Abstract
Objective: To investigate the effectiveness of an existing standard oral care program (SOCP) and factors associated with it during hospitalization in individuals with acquired brain injury (ABI).Material and Methods: A total of 61 individuals underwent a SOCP for 4 weeks in a longitudinal observational study. Rapidly noticeable changes in oral health were evaluated by performing plaque, calculus, bleeding on probing (BOP) and bedside oral examination (BOE) at weeks 1 and 5. Individuals' brushing habits, eating difficulties, and the onset of pneumonia were retrieved from their medical records. Association between oral-health outcomes to systemic variables were investigated through multilevel regression models.Results: Dental plaque (P = 0.01) and total BOE score (P < 0.05) decreased over time but not the proportion of dental calculus (P = 0.30), BOP (P = 0.06), and tooth brushing frequency (P = 0.06). Reduction in plaque and BOE over time were negatively associated with higher periodontitis scores at baseline (coef. −6.8; −1.0), respectively, which in turn were associated with an increased proportion of BOP (coef. ≈ 15.0). An increased proportion of calculus was associated with eating difficulties (coef. 2.3) and the onset of pneumonia (coef. 6.2).Conclusions: Nursing care has been fundamental in improving oral health, especially reducing dental plaque and BOE scores. However, our findings indicate a need for improving the existing SOCP through academic-clinical partnerships.Clinical Relevance: Early introduction of oral care program to brain-injured individuals is beneficial in reducing plaque accumulation and improving oral health.
Highlights
Oral care is essential to maintain oral health and prevent complications such as periodontal diseases and tooth loss in patients with acquired brain injury (ABI) [1,2,3,4,5]
Paired analysis revealed that the proportion of sites with visible dental plaque (P = 0.01) significantly decreased over time but bleeding on probing (BOP) (P = 0.06), calculus (P = 0.30), and the frequency of tooth brushing (P = 0.06) did not achieve statistically significant changes after 5 weeks of hospitalization
The main finding of the study was that the oral health parameters such as visible plaque and Bedside Oral Examination (BOE) scores significantly improved during a 5-week stay at neurorehabilitation setting following the current standard oral care program (SOCP)
Summary
Oral care is essential to maintain oral health and prevent complications such as periodontal diseases and tooth loss in patients with acquired brain injury (ABI) [1,2,3,4,5]. Acquired brain injury individuals with swallowing difficulties have compromised oral clearance that may lead to increased bacterial load [5]. Swallowing impairment, along with poor oral health has a significant impact on an individual’s nutritional intake [11], increasing the risk of aspirational pneumonia [6, 12], which in turn has a negative impact on rehabilitation and other functional outcomes [6, 13]
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