当特別養護老人ホームにおける口腔ケア介入の効果∼保湿ジェルの使用経験∼

Abstract

The effectiveness of oral care in preventing pneumonia among the elderly has recently been elucidated. This study was designed to evaluate the efficacy of moisturizing gel (Oral Balance (T&K Co., Ltd., Tokyo)) at a special nursing home for the aged as an oral care product for preventing dry mouth. The subjects were 9 patients (aged 83.8+/-2.4 years; 3 men and 6 women) with cerebrovascular disease accompanied by frequent onset of loss of appetite, cough, sputum, halitosis, and fever. An oral care assessment table and checklist were prepared in advance, and weekly observations and evaluations were conducted for 6 months following the use of the moisturizing gel regarding the activities of daily living (ADL), physical condition, dietary condition, oral findings. Patients were instructed to apply a suitable amount of the moisturizing gel on their oral mucosa after each meal. In addition, for 6 (aged 83.8+/-2.5 years; 2 men, 4 women) of the subjects, the number of days with fever and the number of administrations of antibiotics and replacement fluid were compared during a six-month period before and after use of the moisturizing gel. Improvements were observed for ADL and consciousness level (n=1 each), dehydration, cough, sputum (n=2 each), fever (n=5) , and dietary intake (n=6). In addition, 6 patients had decreased plaque and dental calculi. No exacerbations were observed for any of the above findings. Comparison of monthly changes in the number of days with fever and the same months of the previous year revealed that no patients developed fever as of March 2007 (6 months after the start of use) following the use of the moisturizing gel. Comparison of the number of days with fever over a 6-month period showed a significant decrease (p<0.05) from a mean of 6.5+/-2.5 days before use to 5.2+/-2.6 days after use. Antibiotics were not given to any patients using the moisturizing gel from February and March 2007 following use. The number of administrations of replacement fluid decreased from around January 2007 following use. These findings suggest that oral care using a moisturizing gel might contribute to prevention of respiratory tract infections by oral contamination due to cerebrovascular disease.