Oral status in home-dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease

doi: 10.1111/j.1741‐2358.2011.00507.x Oral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease Objectives: The aim of this study was to compare the prevalence of edentulous subjects, caries and periodontal disease among the home‐dwelling elderly with moderate and substantial needs of support for daily living. Materials and method: A sample of 302 randomly selected elderly with moderate or substantial needs of supportive care were examined in Sweden. Several oral clinical variables were registered: number of teeth, dentures, caries, probing pocket depth, gingival bleeding and Eichner’s index. Results: Both in general and in oral health, the differences were small when comparing elderly with moderate and substantial care needs for daily living. Those with substantial needs had more caries lesions (p < 0.01) and more gingival bleeding (p < 0.05), while the number of teeth and prevalence of edentulous subjects did not differ in relation to the need of daily support. The elderly had, on average, 9.8–11.7 teeth, one‐third of whom had no natural teeth. According to Eichner’s index, half of the elderly in both groups had no opposing tooth contacts. Fifty‐five per cent used dentures. Conclusions: Elderly people with needs of supportive care have lost many teeth before they become dependent. Health promotion should be a priority in early ageing populations to prevent oral diseases and tooth loss.     

Oral health and dental care facilities in Maltese residential homes

Objectives: To establish oral health care practices, including the use of dental services, in the residential homes of Malta and Gozo by assessing the knowledge of home managers and assistance of care staff regarding residents’ oral health and hygiene; and evaluating the residents’ demand for dental treatment and residential home managers response to this demand. Subjects: A total population sample of licensed residential homes (38) in Malta and Gozo was used comprising all home managers in government (seven), church (20), and privately run (11) residential homes. Method: A 19‐question questionnaire was designed, piloted and sent to the home managers requesting them to report on the dental care provision for their elderly residents. The questionnaire was distributed by post, along with a reply‐paid envelope and an explanatory letter. A response deadline of 1 month was included. Results: An 87% response rate was achieved. Whilst the majority of home managers (64%) were aware of domiciliary dental services, there was no code of care practice for oral health. Routine dental check‐ups were not organised for residents of most homes. Although home staffs were generally given information about residents’ oral health and hygiene, the majority did not assist residents with oral hygiene. Home managers identified the following barriers to the use of dental services by residents: cost, communication problems with dental staff, journey to place of treatment, waiting time at the dental clinic, access to premises/clinic, lack of information on oral health and dental service availability, no one to accompany the person to the clinic, and health problems such as mobility, poor eyesight, hearing impairment and mental health status. Conclusion: Although most home managers appreciate the importance of oral health care for their residents, the residents still face many barriers to maintaining adequate oral health care and accessing dental services.     

Associations of instrumental activities of daily living and handgrip strength with oral self-care among home-dwelling elderly 75+

doi: 10.1111/j.1741‐2358.2010.00427.x Associations of instrumental activities of daily living and handgrip strength with oral self‐care among home‐dwelling elderly 75+ Objective: To study the associations of instrumental activities of daily living (IADL) and the handgrip strength with oral self‐care among dentate home‐dwelling elderly people in Finland. Materials and methods: The study analysed data for 168 dentate participants (mean age 80.6 years) in the population‐based Geriatric Multidisciplinary Strategy for Good Care of the Elderly (GeMS) study. Each participant received a clinical oral examination and structured interview in 2004–2005. Functional status was assessed using the IADL scale and handgrip strength was measured using handheld dynamometry. Results: Study participants with high IADL (scores 7–8) had odds ratios (ORs) for brushing their teeth at least twice a day of 2.7 [95% confidence intervals (CI) 1.1–6.8], for using toothpaste at least twice a day of 2.0 (CI 0.8–5.2) and for having good oral hygiene of 2.8 (CI 1.0–8.3) when compared with participants with low IADL (scores ≤6). Participants in the upper tertiles of the handgrip strength had ORs for brushing the teeth at least twice a day of 0.9 (CI 0.4–1.9), for using the toothpaste at least twice a day of 0.9 (CI 0.4–1.8) and for good oral hygiene of 1.1 (CI 0.5–2.4) in comparison with the study subjects in the lowest tertile of handgrip strength. Conclusion: The results of this study suggest that the functional status, measured by means of the IADL scale, but not handgrip strength, is an important determinant of oral self‐care among the home‐dwelling elderly.     

