Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 7, 2026
Date Accepted: Jul 10, 2026
Bedside Intraoral Scanning to Reduce Procedural Burden in Older Adults With Dementia: A Nonrandomized Counterbalanced Crossover Feasibility Study
ABSTRACT
Background:
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—characterized by sustained intraoral manipulation, sensory overload, and limited opportunities for interruption—may 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.
Objective:
To assess the feasibility and tolerability of bedside maxillary intraoral scanning compared with a conventional impression procedure in people living with dementia.
Methods:
A single-center, counterbalanced crossover feasibility study was conducted on a geriatric ward. Nineteen hospitalized participants with dementia (mean age 83.5 ± 3.4 years; mean Mini-Mental State Examination score 18.2 ± 4.8) underwent bedside maxillary intraoral scanning and a conventional alginate-based impression procedure in an alternating allocation order during a single visit. The primary outcome was feasibility, defined as completion without premature termination due to gag reflex or defensive movements. Secondary outcomes included participant-rated discomfort (0–10 visual analog scale [VAS]), clinician-rated manageability (0–10 VAS; higher scores indicating greater difficulty), adverse reactions (gag reflex, defensive movements), and procedure time (minutes). Paired comparisons were performed using Wilcoxon signed-rank and McNemar tests (two-sided α = .05).
Results:
Feasibility was high for both procedures, with completion in all participants for intraoral scanning (19/19, 100%) and in 18 of 19 participants (94.7%) for the conventional impression procedure. Participants reported significantly lower discomfort with intraoral scanning (median VAS 1.4 vs 5.9; P < .0001), and clinicians rated intraoral scanning as more manageable (median VAS 2.3 vs 5.0; P = .0002). Gag reflex occurred less frequently during intraoral scanning (5.3% vs 47.4%; P = .004). Procedure time was similar between techniques (mean 3.0 vs 2.9 minutes). No evidence of an order effect was observed.
Conclusions:
Bedside intraoral scanning was feasible in hospitalized older adults living with dementia and was associated with markedly lower procedural burden than a conventional alginate-based impression procedure without increasing chairside time. IOS may serve as a gateway technology for low-burden oral data acquisition to support assessment and care planning in dementia care. Larger multicenter implementation studies are warranted to evaluate scalability and integration into routine care pathways. Clinical Trial: DRKS00027119
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