BACKGROUND: Poor oral health of hospitalized patients is associated with an increased risk of hospital-acquired infections and reduced life quality. OBJECTIVES: To systematically review the evidence on oral health changes during hospitalization. DATA SOURCES: Cochrane library, Medline, OldMedline, Embase and CINAHL without language restrictions. STUDY ELIGIBILITY CRITERIA: Observational longitudinal studies. DATA APPRAISAL AND SYNTHESIS METHODS: Two independent reviewers screened studies for inclusion, assessed the risk of bias and extracted data. Risk of bias was assessed using the Newcastle-Ottawa assessment scale. A narrative synthesis was conducted. RESULTS: Five before and after studies were included. The data suggest a deterioration in oral health following hospitalization with an increase in dental plaque accumulation and gingival inflammation and a deterioration in mucosal health. LIMITATIONS: While before and after studies are at a general risk of bias, other specific study characteristics were judged to have a low risk of bias. However, methodological issues such as unvalidated outcome measures and the lack of assessor training limit the strength of the evidence. CONCLUSION: Hospitalization is associated with a deterioration in oral health, particularly in intubated patients.
BACKGROUND: Poor oral health of hospitalized patients is associated with an increased risk of hospital-acquired infections and reduced life quality. OBJECTIVES: To systematically review the evidence on oral health changes during hospitalization. DATA SOURCES: Cochrane library, Medline, OldMedline, Embase and CINAHL without language restrictions. STUDY ELIGIBILITY CRITERIA: Observational longitudinal studies. DATA APPRAISAL AND SYNTHESIS METHODS: Two independent reviewers screened studies for inclusion, assessed the risk of bias and extracted data. Risk of bias was assessed using the Newcastle-Ottawa assessment scale. A narrative synthesis was conducted. RESULTS: Five before and after studies were included. The data suggest a deterioration in oral health following hospitalization with an increase in dental plaque accumulation and gingival inflammation and a deterioration in mucosal health. LIMITATIONS: While before and after studies are at a general risk of bias, other specific study characteristics were judged to have a low risk of bias. However, methodological issues such as unvalidated outcome measures and the lack of assessor training limit the strength of the evidence. CONCLUSION: Hospitalization is associated with a deterioration in oral health, particularly in intubated patients.
Authors: Mary Lyons; Craig Smith; Elizabeth Boaden; Marian C Brady; Paul Brocklehurst; Hazel Dickinson; Shaheen Hamdy; Susan Higham; Peter Langhorne; Catherine Lightbody; Giles McCracken; Antonieta Medina-Lara; Lise Sproson; Angus Walls; Dame Caroline Watkins Journal: Eur Stroke J Date: 2018-05-08