The dental awareness of nursing home staff in Singapore - a pilot study

Objective: The aim of this pilot study was to assess the oral health knowledge among staff working in a local nursing home managed by a voluntary welfare organisation. Method: A self‐administered questionnaire was completed by 53 nursing staff working in a home with 270 residents. The questionnaire was structured to assess the staff's knowledge of dental caries, periodontal disease and the care and use of dentures. Results: 99.6% of the respondents felt that oral health care of the elderly was very important. However, only 45.3% of them attributed the cause of dental caries to the frequent intake of sugar. Bacteria in dental plaque was identified by 88.7% of them as the main cause of periodontal disease while 96.2% of them indicated that dentures should be cleaned at least once a day and rinsed after every meal. Conclusion: The staff of this nursing home demonstrated positive knowledge of periodontal disease and denture care. However, their knowledge of dental caries revealed substantial room for improvement. This could signal an area for future staff training and development. Such efforts would help establish a team of caregivers who can improve the oral health and quality of life for residents in the nursing home.     

Oral implants in dependent elderly persons: blessing or burden?

doi:10.1111/j.1741‐2358.2009.00314.x
Oral implants in dependent elderly persons: blessing or burden? Background: Implant‐supported (partial) dentures may raise problems in patients who have become dependent on others for daily oral health care. Dental hygienists and general dental practitioners, as well as care providers, volunteer aiders and even health care insurance companies, should anticipate the growing demand for specific oral health care for patients provided with implant‐supported (partial) dentures. Objective: To report three cases of dependent patients and to present recommendations to prevent or resolve implant‐related oral problems. Materials and methods: The three case reports are demonstrating that implant insertion in (dependent) elderly people needs careful consideration. Discussion: When considering implant treatment, some questions should be raised: (1) Is the treatment appropriate in contributing to the patient’s well‐being and quality of life? (2) Is the treatment the most suitable treatment? (3) Does the treatment integrate with the patient’s oral health care plan? (4) Is the patient sufficiently cooperative? (5) Is the patient supported by a well‐functioning oral (self) care assisting network? (6) Is it possible for the patient to regular see an oral health care professional and is oral health care easily accessible in cases of an emergency? Conclusion: Dependent elderly people can benefit from oral implants, providing that adequate oral health care and aftercare can be provided. When indicated, removal of the anchorage structure is easily performed by putting the implants to sleep. All implant patients should be provided with an ‘implant passport’. Regular information and instruction for care providers about the oral condition of the patient are essential.     

Attitudes to and knowledge about oral health care among nursing home personnel--an area in need of improvement

doi: 10.1111/j.1741‐2358.2011.00562.x
Attitudes to and knowledge about oral health care among nursing home personnel – an area in need of improvement Background: In 1999, a dental reform became law in Sweden that regulated both dental care to dependent individuals and training in oral health care for nursing home personnel. Substantial resources have been channelled into these efforts, but the outcome of these efforts has not been evaluated. The aim of this study was to explore attitudes to and knowledge about oral health care among nursing home personnel more than 5 years after the law was adopted, that being 2005. Methods: A total of 454 individuals employed at nursing homes answered a questionnaire of 16 multiple‐choice items concerning attitudes to and knowledge about oral health care. Results: Eighty‐nine per cent considered oral health care to be an important part of good nursing. The answers indicated problems, however, when it came to its implementation and knowledge, and 35% stated that they had had no formal education in oral health care. Conclusions: Despite generally positive oral health care attitudes, it is important that oral health care education is available to and made of interest for all nursing home personnel, especially in light of the increase in number of natural teeth and frequency of crowns and bridges among dependent elderly.     

