Annual distribution of publications
The process of data selection is shown in Fig. 1. Of the 7073 articles preliminary screened, a final analysis of 716 articles was conducted. As seen in Fig. 2, it shows the details of temporal distribution and trends of oral care in the elderly in mainland China over the past two decades. There is generally an upward trend in the volume of Chinese-language articles, among which the number of articles published in 2018 reached a peak of 70, accounting for 9.8% of all literature. In contrast, the overall publication volume of English-language publications tends to be stable and low, with the first article published in 2008. The data in 2022 can’t reflect the publication of the whole year.
Distribution of journals and authors
The 716 papers were published in a total of 240 journals, including 28 nursing journals, taking up 11.7%. All 19 English language literature were published in Science Citation Index journals. 219 Chinese language articles were published in 76 kinds of Chinese core journals, occupying 30.6% of the total literature. Table 1 shows the top 10 journals publishing oral care literature for the elderly in mainland China from 2002 to 2022, of which only a few are core journals. 716 articles involving a total of 1452 authors, of which the author with the largest number of articles was Qiwei Gong, who published 7 articles in total, accounting for 1.0% of the total number of articles. Figure 3 shows the Nightingale Rose Chart of the distribution of the top 20 authors of both Chinese and English literature.
Table 1
Top 10 journals with the highest number of published articles.
No. | Journal | Number | Percentage, % |
1 | Electronic Journal of General Stomatology | 41 | 5.7 |
2 | Chinese Journal of Geriatric Dentistry | 36 | 5.0 |
3 | China Health Care Nutrition | 28 | 3.9 |
4 | Modern Nurse | 19 | 2.7 |
5 | Guide of China Medicine | 16 | 2.2 |
6 | Journal of Qilu Nursing | 13 | 1.8 |
7 | Health guide | 13 | 1.8 |
8 | Medical Information | 13 | 1.8 |
9 | World Latest Medicine Information | 12 | 1.7 |
10 | Nursing Journal of Chinese People's Liberation Army | 11 | 1.5 |
Distribution of issuing institutions
Figure 4, 5 depict the map of institutional networks of Chinese and English literature, respectively. The analysis of addresses shows that 14 papers lack authors’ addresses so only 702 papers are used in this section.
In Fig. 4, the top three Chinese language publishing institutions are the General Hospital of the People's Liberation Army (published 18 articles, accounting for 2.5% of the total), the Affiliated Stomatological Hospital of Nanjing Medical University (published 10 articles, accounting for 1.4% of the total), and the Affiliated Stomatological Hospital of Medical School of Nanjing University (published 7 articles, accounting for 1.0% of the total), respectively. The rest institutions have one to six publications.
In Fig. 5, the top three English language publishing institutions are School of Nursing, Fudan University (published 4 articles, accounting for 0.6% of the total), West China Hospital of Stomatology, Sichuan University (published 2 articles, accounting for 0.3% of the total), and Hospital of Stomatology, Guanghua College of Stomatology, Sun Yat-Sen University (published 2 articles, accounting for 0.3% of the total), respectively. Besides, research collaborations have been conducted by some mainland Chinese institutions with international institutions, such as Rory Meyers College of Nursing New York University, Duke University School of Nursing and College of Dental Science, and Radboud University Nijmegen Medical Centre. According to the time bar at the top of Fig. 5, School of Nursing, Fudan University has been cooperating with other institutions since 2015, which means it is an active cooperative institution in the field of oral care research in the elderly.
Keywords Co-occurrence
Table 2 and Fig. 6 show the top 20 high-frequency keywords and the co-occurrence graph of keywords in articles published in Chinese language on oral care for the elderly from 2002 to 2022, respectively. Based on the frequency and centrality of keyword co-occurrences, “oral care”, “oral health education” and “tooth extraction” were the hot keywords in Chinese language publications. In addition, in Fig. 6, the color of annual rings corresponds to the timeline at the top of the figure, although the diameter of the annual ring of periodontitis, mental nursing, quality of life and oral health care is small, the outer ring is orange, which indicates that these keywords are receiving more and more attention in recent years.
Table 2
Distribution of the top 20 high-frequency keywords in Chinese language publications.
