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 the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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