scholarly journals Effectiveness of Standard Oral Care Plan During Hospital Stay in Individuals With Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Simple F. Kothari ◽  
Gustavo G. Nascimento ◽  
Mille B. Jakobsen ◽  
Jørgen F. Nielsen ◽  
Mohit Kothari
Keyword(s):  
Brain Injury ◽  
Oral Health ◽  
Dental Plaque ◽  
Oral Care ◽  
Care Program ◽  
Care Plan ◽  
Multilevel Regression ◽  
Early Introduction ◽  
Brain Injured ◽  
Over Time

Objective: To investigate the effectiveness of an existing standard oral care program (SOCP) and factors associated with it during hospitalization in individuals with acquired brain injury (ABI).Material and Methods: A total of 61 individuals underwent a SOCP for 4 weeks in a longitudinal observational study. Rapidly noticeable changes in oral health were evaluated by performing plaque, calculus, bleeding on probing (BOP) and bedside oral examination (BOE) at weeks 1 and 5. Individuals' brushing habits, eating difficulties, and the onset of pneumonia were retrieved from their medical records. Association between oral-health outcomes to systemic variables were investigated through multilevel regression models.Results: Dental plaque (P = 0.01) and total BOE score (P < 0.05) decreased over time but not the proportion of dental calculus (P = 0.30), BOP (P = 0.06), and tooth brushing frequency (P = 0.06). Reduction in plaque and BOE over time were negatively associated with higher periodontitis scores at baseline (coef. −6.8; −1.0), respectively, which in turn were associated with an increased proportion of BOP (coef. ≈ 15.0). An increased proportion of calculus was associated with eating difficulties (coef. 2.3) and the onset of pneumonia (coef. 6.2).Conclusions: Nursing care has been fundamental in improving oral health, especially reducing dental plaque and BOE scores. However, our findings indicate a need for improving the existing SOCP through academic-clinical partnerships.Clinical Relevance: Early introduction of oral care program to brain-injured individuals is beneficial in reducing plaque accumulation and improving oral health.

scholarly journals Is Oral Health All About Tooth Brushing? A Longitudinal Study in Individuals With Brain Injury in A Neurorehabilitation Setting

2020 ◽  
Author(s):  
Simple Kothari ◽  
Gustavo Nascimento ◽  
MIlle Jakobsen ◽  
Jørgen Nielsen ◽  
Mohit Kothari
Keyword(s):  
Brain Injury ◽  
Oral Health ◽  
Oral Care ◽  
Care Program ◽  
Tooth Brushing ◽  
Cognitive State ◽  
Multilevel Regression ◽  
Acute Changes ◽  
Systemic Variables ◽  
Over Time

Abstract Objective: To investigate oral health changes and its associated factors during hospitalization in individuals with acquired brain injury (ABI).Material and Methods: Sixty-one individuals were recruited to evaluate the acute changes in oral health by performing plaque, calculus, bleeding on probing (BOP) and bedside oral examination (BOE) at week 1 and week 5. Individuals’ brushing habits, eating difficulties, onset of pneumonia etc. were retrieved from e-journal. Association between oral-health outcomes to systemic variables were investigated through multilevel regression models.Results: Dental plaque (P=0.01) and total BOE score (P<0.05) decreased over time but not the calculus (P=0.30), BOP (P=0.06) and increase in tooth brushing frequency (P=0.06). Reduction in plaque, and BOE over time were negatively associated with higher score of periodontitis at baseline (coef. -6.8; -1.0, respectively), which in turn were associated with an increased proportion of BOP (coef. ≈ 15.0). Increased proportion of calculus was associated with eating difficulties (coef. 2.3) and onset of pneumonia (coef. 6.2).Conclusions: Nursing care has been fundamental in improving oral health but non-significant improvement in calculus, BOP and brushing frequency indicates a need for development in existing oral care program through academic-clinical partnership keeping eating difficulties and patients’ vegetative and cognitive state in consideration.

Improving oral health in low-income pregnant women with a nurse practitioner-directed oral care program

2011 ◽  
Vol 23 (5) ◽  
pp. 249-257 ◽  
Author(s):  
Nancy J. Cibulka ◽  
Sandra Forney ◽  
Kathy Goodwin ◽  
Patricia Lazaroff ◽  
Rebecca Sarabia
Keyword(s):  
Oral Health ◽  
Pregnant Women ◽  
Nurse Practitioner ◽  
Low Income ◽  
Oral Care ◽  
Care Program

scholarly journals Residual Pituitary Function after Brain Injury-Induced Hypopituitarism: A Prospective 12-Month Study

2005 ◽  
Vol 90 (11) ◽  
pp. 6085-6092 ◽  
Author(s):  
Gianluca Aimaretti ◽  
Maria Rosaria Ambrosio ◽  
Carolina Di Somma ◽  
Maurizio Gasperi ◽  
Salvatore Cannavò ◽  
...  
Keyword(s):  
Brain Injury ◽  
High Risk ◽  
Gh Deficiency ◽  
Pituitary Function ◽  
Brain Injured ◽  
Injured Patients ◽  
The Brain ◽  
Over Time

