Hospitalization is associated with a deterioration in oral health

An operating theatre.

Maintaining oral health is important for hospitalised patients as it can affect quality of life and personal dignity.  The aim of this systematic review was to assess the impact of hospitalization on oral health.

The authors searched Cochrane library, Medline, OldMedline, Embase and CINAHL without language restrictions for longitudinal prospective observational studies in individuals of all ages being hospitalized that assessed changes of the following outcomes: tooth loss, any measures of periodontal health, dental caries and stomatological diseases.

Papers were reviewed independently  with risk of bias being assessed using the Newcastle–Ottawa assessment scale and a narrative synthesis conducted.

They included five before and after studies  and found that the data suggested a deterioration in oral health following hospitalization with an increase in dental plaque accumulation and gingival inflammation and a deterioration in mucosal health.    While the included before and after studies are seen to be at general risk of bias their other study characteristics were thought to have a low risk of bias .  There is a concern that the use of unvalidated outcome measures and the lack of assessor training may limit the strength of the evidence

They concluded

Hospitalization is associated with a deterioration in oral health, particularly in intubated patients.

Terezakis E, Needleman I, Kumar N, Moles D, Agudo E. The impact of hospitalization on oral health: a systematic review. J Clin Periodontol. 2011 Jul;38(7):628-36. doi: 10.1111/j.1600-051X.2011.01727.x. Epub 2011 Apr 7. Review.PubMed PMID: 21470276.


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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