Oral health care in long‐term care facilities for elderly people in southern Brazil: a conceptual framework

doi:10.1111/j.1741‐2358.2009.00280.x
Oral health care in long‐term care facilities for elderly people in southern Brazil: a conceptual framework Objective: To present a theoretical model for understanding oral health care for the elderly in the context of long‐term care institutions (LTCI). Methods: Open‐ended individual interviews were conducted with the elderly residing in LTCI, their carers, nursing technicians and nurses, directors of care, dental surgeons and managers of public health services. A grounded theory methodological approach was adopted for data collection and analysis. Results: The emerging core category revealed a basic social process: ‘Promoting oral health care for the elderly based on the context of LTCI’. This process was composed of two contradicting yet correlated aspects: the oral health care does not minimise the poor oral epidemiological condition, and at the same time, there was a continued improvement in the oral care expressed by better care practices. These aspects were related to the: attribution of meaning to oral health, social determination of oral health, the ageing process, interactions established in the oral health care practices, oral health care management in LTCI, inclusion of oral health care into the political–organisational dimension and possibility of conjecturing better oral health care practices. Conclusion: The core concept of ‘Promotion of oral health care for elderly people based on the context of LTCI’ is capable of explaining the variations in the structure and process of LTCI, as well as in helping to understand the meaning of the oral health care practices for the institutionalised elderly.     

Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons

doi: 10.1111/j.1741‐2358.2011.00459.x
Relationship between subjective assessment of oral health and medical expenses in community‐dwelling elderly persons Objectives: The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self‐assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods: Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U‐test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results: A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion: The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community‐dwelling elderly persons after adjusting for social background, living environment and physical factors.     

Oral health‐related quality of life in patients receiving home‐care nursing: associations with aspects of dental status and xerostomia

doi:10.1111/j.1741‐2358.2009.00344.x
Oral health‐related quality of life in patients receiving home‐care nursing: associations with aspects of dental status and xerostomia Objective: To explore the differences in oral status, dental attendance and dry mouth problems between patients with long‐term disease with high and low scores on Oral Health Impact Profile 14 (OHIP 14) and how patients cope with oral problems such as xerostomia and a reduced ability to brush their teeth. Background: There has been a lack of studies of oral health and oral health‐related quality of life in the frail elderly within the community services. Materials and methods: A cross‐sectional questionnaire study was conducted with 137 patients receiving home‐care nursing. Structured interviews were conducted by student nurses using OHIP‐14, items from the Xerostomia Inventory and questions concerning dental visit habits, brushing of teeth and data from medical records. Results: Eighty‐three per cent of patients had natural teeth and 60% had only natural teeth. ‘Natural teeth only’ indicated a low score on OHIP‐14. Problems with brushing and items concerning xerostomia indicated a high score on OHIP‐14. Contrasts in the assessments concerning brushing of teeth and xerostomia indicated low priority from the patients themselves and the nursing staff. Conclusion: Community health services should focus upon oral health. Both patients and nurses should assess the need for regular brushing of teeth carried out by home‐care nurses. Assessment and treatment of dry mouth problems should have higher priority.     

Relationships between higher‐level functional capacity and dental health behaviors in community‐dwelling older adults

