Effect of professional oral health care on the elderly living in nursing homes

doi:10.1067/moe.2002.123493

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 94, Issue 2, August 2002, Pages 191-195

https://doi.org/10.1067/moe.2002.123493 Get rights and content

Abstract

Objective. We evaluated the effectiveness of professional oral health care (POHC) given by dental hygienists once a week for 24 months to 141 elderly persons needing daily care and living in 2 nursing homes. Study Design. Elderly subjects with POHC and without POHC living in 2 nursing homes were examined for 24 months to detect any fevers of 37.8°C or more and the prevalence of fatal aspiration pneumonia. The numbers of Staphylococcus species and Candida albicans in swab samples from oral cavities were compared between the POHC group and the non-POHC group. The amounts of methylmercaptan exhaled in the POHC group were determined and compared with those in the non-POHC group. Results. The prevalence of fevers of 37.8°C or more in the subjects receiving POHC was significantly lower than in the non-POHC group (P <.05). We found that the ratio of fatal aspiration pneumonia in the POHC group during the 24 months was significantly lower than in the non-POHC group (P <.05). Numbers of C albicans species in samples obtained from the oral cavity after 6 months of POHC were significantly lower than those in the non-POHC group (P <.01). POHC resulted in the reduction of the presence of Staphylococcus but not to a statistically significant extent. The amounts of methylmercaptan exhaled by the POHC group were significantly less than those of the non-POHC group (P <.05). Conclusion. This study showed that POHC administered by dental hygienists to a group of elderly patients needing daily nursing care was associated with a reduction in prevalence of fever and fatal pneumonia. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:191-5)

Section snippets

Materials and methods

The subjects of the study were 141 elderly persons in 2 nursing homes in Tokyo. Informed consent to the study was obtained from some of the subjects, but some had dementia and other conditions that prevented them from giving fully informed consent. In such cases, the consents of the director of the institute and of the persons charged with the daily care of those patients were obtained. The subjects were afflicted with a variety of medical problems, and all were under medication of some kind.

Results

We examined fevers of 37.8°C or more in subjects living in the 2 nursing homes. At the beginning of this study, there were 40 and 48 subjects in the POHC group and non-POHC group, respectively. We were able to follow 30 elderly persons in whom POHC was maintained and in 33 without POHC throughout the 24 months of the study. The results of monthly prevalence of fevers of 37.8°C or more in the 2 groups are summarized in Fig 1.

. Monthly proportions of patients with more than 37.8°C fever in POHC and

Discussion

In the past decade, endogenous oral microorganisms have been repeatedly reported to possess various degrees of pathogenicity and to be related to various systemic diseases. Association between poor dental health and coronary heart disease has been reported.7, 22 Recently, we and other groups have shown that oral bacteria can be found in atherosclerotic lesions and atherosclerotic plaque samples.12, 23, 24 The most probable route of systemic infection by oral microorganisms is incorporation

Acknowledgements

We thank Dr B. L. Pierce and Mr C. W. P. Reynolds for their comments and revision of the English of the manuscript.

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^*: Supported in part by a grant (No. 981A02) to the Oral Health Science Center from Tokyo Dental College.

^**: ^aDental Hygienist, Fuchu Health Center, Fuchu City, Tokyo, Japan.

^*: ^bAssistant Professor, Department of Microbiology, Tokyo Dental College, Tokyo, Japan.

^**: ^cVisiting Researcher, Department of Microbiology, Tokyo Dental College, Tokyo, Japan.

^*: ^dProfessor and Chairman, Department of Microbiology, Tokyo Dental College, Tokyo, Japan.

^**: ^eDean and Professor, Department of Operative Dentistry, Tokyo Dental College, Tokyo, Japan.

^♦: Reprint requests: Katsuji Okuda, PhD, DDS, Department of Microbiology, Tokyo Dental College, Masago 1-2-2, Mihama-ku, Chiba City, Japan 261-8502, [email protected]

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Oral MedicineEffect of professional oral health care on the elderly living in nursing homes*,**,*,**,*,**,♦

Abstract

Section snippets

Materials and methods

Results

Discussion

Acknowledgements

Atherosclerosis

Arch Gerontol Geriatr

Am Heart J

Lancet

Lancet

Bacterial pneumonia in the elderly: clinical features, diagnosis, etiology, and treatment

Gerontology

Colonization of dental plaque by respiratory pathogens in medical intensive care patients

Crit Care Med

Relationships between periodontal disease and bacterial pneumonia

J Periodontol

Associations between oral conditions and respiratory disease in a national sample survey population

Ann Periodontol

The platelet interactivity phenotype of Streptococcus sanguis influences the cause of experimental endocarditis

Infect Immun

Dental plaque, platelets, and cardiovascular disease

Ann Periodontol

Association between dental health and acute myocardial infarction

Br Med J

Periodontal disease and cardiovascular disease

J Periodontol

Periodontitis: a risk factor for coronary heart disease

Ann Periodontol

Porphyromonas gingivalis virulence factors and invasion of cells of the cardiovascular system

J Periodontal Res

Oral Medicine
Effect of professional oral health care on the elderly living in nursing homes*,**,*,**,*,**,♦