Professional Design of a Geriatric Oral Health Assessment Tool for Nigerian Primary Healthcare Settings

Systematic oral health assessment for elderly patients in primary healthcare is absent from routine geriatric practice in Nigeria, and developing a standardised assessment tool bridges the gap between medical and dental care for older adults. This study designed a Geriatric Oral Health Assessment Tool for use in primary healthcare settings in Nigeria, with contextualisation for North Central Nigeria as the design environment. A professional tool development methodology was applied, drawing on structured consultations with 15 PHC physicians and nurses managing elderly patients, 10 prosthodontists and gerodontists, and 6 public health specialists, alongside review of validated geriatric oral health tools including the General Oral Health Assessment Index and GOHAI. The tool developed encompasses 12 items covering number of teeth, denture status and comfort, oral mucosal lesion screening, xerostomia assessment, chewing difficulty, oral hygiene status, pain or discomfort, and periodontal health indicators. Each item uses a simple observational or patient-report format accessible to non-dental health workers. A scoring and action matrix guides referral decisions. Expert review by nine gerodontology and primary care specialists confirmed the tool's clinical validity and practical usability. Pilot testing of the tool with 40 elderly patients in a Kogi State PHC facility confirmed completion time of under 8 minutes by trained community health extension workers. Recommendations include validation in a multi-site study across six geopolitical zones and endorsement by Nigeria's Geriatrics Society before national deployment.

Keywords: geriatric oral health assessment, primary healthcare, elderly patients, tool development, Nigeria