Effect of an Oral Hygienic Care Program for Stroke Patients in the Intensive Care Unit

Abstract

PurposeThe effects of an oral hygienic care program (OHCP) have been reported in several diseases. However, no study exists investigating the influence of an OHCP on stroke patients or patients in the intensive care unit (ICU) has been reported, thus we sought to investigate the potential effect of an OHCP.Materials and MethodsFifty-six consecutive stroke patients who were admitted to the ICU were randomly assigned to two groups: the intervention (29 patients) and control groups (27 patients). The OHCP included tooth brushing with an inter-dental brush and tongue cleaner and cleaning with chlorhexidine was administered to patients by one dentist once per day during admission in the ICU (mean, 2.2 weeks). The plague index, gingival index, clinical attachment loss, and colonization degree of candida albicans were assessed.ResultsAfter OHCP, the plaque index, gingival index, and colonization degree of candida albicans in saliva showed a significant decrease in the intervention group compared to those of the control group (p<0.05). However, no significant difference was observed in clinical attachment loss and the colonization degree of candida albicans on the tongue (p>0.05).ConclusionOur OHCP was effective in improving the oral hygienic status and periodontal health of stroke patients during their stay in the ICU. Therefore, we recommend administration of the OHCP for stroke patients during their stay in the ICU.

Effectiveness of a Dental Care Intervention in the Prevention of Lower Respiratory Tract Nosocomial Infections among Intensive Care Patients: A Randomized Clinical Trial

“…28 Our data support the hypothesis that a dental surgeon may make a difference in this scenario, thus enhancing the effect of oral antiseptics and preventing around 56.0% of LRTI episodes. Although other authors have reported having a dental surgeon within their ICU team, 29,30 to the best of our knowledge, this is the first study to address the impact of that on a relevant clinical outcome, such as the LRTI incidence. The number needed to treat of 10.5 suggests that intervention may be cost effective, if we consider that 1 VAP episode may produce an extra cost of US$10,019-US$25,072.…”

Effects of combination oral care on oral health, dry mouth and salivary pH of intubated patients: A randomized controlled trial

“…However, patients who are critically ill are especially vulnerable to oral health problems, such as ulcers of the mucous membranes, gum inflammation, bleeding, periodontitis and stomatitis. These problems worsen when patients require endotracheal tubes (ETT) or mechanical ventilator support . As patients who are intubated cannot eat orally and are prone to inadequate oral hygiene, bacteria can grow and form plaque and bacterial colonies.…”

“…These problems worsen when patients require endotracheal tubes (ETT) or mechanical ventilator support. 2 As patients who are intubated cannot eat orally and are prone to inadequate oral hygiene, bacteria can grow and form plaque and bacterial colonies. Poor oral hygiene can trigger systemic or respiratory infections because of bacterial colonization in the oropharyngeal cavity.…”

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

“…The primary outcome was the changes in the dental plaque score [PI scores]. A sample size of 23 subjects per group was calculated based on the detection of a clinically meaningful PI change score of 0.55 an anticipated SD of 0.6 and 80% power. To allow for potential dropout rates of 40%; at least 38 patients per group were required.…”