Regular cleanings of teeth
and gums may help prevent pneumonia in nursing home residents.
The results are based on comparing
pneumonia rates between residents of 11 nursing homes in Japan who received
regular teeth cleanings and those who received no additional oral care.
The researchers found that
residents whose teeth were regularly cleaned had fewer cases of pneumonia
and were less likely to die from the infection.
Pneumonia is caused by germs
that build up in the lungs and block the flow of oxygen to the body. If
the mouth is not clean, there are more germs in the mouth and throat,
increasing the chances of sparking an infection.
If air and/or material brought
into the lungs has lots of germs in it to begin with, it makes it easier
for an infection to get started.
However, the oral care administered
in this study was quite intense, and perhaps not something to which all
nursing home residents would agree. As part of the study, 184 residents
were given tooth brushings after every meal and some were swabbed with
a bad-tasting antiseptic. In addition, they received professional cleanings
once a week from a dentist or dental hygienist.
Some of the 182 residents not
assigned to the oral care group brushed their own teeth, and those with
dentures had them cleaned regularly, but they did not receive any additional
assistance in cleaning their teeth or dentures.
After following the patients
for 2 years, the investigators found that residents whose teeth were not
given additional dental care were almost twice as likely to get pneumonia.
In addition, these residents were twice as likely to die from the infection,
relative to those whose teeth were cleaned regularly.
One of the required daily nursing
chores in US nursing homes is oral care, but previous studies have shown
that this is rarely enforced or done effectively. While ensuring residents
receive regular dental care will cost money, the price is significantly
less than the costs associated with pneumonia. Although most patients
may not like the antiseptic, he said facilities could hire a staff member
exclusively charged with brushing residents' teeth.
It is very compelling to have
evidence that a common-sense, cheap, anyone-can-do-it intervention --
that is supposed to be done anyway -- could be saving multiple billions
of dollars.
The benefits of oral care go
beyond simple economics. As important as the cost savings, though, should
be the improved odor, taste perception, food enjoyment, and social interaction
-- altogether loosely referred to as quality of life -- that occurs when
the daily oral care is provided as it should be.
Journal
of the American Geriatrics Society 2002;50:430-433
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