Oral health care and aspiration pneumonia in frail older people

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A number of previous studies have highlighted the risk of poor oral health as a potential risk factor for aspirational pneumonia in frail older people. The aim of this review was to review the literature on oral health care interventions in frail older people and the effect on the incidence of aspiration pneumonia.

The authors searched PubMed, Web of Science, Cochrane Library, EMBASE and CINHAL  databases for eligible intervention studies.   Publications that considered hospitalized or institutionalized older people, who were not dependent on mechanical ventilation were eligible. Study quality was assessed independently by two authors

Five publications were included. Two studies showed that improvement of oral health care diminished the risk of developing aspiration pneumonia and the risk of dying from aspiration pneumonia directly. The three studies remaining showed that adequate oral health care decreased the amount of potential respiratory pathogens and suggested a reduction in the risk of aspiration pneumonia by improving the swallowing reflex and cough reflex sensitivity.

The authors concluded

According to the results of the current systematic literature review oral health care, consisting of tooth brushing after each meal, cleaning dentures once a day, and professional oral health care once a week, seems the best intervention to reduce the incidence of aspiration pneumonia.

van der Maarel-Wierink, C. D., Vanobbergen, J. N., Bronkhorst, E. M., Schols, J. M. and de Baat, C. (2012), Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. doi: 10.1111/j.1741-2358.2012.00637.x

Related reviews

van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc. 2011 Jun;12(5):344-54. Epub 2011 Mar 21. Review. PubMed PMID: 21450240.

Pace CC, McCullough GH. The association between oral microorgansims and aspiration pneumonia in the institutionalized elderly: review and recommendations. Dysphagia. 2010 Dec;25(4):307-22. Epub 2010 Sep 8. Review. PubMed PMID: 20824288.

Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol. 2006 Sep;77(9):1465-82. Review. PubMed PMID: 16945022.

 

 

 

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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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