One hour of teaching in oral hygiene and oral diseases to health care professionals at the intervention nursing homes.

The dentists will make an assessment of the elderly's oral hygiene at baseline, after three and six months using a mucosal and plaque score. During the six months, a dentist will be doing ward rounds at each nursing home in a specific time interval. In dialog with the resident and the healthcare professional, the dentist will present individual advice on how to perform oral care based on the resident's oral care routines, oral hygiene status, and the resident's physical and cognitive function level.

Mucosal Plaque Score Mucosal Score, MS (score 1-4), and Plaque Score, PS (score 1-4). The sum of MS and PS is labeled MI'S (score 2-8). An MPS status is judged as good or acceptable when MI'S = 2-4, as unacceptable when MPS = 5-6, and as poor when MI'S = 7-8.

modified Oral Health Impact Profile (OHIP14)

The modified Oral Health Impact Profile:

1. Have you had painful aching in your mouth?
2. Do you have trouble biting or chewing any kinds of food, such as firm meat or apples?
3. Do you limit the kinds or amounts of food you eat because of problems with your dentures?
4. How often are your teeth or gums sensitive to hot, cold, or sweets?

Responses are made in a five point scale:

Very often = 4 Often = 3 Sometimes = 2 Seldom = 1 Never = 0 Do to cognitively impaired elderly the response "I don't know" is added to each question coded 9.