Feature ArticleEffective elimination of contaminants after oral care in elderly institutionalized individuals
Section snippets
Subjects and materials
We conducted a prospective cross-over trial in the neurology unit of our hospital from June 2013 to November 2013. The sample size was calculated based on our previous study with healthy individuals for a two-tailed significance level, a type I error of 0.05, and a type II error of 0.10 (power = 0.90).14 Patients who were not able to properly brush their teeth by themselves were recruited. Patients were excluded if they were edentulous, of unstable general physical condition, or had a bleeding
Results
Mean BI (mean ± SD) score of participants was 28.7 ± 28.6. Only seven patients had a score of over 60, indicating an assisted independence level, while 22 patients scored below 40 and required substantial assistance in activities of daily living. In the protocol of this study, all oral care was performed by nurses even if the participants could somewhat brush their teeth.
There were no statistical differences in the amount of oral bacteria between the rinse and wipe groups at any of the three
Discussion
The oral health condition of frail institutionalized elderly patients is easily deteriorated by systemic diseases, diminished physical function, and xerostomia, thus providing favorable conditions for dental plaque biofilm formation. If the biofilm is not properly eliminated by mechanical cleaning in the early stages of colonization, pathogenic bacteria may subsequently proliferate in later colonization. Moreover, several studies have reported that oral care intervention reduces the incidence
Conclusion
We examined the effectiveness of wiping the mouth with mouth wipes as a means to reduce oral bacteria after oral care. We witnessed that the amount of bacteria decreased significantly with wiping to a degree comparable to rinsing with water and suction. Our findings suggest that wiping with mouth wipes may be an alternative procedure to eliminate contaminants after oral care that prevents the unnecessary risk of aspiration and possible pneumonia in institutionalized dependent patients.
Acknowledgments
This study was partly supported by Longevity Sciences (25-7) from the National Center for Geriatrics and Gerontology, Japan, 8020 foundation grant, and a research grant from Wakodo Co., Ltd.
The authors declare that there is no conflict of interest.
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