{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:33:13Z","timestamp":1786120393832,"version":"build-2736575974"},"reference-count":37,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults living with dementia often have limited tolerance for intraoral procedures, which can restrict access to even basic oral health assessment in clinical care. Procedural burden\u2014characterized by sustained intraoral manipulation, sensory overload, and limited opportunities for interruption\u2014may represent a key barrier to equitable oral care. Intraoral scanning (IOS) enables stepwise, interruptible acquisition of oral data and may reduce this burden, but feasibility and tolerability in people living with dementia have not been systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess the feasibility and tolerability of bedside maxillary IOS compared with a conventional impression procedure in people living with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center, nonrandomized, counterbalanced, crossover feasibility study was conducted in a geriatric ward. Nineteen hospitalized participants with dementia (mean age 83.5, SD 3.4 years; mean Mini-Mental State Examination score 18.2, SD 4.8) underwent both bedside maxillary IOS and a conventional alginate-based impression procedure during a single visit. The order of procedures was not randomized but assigned using an alternating allocation sequence based on chronological enrollment to counterbalance potential order effects. The primary outcome was feasibility, defined as procedure completion without premature termination due to gag reflex, defensive movements, participant refusal, or withdrawal of assent or cooperation. Secondary outcomes included participant-rated discomfort using a 0 to 10 visual analog scale (VAS); clinician-rated manageability using a 0 to 10 VAS, with higher scores indicating greater difficulty; adverse reactions, including gag reflex and defensive movements; and active bedside procedural time in minutes. Paired comparisons were performed using the Wilcoxon signed-rank tests for VAS outcomes, a sign test for active bedside procedural time, and McNemar tests for binary outcomes, with a 2-sided significance level of .05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants reported significantly lower discomfort with IOS than with the conventional impression procedure (median 1.0, IQR 0.5-1.5 vs median 7.75, IQR 3.7-8.5;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001), and clinician-rated manageability was more favorable for IOS (median 2.0, IQR 1.0-3.0 vs median 5.0, IQR 3.0-6.5;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Active bedside procedural time was similar in the analysis of all initiated procedures, with a mean duration of 3.02 (SD 0.72) minutes for IOS and 2.92 (SD 0.78) minutes for the conventional impression procedure. Exploratory analyses showed no statistically detectable evidence of an order effect. Gag reflex occurred less frequently during IOS (1\/19, 5.3% vs 9\/19, 47.4%;\n                      <jats:italic>P<\/jats:italic>\n                      =.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bedside IOS was feasible in hospitalized older adults living with dementia and was associated with lower immediate procedural burden than a conventional alginate-based impression procedure. These findings support further evaluation of IOS as a low-burden approach for oral data acquisition in dementia care, while downstream treatment effects and implementation in other settings require further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/92879","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:51:25Z","timestamp":1786049485000},"page":"e92879-e92879","source":"Crossref","is-referenced-by-count":0,"title":["Bedside Intraoral Scanning to Reduce Procedural Burden in Older Adults With Dementia: Nonrandomized Counterbalanced Crossover Feasibility Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3340-8857","authenticated-orcid":false,"given":"Anna-Lena","family":"Hillebrecht","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9278-2203","authenticated-orcid":false,"given":"Kirstin","family":"Vach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-0797","authenticated-orcid":false,"given":"Christoph","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7095-4190","authenticated-orcid":false,"given":"Ralf J","family":"Kohal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1702-1679","authenticated-orcid":false,"given":"Benedikt C","family":"Spies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"R1","unstructured":"Global status report on the public health response to dementia. World Health Organization. 