Effects of oral care with tongue cleaning on coughing ability in geriatric care facilities: a randomised controlled trial

Abstract

Methods for preventing aspiration pneumonia are needed soon in order to reduce mortality from aspiration pneumonia and promote the health of the elderly. The aim of this randomised controlled trial was to examine whether oral care with tongue cleaning improves coughing ability in elderly individuals living in geriatric care facilities. Participants comprised of 114 residents of 11 group homes and private nursing homes in Aso City in Kumamoto Prefecture. Participants were randomly assigned to either (i) a group that underwent routine oral care with tongue cleaning (intervention group; n = 58) or (ii) a group that underwent routine oral care alone (control group; n = 56). Coughing ability was evaluated by measuring peak expiratory flow (PEF) before and after 4 weeks of intervention. Before the intervention, PEF did not differ significantly between the intervention group (1·65 ± 1·11 L s ) and control group (1·59 ± 1·05 L s ; P = 0·658). However, on termination of the intervention, PEF was significantly higher in the intervention group (2·54 ± 1·42 L s ) than in the control group (1·90 ± 1·20 L s ; P = 0·014). After the intervention, PEF had increased significantly in both groups; however, this increase was significantly greater in the intervention group (0·90 ± 0·95 L s ) than in the control group (0·31 ± 0·99 L s ; P < 0·001). Oral care with tongue cleaning led to increased PEF, suggesting improved coughing ability. Oral care incorporating tongue cleaning appears to be important for preventing aspiration pneumonia.

The effect of a daily application of a 0.05% chlorhexidine oral rinse solution on the incidence of aspiration pneumonia in nursing home residents: a multicenter study

“…Tongue cleaning too seems to improve the coughing ability in nursing home residents, which may prevent aspiration [54]. …”

Long‐term success of oral health intervention among care‐dependent institutionalized seniors: Findings from a controlled clinical trial

“…These seniors frequently wear complete dentures in need of improvement which can also be associated with malnutrition . There are, furthermore, correlations between reduced oral health and such general medical issues as arteriosclerosis, infection‐related disorders and pneumonia …”

“…4 There are, furthermore, correlations between reduced oral health and such general medical issues as arteriosclerosis, 5 infection-related disorders 6 and pneumonia. 7 Although the compromised oral health of the institutionalized seniors is addressed in cross-sectional research, 2,8,9 little information is available on the effect of intervention to improve oral health. The purpose of such intervention is, usually, education of nursing home staff in oral health and implementation of recall programmes for the residents.…”

Prevalence of Tongue Cleaning Using a Toothbrush: A Questionnaire Survey in Fukui Prefecture, Japan

“…In institutionalized elderly, the importance of oral care, including tongue cleaning has received attention, and several studies have reported on the topic. Izumi et al reported that oral care with tongue cleaning is important for preventing aspiration pneumonia, because it could improve coughing ability [2]. Recently, the relationship between tongue coating and food type were clari ed, and its result suggested that tongue cleaning should be performed with consideration for the food type [3].…”