Improvement Of Oral Conditions Research Articles

A systematic review of interventional studies on oral care of palliative patients

To study and review the effectiveness of oral care interventions for palliative patients for amelioration of clinical conditions affecting oral cavity. Following PRISMA standard, a systematic evaluation of articles published between 2000 and 2021 was undertaken utilising five databases on interventions studies. This comprehensive review consists of randomised controlled trials (RCTs) and specific types of non-randomised studies (NRS) examining oral care interventions for palliative patients. Three independent authors screened search records, identified related studies, extracted data and evaluated risk of bias. The key findings of each study were summarised according to the research questions and data that generated during the data extraction procedure. Out of the 67 identified studies, seven were included in this review (five RCTs and two NRSs) involving head-and-neck cancer, oral cancer, oral mucositis, xerostomia and individuals with malignant disease. Interventions studied were: Ziziphus honey, artificial saliva, CAM2028-Benzydamine, morphine mouthwash, ketamine mouthwash, bethanechol tablets and caphosol with regular oral-care. The durations of interventions in the included studies were largely short-term (six weeks or less). Overall, six studies revealed good results in support of the intervention, with magnitudes of effect ranging from 13.2-10,110.0%. However, just four researches found significant changes, with magnitudes of effect ranging from 50.0-10,110.0%. Although two of the trials have not revealed significant changes in the results, investigations have indicated a reduction in oral conditions in the group with interventions. Only one trial has not indicated an improvement in oral conditions in the groups which received the interventions. By assessing the efficacy of available oral hygiene interventions for palliative patients, this systematic review can help palliative team finds the viable strategies to apply in controlling oral problems among hospice patients. Even though only four of the seven research found a statistically significant difference, most studies found great effectiveness in favour of intervention.

Professional oral care in end-of-life patients with advanced cancers in a hospice ward: improvement of oral conditions

BackgroundIn end-of-life patients with advanced cancers, oral examination, oral care, and oral re-examination are crucial. Although oral symptoms are among the major complaints of end-of-life patients, few studies have focused on oral care in these patients. In this study, the association between oral symptoms and oral dryness among end-of-life patients was examined, and improvement of oral conditions after oral care interventions by a professional dentist was quantified.MethodsThis prospective intervention study included 27 terminally ill patients with advanced cancers in a hospice ward. Professional oral care was administered every morning, and the improvement of oral conditions was assessed by comparing oral conditions before and after the intervention. Oral assessment was performed using the Oral Health Assessment Tool (OHAT) and Oral Assessment Guide. Oral dryness was evaluated through Clinical Diagnosis Classification of oral dryness and an oral moisture device. Oral cleanliness was evaluated using a bacterial counter, and tongue smears were collected for Candida examination; furthermore, oral function was recorded.ResultsThe presence of oral mucositis was closely associated with severe oral dryness (odds ratio [OR] = 14.93; 95% confidence interval [CI]: 1.95–114.38). The level of oral debris retention was significantly related to the degree of oral dryness (OR = 15.97; 95% CI: 2.06–123.72). The group with higher scores (OHAT > 8), which represent poor oral conditions, showed severe oral dryness (OR = 17.97; 95% CI: 1.45–223.46). Total OHAT scores (median: 7 vs 2) and those of other subgroups (lip, tongue, gums and tissues, saliva, and oral cleanliness showed a significant decrease after the intervention. Furthermore, the occurrence of mucositis (47.1% vs 0%), candidiasis rate (68.8% vs 43.8%), oral dryness self-sensation (63.6% vs 9.1%), and severe oral debris (52.9% vs 11.8%) decreased significantly.ConclusionsProper oral care can improve oral health and hygiene, reduce the rate of mucositis, reduce the sensation of oral dryness, increase oral moisture, and reduce the chances of oral infections among end-of-life patients. Daily oral care is necessary and can alleviate oral discomfort, increase food intake, and increase the chances of communication between end-of-life patients and their families.

Prosthetic Tooth Replacement in a German Population Over the Course of 11 Years: Results of the Study of Health in Pomerania.

