Oral care intervention in people with and without dementia living in residential aged care

Not Applicable

Completed

• Conditions: Aspiration pneumonia; Dementia; Oral health; Public Health - Health promotion/education; Neurological - Dementias; Respiratory - Other respiratory disorders / diseases; Oral and Gastrointestinal - Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon

• Registration Number: ACTRN12617001646336
• Lead Sponsor: niversity of Tasmania

Brief Summary

Oral swabs from the cheek, gum, and tongue of a cohort of 27 people with dementia in residential aged care were analysed prior to and following a 6-week period of intervention. There was no significant difference in the abundance of bacteria and fungi at the three sites prior to intervention. There was a significant difference in the diversity of bacteria, compared to fungi, particularly for the tongue prior to intervention. Participants then self-selected into two groups, Control (n = 10; regular oral care) and Experimental (n = 17; evidence-based oral care [2-minutes of teeth brushing after meals twice per day or daily cleaning of dentures]) for the intervention period. Following intervention, participants receiving evidence-based oral care had significant decreases in four potentially pathogenic bacteria and an increased abundance of Lactobacillus reuteri, a protective bacteria, compared to participants receiving regular oral care. There were no significant differences between the groups for the abundance and type of fungi. The 6 weeks of evidence-based oral care also significantly reduced the absolute count of E. coli, a gut-based pathogen specifically associated with aspiration pneumonia. Although there are limitations with this study, results support the importance of evidence-based oral care for people with dementia, particularly those who are dependent on others for their oral care. Results also support the use of next-generation sequencing and analysis.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2017-12-21
• Study Completion: 2018-08-06
• Last Update Posted: 12 April 2021

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 27

Inclusion Criteria

All adults who live in a particular residential aged care community in northern Tasmania.

Exclusion Criteria

1. Inability to remain alert or to follow simple, 1-step directions
2. Head-of-bed is restricted to < 30 degrees
3. Unable to open mouth

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Change in type of oral microorganisms, as documented through real-time polymerase chain reaction (qPCR) assays using 7 primers for major oral pathogens.[Types of oral microorganisms prior to the 6-week intervention commencement will be compared to types of oral microorganisms immediately following the intervention period.];Change in load of oral microorganisms, as documented through real-time polymerase chain reaction (qPCR) assays using a universal primer for oral pathogens.[The load of oral microorganisms prior to the 6-week intervention commencement will be compared to the load of oral microorganisms immediately following the intervention period.];Proportion of participants with an improvement in oral health, as measured by repeat screening with the Oral health Assessment Tool.[At 6-weeks after the daily oral care intervention]

Secondary Outcome Measures

Name	Time	Method
Change in instances of unplanned hospital transfers or admissions to hospital related to clinical signs of aspiration pneumonia, as documented from residents' medical charts by each Facility Manager[Instances during the 6-months prior to the 6-week intervention commencement will be compared to instances throughout the 6-week intervention period.]