doi: 10.1111/j.1741‐2358.2012.00654.x Relationships between higher‐level functional capacity and dental health behaviors in community‐dwelling older adults Objective: The aim of the present study was to elucidate relationships between higher‐level functional capacity and dental health behaviours in community‐dwelling older adults. Background: In ageing society, it is necessary to promote oral health in the elderly, because good oral health is a significant contributing factor to good general health. Higher‐level functional capacity has been considered a crucial factor for successful independent living in the elderly. We hypothesised that functional capacity is a significant indicator of dental health behaviours. Methods: Three hundred and thirty‐eight adults aged 65 years or older were enrolled in this study. Higher‐level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG‐index). Univariate and multivariate models were constructed with dental health behaviours, such as regular visits to a dentist, brushing frequency and use of extra cleaning devices, as the dependent variable, and the total TMIG‐index score and its subcategory scores as the principal independent variable. Results: Univariate logistic regression analysis demonstrated a significant correlation between low TMIG‐index and ‘intellectual activity’ subcategory scores to lack of regular visits to a dentist and not using extra cleaning devices. Using a multivariate model, significant relationships remained after adjusting for a number of variables including demographics, medical status, lifestyle and number of remaining teeth. Conclusion: Intellectual activity of higher‐level functional capacity may be an accurate indicator of dental health behaviours in community‐dwelling older adults. Intellectual activity should be taken into consideration to effectively promote oral health behaviours and oral hygiene in elderly persons living independently.     

The effect of awareness on the outcome of oral health performed by home care service providers

Objectives: The purpose of this study was to investigate the correlations amongst factors, such as knowledge, attitude, practice and oral health behaviour, in caregiver managers so as to improve the oral health of the dependent elderly. Methods: Data were collected from a sample of 102 caregiver managers from home care service providers using a questionnaire. The respondents were divided into two groups: the group who were aware of effective oral care (A group) and the group who were unaware of effective oral care (U group). The evaluations were frequency distribution tables followed by chi‐squared tests of independence and Fisher’s exact test. Results: Ninety percent of the respondents thought that dependent elderly needed to be provided with oral care and 77% had been trained in oral care. However, only 44% thought that they could provide appropriate oral care and only 52% had experienced its effect on oral health and general health. There was a significant difference in training by dental hygienists between the A group (36%) and the U group (11%). There was also a significant difference in learning of oral care skills. Conclusion: The results suggested a high oral care awareness amongst caregiver managers and an inadequate oral care training system. To improve oral health of the dependent elderly, theoretical teaching alone is not sufficient when providing oral health education and a positive contact with the dental team, especially dental hygienists, is an important factor which supports oral care provided by caregivers.     

Challenges and barriers to quality oral care as perceived by caregivers in long-stay institutions in Brazil

doi: 10.1111/j.1741‐2358.2011.00475.x
Challenges and barriers to quality oral care as perceived by caregivers in long‐stay institutions in Brazil Objective: To describe how caregivers perceive the oral health status in the elderly they care for; the routines for oral hygiene in nursing homes; caregivers perceived barriers for quality oral care; and the caregivers competence and need for training in this area. Background: The phenomena surrounding ageing has been the subject of worldwide interest, particularly concerning issues related to institutionalised elderly, where several studies have shown the precarious oral health status of such individuals. Materials and methods: A qualitative interview study was held in a city in southern Brazil. Study participants were 26 caregivers of elderly people, belonging to seven institutions. Statements were collected through interviews, whose results were interpreted by phenomenological analysis. Results: Caregivers of institutionalised elderly reveal contradictions in knowledge and practices of oral health. Although it could be expected that the perception and attitudes of caregivers of their own oral health could influence the care they offer to the elderly, barriers to the implementation of such activities appear to refer to situations outside of their responsibility, especially in the absence of time and staff. Conclusions: The oral care of older people in geriatric institutions requires multidisciplinary and interinstitutional actions capable of reversing the continuing framework of neglect, requiring interventions for health promotion and disease prevention that can and should be implemented in institutions.     

Effect evaluation of a supervised versus non‐supervised implementation of an oral health care guideline in nursing homes: a cluster randomised controlled clinical trial

