Oral Care Protocol Has Positive Impact on Hygiene, Health

December 10, 2018

Poor oral care in older individuals can produce a cascade of problems—including pain, weight loss, diminished self-esteem, speech problems, periodontal disease, and even pneumonia. A study published in the December issue of JAMDA showed how staff attending to residents’ oral hygiene and denture care using a specialized protocol resulted in a sustained, favorable impact.

This two-year study, “Improving Nursing Home Residents’ Oral Hygiene: Results of a Cluster Randomized Intervention Trial,” involved the use of a protocol called “Mouth Care Without Battles” (MCWB). The researchers trained staff on using MCWB, then analyzed outcomes such as plaque, gingival health, and denture hygiene status in groups using the protocol versus those providing care without this resource.

MCWB stresses that mouth care is health care, related to medical issues such as pneumonia incidence. The protocol provides instruction on techniques and products to clean and protect teeth, tongue, gums, and dentures, as well as providing care in special situations and/or to resistant people.

Over the 24-month period, MCWB intervention was effective in improving oral and denture hygiene and reducing gingival inflammation. The greatest improvements in the intervention group related to denture cleanliness.

The authors noted that MCWB is particularly useful to help overcome some of the barriers to providing mouth care for nursing home residents. These include lack of time, inadequate knowledge and skills, lack of prioritization for this activity, the need for clear oral health guidelines, and uncooperative residents. MCWB helps, the authors said, by “including instructions on providing oral hygiene for NH residents, behavioral techniques, easy access to mouth care supplies, and an on-site oral health champion.”

Having Alzheimer’s disease or other dementias is related to worse oral hygiene, the authors observed. However, they noted that this study had favorable outcomes, even though half of the study population had dementia.  They said this is due to the ability of MCWB to improve oral hygiene even among persons with Alzheimer’s disease or other cognitive impairment.

This study was conducted by researchers at the School of Dentistry, the Gillings School of Global Public Health, the Cecil G. Sheps Center for Health Services Research, the School of Social Work, and the Department of Family Medicine, all at the University of North Carolina at Chapel Hill.

Click here for more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email emullally@paltc.org.



JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.

About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PA/LTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.