.9% dentate) using the OHS, Oral Hygiene Index, Modified Gingival Index, and Pulp Ulceration Fistula Abscess index. For item Oral Hygiene, 76.4% of residents were rated as poor, with 86.4% sensitivity and 68.3% specificity. Item Teeth identified poor condition in 56.9%, with 96.2% sensitivity and 74.2% specificity. The Gums item scored poor in 78.2%, with 94.0% sensitivity and 60.6% specificity. Predictive values and likelihood ratios supported clinical utility. The findings indicate that the OHS has fair to considerable diagnostic accuracy as a screening instrument for identifying insufficient oral hygiene, tooth decay and gum problems in nursing home residents. It can support non-dental caregivers in early detection and intervention, reducing risk of progression, and supporting better oral health in residents. Trial registration: ClinicalTrials.gov NCT06536322 July 23rd, 2024.