No. | Keyword | Frequency | Centrality | No. | Keyword | Frequency | Centrality |
1 | the elderly | 152 | 0.12 | 11 | prosthodontics | 28 | 0.09 |
2 | elderly patients | 133 | 0.21 | 12 | periodontitis | 25 | 0.05 |
3 | nursing | 128 | 0.16 | 13 | oral | 23 | 0.19 |
4 | oral care | 97 | 0.55 | 14 | oral cancer | 22 | 0.07 |
5 | old age | 95 | 0.11 | 15 | quality of life | 21 | 0.06 |
6 | mental nursing | 48 | 0.16 | 16 | oral health care | 19 | 0.04 |
7 | nursing intervention | 32 | 0.08 | 17 | oral disease | 18 | 0.12 |
8 | tooth extraction | 31 | 0.24 | 18 | diabetes | 17 | 0.42 |
9 | oral health education | 28 | 0.3 | 19 | perioperative period | 15 | 0.31 |
10 | oral health | 28 | 0.2 | 20 | complete denture | 14 | 0.04 |
Table 3 and Fig. 7 show the top 6 high-frequency keywords and the co-occurrence graph of keywords in articles published in English language on oral care for the elderly from 2002 to 2022, respectively. It can be seen by combining the frequency and centrality of keyword co-occurrence that the hot keywords in English language publications were “risk factor”, “tooth loss”, “oral health”, “quality of life” and “older adult”.
Table 3
Distribution of the top 6 high-frequency keywords in English language publications.
No. | Keyword | Frequency | Centrality |
1 | oral health | 6 | 0.24 |
2 | older adult | 6 | 0.13 |
3 | tooth loss | 4 | 0.27 |
4 | quality of life | 3 | 0.25 |
5 | risk factor | 2 | 0.28 |
6 | dental status | 2 | 0.01 |
Burst Terms
Figure 8 shows the top 20 keywords with the strongest citation burst in both Chinese and English language published articles on oral care in the elderly in mainland China. In Chinese language publications, the burst keywords in the beginning included “the elderly”, “nursing”, “tooth extraction”, and “oral disease”. Burst keywords including “periodontitis”, “nursing efficacy”, “influence factor”, “quality of life”, “satisfaction”, “high quality nursing” and “oral health” have been bursting since 2018, of which the keywords of “periodontitis”, “nursing efficacy” and “influence factor” have a long burst time of 5 years. It’s worth noting that the burst intensity of “quality of life” reached 6.22, indicating that the oral health related quality of life of the elderly has received the highest attention and is a hot research area. In English language publications, “tooth loss” burst the earliest and lasted the longest, plus the burst intensity, verifying its importance and popularity during 2008 to 2015. "Quality of Life" has continued to burst with the highest intensity since 2021, which is consistent with the conclusion drawn from data of Chinese language publications.
Keywords Time zone diagram
Figure 9 shows the distribution of keywords over time in Chinese language articles, it can be seen that there are different concerns in different periods. Hence, the evolution of oral care research for the elderly in mainland China can be divided into three development stages: basic initial stage, prosperous stage and new stage.
Basic initial stage (2002–2003): At this stage, oral care research for the elderly was in the initial development stage, the research was messy and not systematic.
Prosperous stage (2004–2014): During this period, the study of oral care for the elderly gradually increased, and the research direction began to diversify. Researches were approximately spread out from the aspects of mental nursing, health education, oral health related quality of life, oral nursing intervention etc.
New stage (2015-): In this phase, the research of oral care for the elderly is gradually deepening and meticulous in mainland China. During this period, mental nursing, health education and oral care intervention are still issues that need to be concerned. However, different from the past, in-depth analysis of its research problems has been done in the new era. That is to say, from the perspectives of satisfaction, application effect and compliance etc., the improvement situation of various nursing interventions on oral health and oral health related quality of life of the elderly is specifically explored.
Figure 10 shows the distribution of keywords over time in English language articles. The research on oral care in the elderly started relatively late, the first English literature was published in 2008, there was a period of stagnation between 2011 and 2015, we divided the study into two stages for analysis.
Phase one (2008–2011): In this phase, a total of three articles were published, and the research content was relatively scattered.
Phase two (2015-): In this phase, the number of published papers has increased significantly, and research contents have become more abundant, focusing not only on the oral health problems of the elderly, but also on the nutritional status, masticatory function, cognitive dysfunction and quality of life of the elderly, comprehensively discuss the field of oral care for the elderly in a multi-dimensional and multi-level way.