Abstract Context: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are conditions at high risk for the development of hypopituitarism. Objective: The objective of the study was to clarify whether pituitary deficiencies and normal pituitary function recorded at 3 months would improve or worsen at 12 months after the brain injury. Design and Patients: Pituitary function was tested at 3 and 12 months in patients who had TBI (n = 70) or SAH (n = 32). Results: In TBI, the 3-month evaluation had shown hypopituitarism (H) in 32.8%. Panhypopituitarism (PH), multiple (MH), and isolated (IH) hypopituitarism had been demonstrated in 5.7, 5.7, and 21.4%, respectively. The retesting demonstrated some degree of H in 22.7%. PH, MH, and IH were present in 5.7, 4.2, and 12.8%, respectively. PH was always confirmed at 12 months, whereas MH and IH were confirmed in 25% only. In 5.5% of TBI with no deficit at 3 months, IH was recorded at retesting. In 13.3% of TBI with IH at 3 months, MH was demonstrated at 12-month retesting. In SAH, the 3-month evaluation had shown H in 46.8%. MH and IH had been demonstrated in 6.2 and 40.6%, respectively. The retesting demonstrated H in 37.5%. MH and IH were present in 6.2 and 31.3%, respectively. Although no MH was confirmed at 12 months, two patients with IH at 3 months showed MH at retesting; 30.7% of SAH with IH at 3 months displayed normal pituitary function at retesting. In SAH, normal pituitary function was always confirmed. In TBI and SAH, the most common deficit was always severe GH deficiency. Conclusion: There is high risk for H in TBI and SAH patients. Early diagnosis of PH is always confirmed in the long term. Pituitary function in brain-injured patients may improve over time but, although rarely, may also worsen. Thus, brain-injured patients must undergo neuroendocrine follow-up over time.

scholarly journals Effectiveness of the Oral Care Program in Type 2 Diabetic Elderly Patients with Periodontitis: A Clustered Randomised Controlled Study With 6-month Follow-Up

2020 ◽  
Author(s):  
Namon Phetnin ◽  
Vichayanrat Tippanart ◽  
Anunmana Chuchai
Keyword(s):  
Oral Health ◽  
Oral Hygiene ◽  
Oral Care ◽  
Intervention Group ◽  
Health Behaviours ◽  
Care Program ◽  
Controlled Study ◽  
Control Group ◽  
Oral Health Behaviours ◽  
Oral Hygiene Instruction

Abstract Background: Diabetes mellitus and periodontal disease have a bidirectional relationship. This study aimed to assess the effectiveness of the oral care program in reducing glycaemic status and improving oral health behaviours and oral hygiene among type 2 diabetes mellitus (T2DM) older patients with periodontitis.Methods: A clustered randomised controlled study was conducted in Nakhon Ratchasima province between July 2019 and January 2020. The two health centres were randomly assigned to control and intervention groups, which thirty-five T2DM older patients with chronic periodontitis were recruited in each group. The intervention group received the program consisted of oral health education based on Health Belief Model (HBM), individual oral hygiene instruction and scaling and root planning at one month and followed by individual oral hygiene instruction at three months. The patients in the control group received the routine program provided by the health centre. Outcomes were measured using the interviewed questionnaire, simplified oral hygiene index, and the glycaemic status (HbA1c) at baseline, 3 months and 6 months, respectively. Data were analysed using a descriptive statistic, Chi-square test, t-test, repeated measure ANOVA at p-value = 0.05. Results: After the 3 and 6 months, the results showed that the intervention group significantly improved in the HBM scores, oral health behaviours scores, and decreased in OHI-S scores and HbA1c level (p < 0.05), while there was no significant difference in the control group.Conclusion: The findings suggested that the proposed program was effective among diabetic older people with periodontitis to improve oral health perception, behaviours, oral hygiene, and decreased glycaemic status at 3- and 6-month evaluation.Trial registration: Thai Clinical Trials Registry (TCTR), TCTR202004230005. Registered 22 April 2020 - Retrospectively registered.

Oral Health and Care in the Intensive Care Unit: State of the Science

2004 ◽  
Vol 13 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Cindy L. Munro ◽  
Mary Jo Grap
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oral Health ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Dental Plaque ◽  
Oral Care ◽  
Microbial Flora ◽  
Tooth Surface ◽  
Ventilator Associated Pneumonia

Oral health is influenced by oral microbial flora, which are concentrated in dental plaque. Dental plaque provides a microhabitat for organisms and an opportunity for adherence of the organisms to either the tooth surface or other microorganisms. In critically ill patients, potential pathogens can be cultured from the oral cavity. These microorganisms in the mouth can translocate and colonize the lung, resulting in ventilator-associated pneumonia. The importance of oral care in the intensive care unit has been noted in the literature, but little research is available on mechanical or pharmacological approaches to reducing oral microbial flora via oral care in critically ill adults. Most research in oral care has been directed toward patients’ comfort; the microbiological and physiological effects of tooth brushing in the intensive care unit have not been reported. Although 2 studies indicated reductions in rates of ventilator-associated pneumonia in cardiac surgery patients who received chlorhexidine before intubation and postoperatively, the effects of chlorhexidine in reducing ventilator-associated pneumonia in other populations of critically ill patients or its effect when treatment with the agent initiated after intubation have not been reported. In addition, no evaluation of the effectiveness of pharmacological and mechanical interventions relative to each other or in combination has been published. Additional studies are needed to develop and test best practices for oral care in critically ill patients.

