Oral health is an important contributor to the health and well-being of older adults. Recent associations between oral health and systemic disease have led to renewed interest in oral health and its contribution to health outcomes. Consequently, an oral health assessment has been included of as part of routine medical checkups.
The BOHSE was designed to evaluate the oral condition of nursing home residents, both with and without cognitive impairment. It was found to be the most comprehensive, validated, and reliable screening tool.
The 10-item examiner-rated BOHSE catalogs oral health problems: a higher score identifies more problems.
BOHSE's 10 items for examiners to rate
1. Lymph nodes
2. Lips
3. Tongue
4. Tissue inside cheek, floor, and roof of mouth
5. Gums between teeth and/or under artificial teeth
6. Saliva (effect on tissue)
7. Condition of natural teeth
8. Condition of artificial teeth
9. Pairs of teeth in chewing position (natural or artificial)
10. Oral cleanliness
The assessment begins with observation and palpation for enlarged cervical lymph nodes and includes a complete oral cavity evaluation. Using a penlight, tongue depressor, and gauze, the conditions of the oral cavity, surrounding tissues, and natural/artificial teeth are examined and categorically graded from 0 (normal) to 2 (significantly problematic).
See reference for more information. Adapted from Kayser-Jones J, Bird WF, Paul SM, Long L, Schell ES. An Instrument to Assess the Oral Health Status of Nursing Home Residents. Gerontol 1995; 35(6): 814-824. Internet. Available at https://pubmed.ncbi.nlm.nih.gov/8557208/. Accessed on November 28, 2021.