Article

Lung

, Volume 189, Issue 3, pp 173-180

Association Between Pneumonia and Oral Care in Nursing Home Residents

  • Ali A. El-SolhAffiliated withMedical Research, Bldg. 20 (151) VISN02, VA Western New York Healthcare SystemDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health ProfessionsDepartment of Anesthesiology, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health ProfessionsDepartment of Social and Preventive Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions Email author 

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Abstract

Pneumonia remains the leading cause of death in nursing home residents. The accumulation of dental plaque and colonization of oral surfaces and dentures with respiratory pathogens serves as a reservoir for recurrent lower respiratory tract infections. Control of gingivitis and dental plaques has been effective in reducing the rate of pneumonia but the provision of dental care for institutionalized elderly is inadequate, with treatment often sought only when patients experience pain or denture problems. Direct mechanical cleaning is thwarted by the lack of adequate training of nursing staff and residents’ uncooperativeness. Chlorhexidine-based interventions are advocated as alternative methods for managing the oral health of frail older people; however, efficacy is yet to be demonstrated in randomized controlled trials. Development and maintenance of an oral hygiene program is a critical step in the prevention of pneumonia. While resources may be limited in long-term-care facilities, incorporating oral care in daily routine practice helps to reduce systemic diseases and to promote overall quality of life in nursing home residents.

Keywords

Oral care Pneumonia Nursing home Chlorhexidine