To evaluate changes in distribution of teeth and in prosthodontic tooth replacement during an 11-year period in an adult population. Information on prosthetic status was collected from 4,288 participants aged 20 to 81 years at baseline in the Study of Health in Pomerania (SHIP-0) and from 2,244 participants aged 30 to 92 years who reappeared in the 11-year follow-up (SHIP-2). The tooth distribution per arch was classified into one of the six following classes: class 0 (edentulous), class 1 (one to three remaining teeth), class 2 (extended tooth-bounded space or extreme shortened dental arch), class 3 (small anterior space), class 4 (small posterior space with one or more missing premolars), or class 5 (functional dentition). Longitudinally, the most pronounced change in class was the transition from class 1 to class 0 (maxilla: 54.5%, mandible: 58.3%). The percent change from other higher classes to lower classes ranged between 10% and 40%. In the same age groups of 40 to 79 years, the number of edentate arches was cut in half, with a corresponding increase in functional dentitions. The proportion of unrestored arches decreased in all classes. Double crown-retained partial removable dental prostheses (PRDPs) showed the highest increase (a 15% to 20% increase) at the expense of acrylic PRDPs in classes 1 and 2. In small spaces, the proportion of fixed dental prostheses (FDPs) also increased by 15% to 20%. Seven participants of SHIP-0 (0.16%) and 56 participants of SHIP-2 (2.5%) had dental implants. Similar age groups showed improvement in oral conditions. The proportion of higher-end restorations (FDPs and double crown-retained PRDPs), including the frequency of dental implants, increased.

Effects of heat-treated Lactobacillus crispatus KT-11 strain consumption on improvement of oral cavity environment: a randomised double-blind clinical trial.

Heat-treated lactic acid bacteria is added to some foods because it is easier to store and transport, and have less interference with other food ingredient compared with living lactic acid bacteria. We have reported that oral administration of heat-treated Lactobacillus crispatus KT-11 strain (KT-11) suppressed the symptoms of periodontal disease in mice orally infected with Porphyromonas gingivalis. However, the preventive effect of KT-11 on periodontal disease in human is unclear. The aim of this randomised double-blind clinical trial was to examine the effects of KT-11 consumption on the oral environment in healthy volunteers. Sixteen healthy volunteers were randomly assigned to two groups (KT-11 or placebo), and they consumed a KT-11 food tablet (1.2×1010 KT-11 cells) or a placebo food tablet (without KT-11) every day for 4 weeks. Clinical parameters including numbers of major periodontopathic bacteria in saliva, plaque score, gum conditions, and oral mucosal fluid level were evaluated at weeks 0 and 4. Amount of change in P. gingivalis numbers decreased in the KT-11 group compared to that in the placebo group at week 4. Female participants in the KT-11 group had decreased plaque scores, reddish tinge, and gingival swelling scores compared to those in the placebo group at week 4. Furthermore, male participants in the KT-11 group demonstrated increased oral mucosa fluid scores. These clinical findings suggest that daily KT-11 intake can prevent periodontal disease through the improvement of oral conditions.

Oral health status of children with acute lymphoblastic leukemia undergoing chemotherapy

The aim of this study was to evaluate the oral health status of children with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. A total of 94 patients of both sexes in the age group of 2-14 years who were diagnosed with acute lymphoblastic leukemia were selected for the study. The oral cavity was examined for dental caries using def-t and DMF-T indices, gingival status was evaluated by using the modified gingival index, and the WHO oral toxicity scale was used to record oral mucositis. Statistical analysis was done by using Kruskal-Wallis and Mann-Whitney tests. Both DMF-T and def-t were highest in children during the maintenance phase of the chemotherapy followed by the induction therapy with radiotherapy (I 2 ) and induction therapy (I 1 ) phases. The prevalence of gingival inflammation was highest in the maintenance phase of the chemotherapy followed by the induction therapy with radiotherapy (I 2 ) and Induction therapy (I 1 ) phases. Signs and severity of oral mucositis were highest in children undergoing induction therapy with radiotherapy (I 2 ). Good oral care is essential to maintain healthy oral cavity in children with acute lymphoblastic leukemia, as improvement in oral conditions may diminish their sufferings and prevent the spread of serious infections from oral cavity.