Integrated oral health care for stroke patients – a scoping review

Ajwani, Shilpi; Jayanti, S.; Burkolter, Nadia; Anderson, Craig S.; Bhole, Sameer; Itaoui, Rhonda; George, Ajesh

doi:10.1111/jocn.13520

Cited by 49 publications

(43 citation statements)

References 38 publications

(64 reference statements)

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“…Patients with ABI usually have physical impairment, lack of motor co‐ordination and the cognitive deficits, which become important barriers to the practice of routine oral hygiene, especially with complications like dysphagia . However, compared to previous surveys among ICU nurses, the percentage finding it difficult to clean the oral cavity (41%) was lower in the current survey.…”

Section: Discussioncontrasting

confidence: 73%

Survey of oral nursing care attitudes, knowledge and practices in a neurorehabilitation setting

Odgaard¹,

Kothari

2019

J of Oral Rehabilitation

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The provision of oral care is an important fundamental nursing activity. The purpose of the study was to gain knowledge on nursing care professionals´ attitude, belief, knowledge and practice towards oral care in a neurorehabilitation setting. Nursing care professionals (n = 260, response rate: 60%) at neurorehabilitation hospital took part in cross‐sectional web‐based 59‐items survey. Attitudes were cross‐tabulated and compared using Fisher's exact test. Oral care product frequencies were compared between patients with/without eating difficulties using McNemar's test. Most professionals agreed that oral health impacts general health (93%) and poor oral health can cause pneumonia (85%). 41% professionals found it difficult to clean the oral cavity and 12% found it unpleasant. 40% indicated that time allocated for oral hygiene was insufficient, 27% indicated a need for broader range of oral care supplies and >80% would like continuing oral care education. Manual toothbrush and toothpaste were used more than once per shift by >75% in all patients. Swabs, premixed mouth rinse, carbonated water and lip moisturiser were more frequently used in patients with eating difficulties compared to with no eating difficulties. Oral care is perceived as an essential component of care in neurorehabilitation. However, professionals indicated lack of time, need for better supplies and oral care training. The differentiated use of oral care products shows that professionals were aware that patients with eating difficulties have different requirements; however, some oral care practices were inappropriate. The results should be considered while designing oral care guidelines and training.

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Section: Discussioncontrasting

confidence: 73%

Survey of oral nursing care attitudes, knowledge and practices in a neurorehabilitation setting

Odgaard¹,

Kothari

2019

J of Oral Rehabilitation

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“…The effectiveness of non‐dental professional‐led oral care routines remains controversial in the literature. A recent systematic review found mixed results when it came to the improvement of oral health of stroke patients with a nurse‐led oral care programme and a dearth of evidence about knowledge and attitudes of non‐dental professionals . These authors found no Australian studies regarding the oral health care of patients post‐stroke but suggested that an integrated oral care programme involving the key non‐dental professionals such as nurses, occupational therapists, speech pathologists and dieticians is worthy of future research.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that three times daily oral hygiene is not necessarily a common practice in hospitals, it was promising to see that improvements could be made in such a short time frame. The positive findings in this short time span are unique, comparing favourably with other studies of longer duration . The protocol used was easy to follow and required only inexpensive commonplace materials such as toothpaste and toothbrush.…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review found mixed results when it came to the improvement of oral health of stroke patients with a nurse-led oral care programme and a dearth of evidence about knowledge and attitudes of non-dental professionals. 41 These authors found no Australian studies regarding the oral health care of patients post-stroke but suggested that an integrated oral care programme involving the key non-dental professionals such as nurses, occupational therapists, speech pathologists and dieticians is worthy of future research. The nurse-led oral hygiene protocol presented in this paper resulted in improved oral health for hospital inpatients and further supports the inclusion of oral care in stroke care pathways.…”

Section: Discussionmentioning

confidence: 99%

“…The positive findings in this short time span are unique, comparing favourably with other studies of longer duration. 41 The protocol used was easy to follow and required only inexpensive commonplace materials such as toothpaste and toothbrush.…”

Section: Discussionmentioning

confidence: 99%

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An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation

Murray

Scholten

2017

Gerodontology

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The objective: To determine whether a simple oral hygiene protocol improves the oral health of inpatients in stroke rehabilitation.The background data discussing the present status of the field: Poor oral health can lead to serious complications, such as pneumonia. The comorbidities associated with stroke, such as dysphagia, hemiparesis and cognitive impairment, can further impede independent oral care. International stroke guidelines recommend routine oral care but stop short of detailing specific regimes. Materials and methods:The oral health assessment tool (OHAT) was conducted by speech-language pathologists with 100 patients with and without dysphagia in three metropolitan inpatient stroke rehabilitation facilities. A simple nurse-led oral hygiene regime was then implemented with all participants, which included twice daily tooth brushing and mouth rinsing after lunch, and oral health was measured again one week later.Results: Initially, dysphagia was negatively associated with OHAT scores, and independence for oral hygiene was positively associated with oral health. After one week of a simple oral hygiene regime, the OHAT scores available for 89 participants indicated an improvement on average for all participants. In particular, 59% of participants with dysphagia had an improvement of 1 or more points. None of the participants developed pneumonia. Conclusion:A simple, inexpensive oral hygiene regime resulted in positive outcomes for patients with and without dysphagia in inpatient stroke rehabilitation settings. Oral health assessments and oral hygiene regimes that are simple to implement by the interdisciplinary team can be incorporated into standard stroke care with positive effect. K E Y W O R D Sclinical protocols, deglutition disorders, dysphagia, nursing, oral health, oral hygiene, rehabilitation, stroke

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Oral health knowledge, attitudes and practices of dietitians in Australia: A national survey

Patterson‐Norrie,

Ramjan,

Sousa

et al. 2024

Health Prom J of Aust

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AimDietitians are a well‐placed profession to be providing pre‐emptive oral health promotion. Despite recommendations that oral health promotion should be routinely part of dietetic practice, there is limited data informing the current practices of clinical dietitians in this area across Australia. Hence, the aim of this study was to investigate the knowledge and practices of Australian dietitians and oral health promotion.MethodsA cross‐sectional survey was undertaken involving registered clinical dietitians in Australia using purposive and snowballing sampling (social media/dietetic organisations/public databases). Data were analysed using descriptive and inferential statistics.ResultsA total of 149 dietitians participated in the national survey. Overall, dietitians were knowledgeable about oral health risk factors and preventative measures across general health domains. Majority of dietitians agreed that oral health can affect nutrition interventions (95.5%) and dietitians should be discussing oral health (88.0%). However, nearly half were not confident in providing counselling or education and felt that undergraduate training for oral health promotion was inadequate (78.2%). A small proportion (6.0%) of dietitians were already providing oral health promotion regularly. Key barriers included a lack of clear guidelines for practice, limited training opportunities and indistinct referral pathways.ConclusionDietitians have acknowledged that oral health promotion should be incorporated into their practice. However, they are challenged by a lack of resources and training to support this in clinical practice.So What?Capacity building dietitians to promote oral health allows opportunity for improvement in the oral health, nutritional status and quality of life of priority population groups.

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Integrated oral health care for stroke patients – a scoping review

Abstract: Nondental professionals, especially nurses, can play a key role in the poststroke oral health management of stroke patients to reduce complications, especially pneumonia.

Cited by 49 publications

References 38 publications

Survey of oral nursing care attitudes, knowledge and practices in a neurorehabilitation setting

Survey of oral nursing care attitudes, knowledge and practices in a neurorehabilitation setting

An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation

Oral health knowledge, attitudes and practices of dietitians in Australia: A national survey

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