Clinical detection: ‘information gathering’

2015 ◽  
Author(s):  
Avijit Banerjee ◽  
Timothy F. Watson
Keyword(s):  
Oral Health ◽  
Soft Tissues ◽  
Oral Care ◽  
Signs And Symptoms ◽  
Care Plan ◽  
Healthcare Team ◽  
Dental Management ◽  
Decision Making Processes ◽  
Clinical Detection ◽  
The Individual

The oral healthcare team (dentist, nurse, hygienist/therapist/oral health educator, laboratory technician, receptionist, practice manager), led by the principal dental practitioner, should all be involved in the decision-making processes and dental management of the patient, as part of the minimum intervention philosophy of oral/dental healthcare (see Figure 1.1 in Chapter 1). This care rationale is patientcentred, engaging with the patient to encourage them to take responsibility for their own oral health. The role of the oral healthcare team is to provide advice and guidance to help the patient to maintain oral health, as well as providing operative treatment to repair damaged hard and soft tissues. Sometimes the dentist will refer difficult cases to a specialist dentist for their opinion as to what the diagnosis and care plan should be. To manage patients successfully, there are five stages that must be followed (see Figure 2.1):… 1. Detecting clinical problems and their aetiology (see Chapter 2): • This involves detective work to help to gather clinically relevant and useful information, primarily using the skills of verbal history taking, oral examination, and relevant special investigations. 2. Diagnosis and risk assessment (see Chapter 3): • The art of interpretation of signs and symptoms/results from investigations to conclude with identifying the cause of the problem and the potential the individual patient has of developing further disease in the future or responding to treatment. Both aspects are critical to planning the overall care of the patient. 3. Prognosis (see Chapter 3): • The art of forecasting the course of a disease or problem, whether treated or not. 4. Formulation of an individualized patient care plan (see Chapters 3 and 4): • This must be underpinned by the non-invasive control of disease and lesion prevention, following the principles of minimum intervention oral care. • The care plan will also include itemized, costed, minimally invasive operative treatments when required. 5. Recall/re-assess/review (see Chapter 9): • Reviewing the outcomes of any care provided, re-assessing the patient’s response to evaluate whether knowledge/behavioural adaptations and adherence have helped to control and/ or prevent disease reoccurrence, and developing adaptive recall strategies/ intervals that are patient-centred, rather than generic and guideline-driven.

scholarly journals Effect of Oral Care Protocol on Dental and Gingival Plaque Index in Patients With Endotracheal Tube Admitted to the Intensive Care Unit

2021 ◽  
Author(s):  
Ali Ghaempanah ◽  
Mitra Payami Bosari ◽  
Abolfazl Amini ◽  
Soqrat Faghihzadeh ◽  
Zahra Aghazadeh
Keyword(s):  
Oral Health ◽  
Dental Plaque ◽  
Oral Care ◽  
Plaque Index ◽  
Control Group ◽  
Control Groups ◽  
Double Blind ◽  
Care Protocol ◽  
The Mean ◽  
And Control

Oral health is one of the most critical aspects of nursing care in critically ill patients. The study aimed to investigate the effect of oral health protocol on dental and gingival plaque index in patients with endotracheal tubes admitted into the ICU. This double-blind clinical trial was conducted on 70 patients admitted into ICU randomly by tossing a coin, and 35 patients were assigned to each of the experimental and control groups. Oral care was performed in the experimental group using the chlorhexidine (CHX) solution, toothpaste, and oral moisturizer protocol; in the control group, according to the routine method, 0.2% CHX was used twice a day. The data were collected at the time of inclusion and four days later, using the MGI and the O'Leary dental plaque index. The mean ages in the experimental and control groups were 38.4±14.4 and 41±14.5 years, respectively. In the experimental and control groups, 77% and 83% of the subjects were male, respectively. After the intervention, the mean gingival index in the experimental and control groups was 0.59±0.31 and 0.90±0.41, and the plaque index was 42.53±15.97 and 53.52±11.9, respectively. The differences before and after the intervention in each group and the difference between the two groups in both gingival and dental plaque indices were statistically significant (P=0.0001). The results showed that the oral health protocol was more effective in improving gingival and dental plaque indices than the routine (CHX) method.

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