Improvements in Pneumonia Status After Oral Care Intervention in Taiwan

Study Overview
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Brief Summary
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The correlation between improvement in oral health, reduction in oral bacterial concentration, and status of pneumonia hospitalization remains unclear. To determine the effects of professional oral care intervention on the index of oral health, salivary and sputum bacterial concentrations, and pneumonia hospitalization status of nursing home residents using a quasi-experimental study. Two nursing homes were on demand selected as the intervention and control groups; in the intervention group, weekly professional oral care was administered in addition to regular oral care by trained dental hygienists. Demographic data and oral health status were analyzed. Total salivary and sputum bacterial concentrations were determined using real-time polymerase chain reaction.

Official Title
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Improvements in Pneumonia Status and Salivary Bacterial Concentration After Professional Oral Care Intervention in Taiwanese Nursing Home Residents

Conditions
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Pneumonia

Intervention / Treatment
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* Other: Routine oral cleaning and professional oral care group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Informed consent 51 year-old and above Being bedridden for ≥ 6 months Positive sputum production Difficulty in swallowing reported by caregivers Exclusion Criteria: Below 51 year-old Patients or family refused any oral care

Ages Eligible for Study
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Minimum Age: 51 Years
Maximum Age: 102 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Routine oral cleaning and professional oral care group<br>The subjects in Routine oral cleaning and professional oral care group were received about routine oral cleaning and professional oral care. | Other: Routine oral cleaning and professional oral care group<br>* Besides routine oral cleaning was conducted by caregivers, professional oral care intervention was conducted by dental hygienists, and it included muscle massage, oral cleaning, and oral health education once a week.<br>|
| No Intervention: Routine oral cleaning group<br>The subjects in Routine oral cleaning group were received only routine oral cleaning, just maintain daily condition. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pneumonia hospitalization status | Hospitalization prevalence and days of each hospitalization due to pneumonia were collected from medical records by questionnaire. | 2 hours | 
| Bacterial concentrations | Total salivary and sputum bacterial concentrations were determined using real-time polymerase chain reaction. Staphylococcus aureus (strain ID: ATCC 29213) was used to create the standard growth curve of bacteria. After overnight culture, the samples were prepared by 5-fold serial dilution with normal saline and plating in a Petri dish to produce 2.5×103 to 3.9×107 CFU/mL of bacteria. Genomic DNA of bacteria was extracted from 1 mL of each bacterial serial solution using the modified standard method, which followed three basic steps: lysis, precipitation, and purification. The DNA extracts were resuspended in 20 µL of distilled water and stored at -80°C until real-time polymerase chain reaction (RT-PCR) amplification. The standard curve of bacterial concentration was generated by the bacterial 16S rRNA gene using a serial dilution of Staphylococcus aureus genomic DNA and StepOnePlus Real-Time PCR System (Applied Biosystems). | 3 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oral health examinations | Oral health examinations were conducted by two trained dentists, and data on plaque, gingival, and tongue coating indexes were collected by oral examination tables. | 3 hours | 
| Demographic data | Demographic data included gender, age groups, conscious, educational level, and nutritional route, which were collected by questionnaire. | 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Oral care intervention, Nursing home residents