The short‐term effects of various oral care methods in dependent elderly: comparison between toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine

Abstract

The short-term effects of various oral care methods in dependent elderly: comparison between toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine Objectives: To explore the short-term effects from toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine. Background: Numerous reports have been seen in recent years proving the effectiveness of mouth cleaning with a toothbrush for the prevention of respiratory infections among the dependent elderly. However, the short-term effects from each oral care method have not yet been clarified. Hence, an investigation was conducted by having each subject independently perform various oral care methods for five consecutive days. Materials and Methods: The subjects consisted of 12 assistance-dependent elderly who have difficulties with tooth brushing by themselves, have 10 or more residual teeth and are not yet using plate dentures. After the pre-intervention examination, each of the following oral care methods were performed on the same subject on an approximately three week basis: 1) Tooth brushing 2)Tongue cleaning with sponge brush 3)Wiping on oral mucous with sponge brush by chlorhexidine. Each method was performed independently, once a day for 5 consecutive days and the subjects were reexamined on the sixth day for comparative verification. Results: Consequently, toothbrushing decreased the plaque index and gingival index significantly and an improvement of oral malodour was also acknowledged (p < 0.01). Tongue cleaning with a sponge brush decreased the tongue coat score significantly (p < 0.05) and oral malodour was also improved (p < 0.01). Wiping on oral mucous with a sponge brush soaked in chlorhexidine significantly decreased opportunistic infections in the pharynx region (p < 0.05). Conclusions: It was suggested that the use of not only a toothbrush but also chlorhexidine gluconate may be indicated for dependent elderly people in whom pathogens of opportunistic infection are detected.

The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

“…A previous study conducted among the dependent elderly in Japan found that wiping oral mucosa with a sponge brush soaked in chlorhexidine decreased opportunistic infections in the pharyngeal region (p < 0.05). (14) Another consistent finding from a study in Brazil was that chlorhexidine-based treatment had the ability to remove oral biofilm in 60 geriatric patients. (20) In addition, the present study confirmed that daily application of chlorhexidine 0.2% solution is effective in reducing microbes in the oral cavity.…”

“…A similar study in Japan was also unable to provide data on the incidence of aspiration pneumonia. (14) The absence of aspiration pneumonia in our patients may have been due to the short-term effects of oral hyigene care over seven days and the small sample size. Previous research recommended having a study with a longer duration and higher number of patients, to possibly support the theory that effective oral care is an important contributing factor in the prevention of aspiration pneumonia.…”

“…(13) The present study also aimed to address the recommendation for managing pneumonia from the United States Centers for Disease Control and Prevention. (14) In this clinical practice guideline, the efficacy of chlorhexidine is still an unresolved issue, indicating insufficient evidence or no existing consensus on its efficacy. (14) These research gaps need to be addressed to achieve the recommendations of the WHO.…”

“…(14) In this clinical practice guideline, the efficacy of chlorhexidine is still an unresolved issue, indicating insufficient evidence or no existing consensus on its efficacy. (14) These research gaps need to be addressed to achieve the recommendations of the WHO. Therefore, this study sought to provide evidence of the efficacy of chlorhexidine in reducing oral colonisation in the geriatric population.…”

Oral Hygiene Practices in Critically Ill Patient Requiring Endotracheal Intubation and Mechanical Ventilation

“…Aspiration of oral secretions is one of the most important aetiology of ventilator associated pneumonia [4,7,12,22,23,24]. Contaminated secretions of oral cavity collect above the endotracheal tube cuff and which can trickle down the trachea to lung along the cuff.…”