2021. URL: https:\/\/www.who.int\/publications\/i\/item\/9789240033245 [Accessed 30-03-2025]"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s00784-020-03266-9","article-title":"Epidemiological trends, predictive factors, and projection of tooth loss in Germany 1997-2030: part I. Missing teeth in adults and seniors","volume":"25","author":"Jordan","journal-title":"Clin Oral Investig"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"e105","DOI":"10.1016\/S2468-2667(21)00249-8","article-title":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019","volume":"7","author":"GBD 2019 Dementia Forecasting Collaborators","journal-title":"Lancet Public Health"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1177\/13634593211049891","article-title":"The mouth and oral health in the field of dementia","volume":"27","author":"Scambler","journal-title":"Health (London)"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","DOI":"10.3390\/dj7020049","article-title":"The association between tooth loss and Alzheimer\u2019s disease: a systematic review with meta-analysis of case control studies","volume":"7","author":"Dioguardi","journal-title":"Dent J (Basel)"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/ger.12751","article-title":"Associations between measured masticatory function and cognitive status: a systematic review","volume":"41","author":"Maekawa","journal-title":"Gerodontology"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/j.1754-4505.2003.tb00283.x","article-title":"Oral diseases and conditions in community-living older adults with and without dementia","volume":"23","author":"Chalmers","journal-title":"Spec Care Dentist"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1046\/j.1532-5415.2002.50106.x","article-title":"Oral care reduces pneumonia in older patients in nursing homes","volume":"50","author":"Yoneyama","journal-title":"J Am Geriatr Soc"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1111\/ger.12554","article-title":"Number of teeth, denture wearing and cognitive function in relation to nutritional status in residents of nursing homes","volume":"39","author":"Suma","journal-title":"Gerodontology"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1111\/ger.12525","article-title":"Barriers and facilitators to integrate oral health care for older adults in general (basic) care in East Netherlands. Part 2 functional integration","volume":"38","author":"Niesten","journal-title":"Gerodontology"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S54630","article-title":"Oral health in the elderly patient and its impact on general well-being: a nonsystematic review","volume":"10","author":"Gil-Montoya","journal-title":"Clin Interv Aging"},{"issue":"11","key":"R12","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.3290\/j.qi.b6044427","article-title":"DMS \u2022 6: all new\u202f!","volume":"56","author":"Jordan","journal-title":"Quintessence Int"},{"issue":"11","key":"R13","doi-asserted-by":"publisher","first-page":"S112","DOI":"10.3290\/j.qi.b5982021","article-title":"Oral health in the elderly: results of the 6th German Oral Health Study (DMS \u2022 6)","volume":"56","author":"Samietz","journal-title":"Quintessence Int"},{"issue":"10194","key":"R14","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: a global public health challenge","volume":"394","author":"Peres","journal-title":"Lancet"},{"issue":"4","key":"R15","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1111\/j.1754-4505.2000.tb01152.x","article-title":"Behavior management and communication strategies for dental professionals when caring for patients with dementia","volume":"20","author":"Chalmers","journal-title":"Spec Care Dentist"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1111\/ger.70019","article-title":"Caregivers\u2019 experiences with involuntary oral care for individuals with dementia within the Dutch Care and Coercion Act","volume":"43","author":"Jonker","journal-title":"Gerodontology"},{"issue":"2","key":"R17","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph23020212","article-title":"Value of oral health assessments for older people with memory complaints visiting a memory clinic for a comprehensive geriatric assessment: a cross-sectional study","volume":"23","author":"Pruntel","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1111\/jgs.14697","article-title":"Oral hygiene in the elderly with different degrees of cognitive impairment and dementia","volume":"65","author":"Gil-Montoya","journal-title":"J Am Geriatr Soc"},{"issue":"1S","key":"R19","doi-asserted-by":"publisher","first-page":"101958","DOI":"10.1016\/j.jebdp.2023.101958","article-title":"Dental patient-reported outcomes in geriatric dentistry: a call for clinical translation","volume":"24","author":"Nitschke","journal-title":"J Evid Based Dent Pract"},{"issue":"4","key":"R20","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1111\/jopr.12410","article-title":"Intraoral