doi: 10.1111/j.1741‐2358.2010.00418.x
Effect evaluation of a supervised versus non‐supervised implementation of an oral health care guideline in nursing homes: a cluster randomised controlled clinical trial Objective: To compare a supervised versus a non‐supervised implementation of an oral health care guideline in Flanders (Belgium). Background: The key factor in realising good oral health is daily oral hygiene care. In 2007, the Dutch guideline ‘Oral health care in care homes for elderly people’ was developed to improve oral health of institutionalised elderly. Materials and Methods: A random sample of 12 nursing homes was randomly allocated to the intervention or the control group. Representative samples of 30 residents in each home were monitored during a 6‐month study period. The intervention included a supervised implementation of the guideline. Results: At the 6‐month follow‐up, only a small but statistically significant (p = 0.002) beneficial effect (0.32) of the intervention was observed for denture plaque after adjustment for baseline value and the random effect of the institution. In the linear mixed regression models, including a random institution effect, difference in denture plaque level was no longer statistically significant at the 5% level. Conclusion: Only denture hygiene has been improved by the supervised implementation, although with lower benefits than presumed. Factors on institutional level, difficult to assess quantitatively, may play an important role in the final result.     

Oral health status of the elderly in a residential home in Turkey

Objectives: To determine the oral health status and treatment needs of elderly residents of a residential home in Ankara, Turkey. Background: Little is known about oral health problems of elderly living in the institutions. Methods: Among 216 elderly, 193 of them were interviewed and were clinically examined according to WHO criteria. Age, gender, educational and occupational status, oral hygiene practices, dental insurance, access to dental care and systemic diseases were recorded using a structured questionnaire. Coronal and root caries, periodontal disease, dental status and related treatment needs were assessed by two calibrated dentists. Results: The mean age of the subjects were 75.2 ± 8.3 in males, 79.1 ± 7.9 in females; 32.6% of subjects were dentate and the mean number of teeth was 3.7 ± 7.0 (median = 0). A functional dentition was present in 7.3% of subjects (≥20). The mean decayed, missing and filled teeth (DMFT) was 29.3 ± 5.8 (median = 32) and mean root caries was 2.2 ± 3.1 (median = 1.0). The major reason for tooth extraction was dental caries. Of the subjects, 20.7% had at least one untreated coronal caries and 18.1% root caries. The assessment of periodontal status according to CPI revealed that only four persons had nine healthy sextants with the score of ‘0’. Edentulousness was 67.4% while 11.9% of them lacked denture in both jaws. Conclusion: The results illustrated poor dental health and showed extremely high demand for the dental health services programmes for the elderly living in these institutions.     

TMD and GOHAI indices of Brazilian institutionalised and community-dwelling elderly

Rationale and objectives: Considering the controversy in the literature regarding several aspects of temporomandibular dysfunction (TMD) in elderly populations and the absence of reliable data on elderly Brazilians in this field, this study consisted of an evaluation of TMD prevalence and the self‐perception of oral health among institutionalised and community‐dwelling elderly in São José dos Campos, Brazil. Methods: Two hundred and fifteen community‐dwelling and 185 institutionalised elderly people were evaluated by the Helkimo anamnestic (Ai) and clinical dysfunction (Di) indices and answered a questionnaire using the Geriatric Oral Health Assessment Index (GOHAI). Results: The major prevalence of TMD symptoms was for the Ai0 (symptom‐free) group (69.5%), while the major prevalence of clinical signs was for the DiI (mild) group (56%). Women presented a higher AiII classification than men (χ² test, p = 0.049). Community‐dwelling elderly presented a significantly lower Ai0 classification than the institutionalised ones (Two ratios equality test, p < 0.001). There was no relationship between the institutionalised status and the clinical dysfunction index for Di0 and DiIII classification (Two ratios equality test, p = 0.194 and 0.535 respectively). The institutionalised elderly presented greater (One‐way anova = 0.005) self‐perception of oral health (33.45) than did the community‐dwelling group (32.66). There were only weak Pearson’s correlations among the anamnestic (?33.0%) or clinical (?14.7%) findings by the TMD and GOHAI indices. Symptom‐free (Ai0) institutionalised elderly presented better scores in all GOHAI dimensions and elderly representing an absence of clinical TMD signs (Di0) presented higher GOHAI physical dimension scores in both groups. Conclusions: The prevalence of TMD symptoms among this sample of elderly individuals was relatively low, self‐perception of oral health was reasonable and a weak, inverse correlation was found between TMD signs and symptoms and elderly self‐perception of oral health measured by the GOHAI index.     

