A randomized clinical trial of oral hygiene care programmes during stroke rehabilitation

Dai, Ruoxi; Lam, Olt; Lo, Edward Chin Man; Li, Leonard S.W.; McGrath, Colman

doi:10.1016/j.jdent.2017.04.001

Cited by 24 publications

(87 citation statements)

References 29 publications

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“…Likewise, from findings of systematic reviews of ventilator‐associated pneumonia, chlorhexidine has been shown to reduce the risk of pneumonia by 3%–40% (Hua et al., ; Shi et al., ). Specific to stroke patients, several studies have identified the benefits of chlorhexidine in dental plaque control, in reducing gingival bleeding and in lowering oral pathogen counts (Dai, Lam, Lo, Li, & McGrath, ; Lam, McMillan, Samaranayake, Li, & McGrath, ). There is, however, no systematic review confirming which chemical method of plaque control is best to inform clinical guidelines for stroke oral hygiene care.…”

Section: Discussionmentioning

confidence: 99%

Oral hygiene practices and knowledge among stroke‐care nurses: A multicentre cross‐sectional study

Malik

Yatim

Hussein³

et al. 2018

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 99%

Oral hygiene practices and knowledge among stroke‐care nurses: A multicentre cross‐sectional study

Malik

Yatim

Hussein³

et al. 2018

Journal of Clinical Nursing

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“…42,44 Missing data is not an uncommon scenario in many types of clinical trial research, and this includes trials related to oral health promotion among stroke survivors. [44][45][46] These studies have documented a consistently high dropout rate, greater than recommended level of 20%. 47 Therefore, it is recommended that future studies conducted amongst stroke survivors and other frail patient group account for a higher dropout rate.…”

Section: Discussionmentioning

confidence: 99%

A multi‐centre randomised clinical trial of oral hygiene interventions following stroke—A 6‐month trial

Malik

Yatim

Razak

et al. 2017

J of Oral Rehabilitation

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Maintaining good oral hygiene is important following stroke. This study aimed to evaluate the effectiveness of two oral health promotion (OHP) programmes to reduce dental plaque levels following stroke. A multi-centre randomised clinical control trial was conducted among patients hospitalised following stroke in Malaysia. Patients were randomly allocated to two OHP groups: (i) control group who received the conventional method for plaque control-daily manual tooth brushing with a standardised commercial toothpaste, (ii) test group-who received an intense method for plaque control-daily powered tooth brushing with 1% Chlorhexidine gel. Oral health assessments were performed at baseline, at 3 months and 6 months post-intervention. Within- and between-group changes in dental plaque were assessed over time. Regression analyses were conducted on dental plaque levels at 6 months controlling for OHP group, medical, dental and socio-demographic status. The retention rate was 62.7% (54 of 86 subjects). Significant within-group changes of dental plaque levels were evident among the test group (P < .001) and the control group (P < .001). No significant between-group changes of dental plaque levels were apparent (P > .05). Regression analyses identified that baseline plaque levels (adjusted ß = 0.79, P < .001) and baseline functional dependency level (adjusted ß = -0.34, P < .05) were associated with dental plaques levels at the end of the trial (6 months). Both, "Conventional" and "Intense" oral health promotion programmes may successfully reduce dental plaque during stroke rehabilitation and are of comparable effectiveness. Baseline dental plaque levels and functional dependency level were key factors associated with dental plaque levels at follow-up at 6 months.

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“…Records of poststroke complications and mortality were recorded. Oral clinical health status was also assessed (DMFT, plaque index and gingival bleeding; Dai et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…Oral clinical health status was also assessed (DMFT, plaque index and gingival bleeding; Dai et al, 2017b within a group over time. Mann-Whitney U test was employed to compare difference in the rank of viable counts between intervention groups.…”

Section: Me Thodmentioning

confidence: 99%

“…Forward wald method was adopted in model fitting. The details of model fitting process can be referred to previously published papers of this study (Dai et al, 2017a(Dai et al, , 2017b. Logistic regression analysis was not performed to study the effect of potential factors on the presence of S. aureus since the presence of S. aureus was a rare event in this study (King & Zeng, 2001).…”

Section: Me Thodmentioning

confidence: 99%

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Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation

Dai

Lam²,

et al. 2018

Oral Diseases

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Objectives This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunistic pathogens among patients undergoing stroke rehabilitation. Methods A total of 94 patients were randomized to two groups. Subjects were block randomized to either (a) COHCP: manual toothbrushing with oral hygiene instruction (OHI); or (b) AOHCP: powered toothbrushing, mouthrinsing with chlorhexidine and OHI. Prevalence and viable counts of oral opportunistic pathogens including yeasts, aerobic and facultative anaerobic gram‐negative bacilli, Staphylococcus aureus, were assessed at baseline, the end of 3 and 6 months. Results No significant difference was observed in the prevalence of oral opportunistic pathogens within each group over the clinical trial period. A significant decrease in the viable counts of S. aureus was found over the clinical trial period within AOHCP group (p < 0.05), while the viable counts of yeasts and anaerobic gram‐negative bacillus (AGNB) remained stable within each group. Regression analysis failed to detect an association between intervention and the prevalence/viable counts of oral opportunistic pathogens. Conclusions Neither oral healthcare programme significantly affects AGNB, yeast or S. aureus over the study period in terms of prevalence and viable counts.

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A randomized clinical trial of oral hygiene care programmes during stroke rehabilitation

Cited by 24 publications

References 29 publications

Oral hygiene practices and knowledge among stroke‐care nurses: A multicentre cross‐sectional study

Oral hygiene practices and knowledge among stroke‐care nurses: A multicentre cross‐sectional study

A multi‐centre randomised clinical trial of oral hygiene interventions following stroke—A 6‐month trial

Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation

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