digital impression technique compared to conventional impression technique. A randomized clinical trial","volume":"25","author":"Gjelvold","journal-title":"J Prosthodont"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jpor.2019.07.010","article-title":"Accuracy and practicality of intraoral scanner in dentistry: a literature review","volume":"64","author":"Kihara","journal-title":"J Prosthodont Res"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1111\/ger.12817","article-title":"Accuracy and reliability of intraoral 3D scans for diagnostic evaluations in nursing home residents","volume":"42","author":"Kharbot","journal-title":"Gerodontology"},{"issue":"4","key":"R23","doi-asserted-by":"publisher","DOI":"10.1111\/scd.70071","article-title":"Role of digital technologies in special care dentistry: a scoping review","volume":"45","author":"Kammer","journal-title":"Spec Care Dentist"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-17870-w","article-title":"Comparison of dental findings between dentists and pediatricians using intraoral scan-based teledentistry in children","volume":"15","author":"Schulz-Weidner","journal-title":"Sci Rep"},{"issue":"11","key":"R25","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1111\/joor.13836","article-title":"The role of teledentistry in improving oral health outcomes and access to dental care: an umbrella review","volume":"51","author":"Al-Buhaisi","journal-title":"J Oral Rehabil"},{"issue":"13","key":"R26","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1177\/00220345241271937","article-title":"Recent advances in intraoral scanners","volume":"103","author":"Eggmann","journal-title":"J Dent Res"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2025.105824","article-title":"The relevance of intraoral scanner (IOS) for periodontal diagnosis: a scoping review","volume":"160","author":"Caron","journal-title":"J Dent"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2024.104978","article-title":"Digital plaque monitoring: an evaluation of different intraoral scanners","volume":"145","author":"Jung","journal-title":"J Dent"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.1016\/j.identj.2025.109296","article-title":"Digital dentistry in clinical practice: a scoping review of current capabilities and future directions","volume":"76","author":"Lam","journal-title":"Int Dent J"},{"key":"R30","unstructured":"Digital dentistry. FDI World Dental Federation. URL: https:\/\/www.fdiworlddental.org\/digital-dentistry [Accessed 02-07-2026]"},{"issue":"5","key":"R31","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1111\/j.1468-2230.2012.00923.x","article-title":"The United Nations Convention on the Rights of Persons with Disabilities and mental health law","volume":"75","author":"Bartlett","journal-title":"Mod Law Rev"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2024.105355","article-title":"A feasibility study to recruit, retain and treat periodontitis in volunteers with mild dementia, whilst monitoring their cognition","volume":"150","author":"Cerajewska","journal-title":"J Dent"},{"issue":"11","key":"R33","doi-asserted-by":"publisher","first-page":"6747","DOI":"10.1007\/s00784-023-05287-6","article-title":"Chairside oral prophylaxis for people with profound intellectual or multiple disabilities-a retrospective feasibility study","volume":"27","author":"Auerbacher","journal-title":"Clin Oral Investig"},{"issue":"3","key":"R34","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1177\/00220345211042268","article-title":"Proposal for a conceptual framework for the development of geriatric dentistry","volume":"101","author":"Le\u00f3n","journal-title":"J Dent Res"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04750-4","article-title":"Effects of oral health interventions on cognition of people with dementia: a systematic review with meta-analysis","volume":"24","author":"Guo","journal-title":"BMC Oral Health"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1017\/S1041610216002167","article-title":"Proxy rated quality of life of care home residents with dementia: a systematic review","volume":"29","author":"Robertson","journal-title":"Int Psychogeriatr"},{"issue":"2","key":"R37","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s00784-018-2487-x","article-title":"Efficacy and acceptance of professional dental cleaning among nursing home residents","volume":"23","author":"Barbe","journal-title":"Clin Oral Investig"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:51:27Z","timestamp":1786049487000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e92879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":37,"URL":"https:\/\/doi.org\/10.2196\/92879","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"v10i1e92879"}}