Relationship between periodontal status and intellectual function among community-dwelling elderly persons

doi: 10.1111/j.1741‐2358.2011.00483.x
Relationship between periodontal status and intellectual function among community‐dwelling elderly persons Objective: The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. Background: Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. Materials and Methods: A total of 152 community‐dwelling elderly persons, aged 70–74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven’s Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. Results: Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. Conclusion: Intellectual function is considered a significant indicator of periodontal status among community‐dwelling elderly persons.     

The relationship between seven health practices and oral health status in community‐dwelling elderly Thai

Gerodontology 2012; doi: 10.1111/j.1741‐2358.2012.00672.x The relationship between seven health practices and oral health status in community‐dwelling elderly Thai Objective: This study aims to analyse the relationship between seven health practices, oral health behaviors, and oral health status in community dwelling elderly Thai. Materials and methods: The subjects were 612 elderly people (mean age = 68.8 ± 5.9 years). Questionnaires survey about sociodemographics, self‐reported seven health practices and oral health behaviors were conducted by trained interviewers. Oral examinations investigated the number of teeth present, decayed teeth, periodontal status and functional tooth units (FTUs). Oral malodor was assessed by Organoleptic Test, and unstimulated saliva was collected for 5 min. Results: Five health practices (smoking, drinking, physical activity, breakfast and weight maintenance) were significantly related with oral health behaviors. ancova analysis demonstrated the following significant associations: (i) smoking behavior with number of teeth present, number of FTUs, decayed teeth, periodontal disease, oral malodor and salivary flow rate, (ii) drinking alcohol behavior with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (iii) eating breakfast behavior with periodontal disease, oral malodor and salivary flow rate, (iv) eating between‐meal snack with number of teeth present, number of FTUs, decayed teeth and periodontal disease, (v) maintaining weight with number of teeth present, number of FTUs, periodontal disease and oral malodor, (vi) sleeping with number of teeth present, number of FTUs, periodontal disease, oral malodor and salivary flow rate, (vii) physical activity with periodontal disease and salivary flow rate. Conclusion: Good health practices were related with good oral health behaviors. Moreover, general health practices were associated with the clinical oral health status such as number of teeth present, decayed teeth, FTUs, periodontal disease, oral malodor and salivary flow rate. The elderly with good general health practices were considered to have good oral health status. Improving general health habits are suggested to lead to better oral health for the elderly, and vice versa.     

Effects of oral functional training for nutritional improvement in Japanese older people requiring long-term care

Objectives: The aim of this study was to evaluate the effect of oral functional training and nutrient supplements to improve the nutrition of malnourished elderly people in a nursing home. Background: Malnutrition is a frequent problem in the elderly requiring long‐tem care; however, it is not clear whether oral functional training can be effective to improve nutrition. Subjects and methods: Fourteen subjects of 82 residents (mean age 85.7 ± 6.2 years) in a nursing home, who had a serum albumin level of ≤3.8 g/dl and understood the purpose of this study, were randomly divided into two groups of seven: one group served as the supplement group (mean age 87.0 ± 4.9 years) to which a high‐calorie and high‐protein diet was provided, and the other as the oral training plus supplement group (mean age 84.6 ± 10.1 years) to which oral functional training was given by a dental hygienist once a week as well as the above diet. Nutritional status was evaluated using serum biochemical values as indices at 4 months after the start of the intervention. Results: In the supplement group, serum albumin was 3.44 ± 0.36 g/dl at the start of the study (before intervention) and 3.24 ± 0.45 g/dl at 4 months after intervention. In the oral training plus supplement group, it was 3.56 ± 0.22 g/dl before intervention and significantly increased to 3.70 ± 0.33 g/dl after intervention (p < 0.05: Wilcoxon signed‐rank test). Conclusion: Nutritional supplements alone were not adequate, but with oral functional training to maintain and improve feeding function, nutritional improvement in the elderly could be observed.