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

Stefanie Krausch-Hofmann, Trung Dung Tran, Barbara Janssens, Dominique Declerck, Emmanuel Lesaffre, Johanna de Almeida Mello, Anja Declercq, Jan De Lepeleire, Joke Duyck*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)


Objectives An optimized oral health-related section and a video training were developed and validated for the interRAI suite of instruments. The latter is completed by professional non-dental caregivers and used in more than 40 countries to assess care needs of older adults. Methods The optimized oral health-related section (ohr-interRAI) consists of nine items and a video training that were developed in consecutive phases. To evaluate psychometric properties, a study was conducted in 260 long-term care residents. Each resident was assessed by a dentist and by four caregivers (two who received the video training, two who did not). Results Mean kappa values and percent agreement between caregivers and dentist ranged between kappa = 0.60 (80.2%) for dry mouth and kappa = 0.13 (54.0%) for oral hygiene. The highest inter-caregiver agreement was found for dry mouth with kappa = 0.63 [95% CI: 0.56-0.70] (81.6%), while for the item palate/lips/cheeks only kappa = 0.27 [95% CI: 0.18-0.36] (76.7%) was achieved. Intra-caregiver agreement ranged between kappa = 0.93 [95% CI: 0.79-1.00] (96.4%) for dry mouth and kappa = 0.45 [95% CI: 0.06-0.84] (82.8%) for gums. Logistic regression analysis showed only small differences between caregivers who watched the video training and those who did not. Conclusions Psychometric properties of the optimized ohr-interRAI section were improved compared to previous versions. Nevertheless, particularly the items based on inspection of the mouth require further refinement and caregiver training needs to be improved.
Original languageEnglish
Pages (from-to)3475-3486
Number of pages12
JournalClinical Oral Investigations
Issue number6
Early online dateNov 2020
Publication statusPublished - Jun 2021
Externally publishedYes


  • InterRAI suite of instruments
  • Non-dental caregivers
  • Older care-dependent adults
  • Oral health assessment
  • Oral screening

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