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

Abstract

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

Oral Status of Elderly Patients in Long-Term Care Facilities: A Systematic Review

“…Of the ve studies selected for this systematic review, two were carried out conducted in Europe 9,20 , two in Asia 21,22 , and one in Australia 23 .…”

“…All the works were based on with a sample size that could offer extrapolated data (more than 50 elderly patients): Poisson et al 9 159 patients, Gerritsen et al 20 355, Chen et al 21 120, and that the smallest ones, Murray et al 23 and Nakayama et al 22 with 89 and 50 patients, respectively, making a total of 773 patients.…”

“…Gerritsen and co-workers 20 took as their sample a group of elderly subjects from three retirement homes, while Chen et al 21 studied individuals from a geriatric medical centre and Murray et al 23 patients from three rehabilitation centres for patients who had suffered a cerebrovascular accident (CVA). Poisson et al…”

“…Two of the studies 22,23 did not specify the length of the stay in the institution, but, from the information provided in the articles, we understand that all the studied patients had been institutionalised for at least 7 days 21,23 , while the longest periods were those mentioned by Gerritsen et al 20 (more than two years). Accordingly, the subjects who had been cared for the longest period of time were those mentioned in the only study carried out in retirement homes.…”

“…Except for Murray et al 23 and Nakayama et al (Nakayama et al, 2017), who worked with very speci c types of patient (patients in rehabilitation after CVA and patients with ALS, respectively), none of the studies speci ed the reason for admission to the centres, although Gerritsen et al 20 and Chen et al 21 gave a general outline. In particular, Gerritsen et al 20 speci ed that 47% were in the nursing home for somatic reasons and 53% for psychogeriatric reasons, while Chen et al 21 pointed out that the main diagnoses of their sample at admission were pneumonia, sepsis, idiopathic fever and infection of the urinary tract.…”