Staff-led interventions for improving oral hygiene in patients following stroke

Marian C. Brady, Denise Furlanetto, Romana Hunter, Steff C. Lewis, Vikki Milne

    Research output: Contribution to journalArticle

    50 Citations (Scopus)
    367 Downloads (Pure)

    Abstract

    Background For people with limitations due to neurological conditions such as stroke, the routine practice of oral care may become a challenge. Evidence-based supported oral care intervention is essential for this patient group. Objectives To compare the effectiveness of staff-led oral care interventions with standard care for ensuring oral hygiene for individuals after a stroke. Search strategy We searched the trials registers of the Cochrane Stroke Group and Oral Health Group (August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), CINAHL (1982 to February 2006), Research Findings Electronic Register (February 2006), National Research Register (Issue 1, 2006), ISI Science and Technology Proceedings (August 2005), Dissertation Abstracts and Conference Papers Index (August 2005). We scanned reference lists from relevant papers and contacted authors and researchers in the field. Selection criteria We identified randomised controlled trials that evaluated one or more interventions designed to improve oral hygiene. Trials based on a mixed population were included, provided it was possible to extract the data specific to the individuals post stroke. Data collection and analysis Two review authors independently classified identified trials according to the inclusion and exclusion criteria, assessed the trial quality and extracted data. Clarification was sought from study authors when required. Main results Eight eligible randomised controlled trials were identified but only one provided stroke-specific information. It compared an oral health care education training programme (OHCE) delivered to nursing home care assistants to delayed training intervention in the control group. Comparisons were made at one and six months after the intervention, using the primary outcome measures dental plaque and denture plaque, and three secondary outcomes. The data available for the 67 individuals with a stroke (obtained from the larger cluster randomised controlled trial) showed that denture plaque scores were significantly reduced up to six months (P < 0.00001) after the intervention. Staff knowledge (P = 0.0008) and attitudes (P = 0.0001) towards oral care also improved significantly. Authors' conclusions Based on one study with a small number of stroke survivors, providing oral care training for carers in a nursing home setting improves their knowledge of and attitudes towards the provision of oral care. In turn, residents' dentures were cleaner, though other oral hygiene measures did not change. Further evidence relating to oral care interventions is severely lacking, in particular with reference to care in hospital for those following stroke.
    This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 7. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

    Original languageEnglish
    JournalCochrane Database of Systematic Reviews
    Issue number7
    DOIs
    Publication statusPublished - 2011

    Fingerprint

    Oral Hygiene
    Stroke
    Dentures
    Randomized Controlled Trials
    Oral Health
    Nursing Homes
    Databases
    Dental Plaque
    Home Care Services
    Nursing Care
    Health Education
    Research
    MEDLINE
    Patient Selection
    Caregivers
    Libraries
    Survivors
    Research Personnel
    Outcome Assessment (Health Care)
    Technology

    Cite this

    Brady, Marian C. ; Furlanetto, Denise ; Hunter, Romana ; Lewis, Steff C. ; Milne, Vikki. / Staff-led interventions for improving oral hygiene in patients following stroke. In: Cochrane Database of Systematic Reviews. 2011 ; No. 7.
    @article{157d50a19f444a0ea6bf8e81c8bf48da,
    title = "Staff-led interventions for improving oral hygiene in patients following stroke",
    abstract = "Background For people with limitations due to neurological conditions such as stroke, the routine practice of oral care may become a challenge. Evidence-based supported oral care intervention is essential for this patient group. Objectives To compare the effectiveness of staff-led oral care interventions with standard care for ensuring oral hygiene for individuals after a stroke. Search strategy We searched the trials registers of the Cochrane Stroke Group and Oral Health Group (August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), CINAHL (1982 to February 2006), Research Findings Electronic Register (February 2006), National Research Register (Issue 1, 2006), ISI Science and Technology Proceedings (August 2005), Dissertation Abstracts and Conference Papers Index (August 2005). We scanned reference lists from relevant papers and contacted authors and researchers in the field. Selection criteria We identified randomised controlled trials that evaluated one or more interventions designed to improve oral hygiene. Trials based on a mixed population were included, provided it was possible to extract the data specific to the individuals post stroke. Data collection and analysis Two review authors independently classified identified trials according to the inclusion and exclusion criteria, assessed the trial quality and extracted data. Clarification was sought from study authors when required. Main results Eight eligible randomised controlled trials were identified but only one provided stroke-specific information. It compared an oral health care education training programme (OHCE) delivered to nursing home care assistants to delayed training intervention in the control group. Comparisons were made at one and six months after the intervention, using the primary outcome measures dental plaque and denture plaque, and three secondary outcomes. The data available for the 67 individuals with a stroke (obtained from the larger cluster randomised controlled trial) showed that denture plaque scores were significantly reduced up to six months (P < 0.00001) after the intervention. Staff knowledge (P = 0.0008) and attitudes (P = 0.0001) towards oral care also improved significantly. Authors' conclusions Based on one study with a small number of stroke survivors, providing oral care training for carers in a nursing home setting improves their knowledge of and attitudes towards the provision of oral care. In turn, residents' dentures were cleaner, though other oral hygiene measures did not change. Further evidence relating to oral care interventions is severely lacking, in particular with reference to care in hospital for those following stroke. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 7. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.",
    author = "Brady, {Marian C.} and Denise Furlanetto and Romana Hunter and Lewis, {Steff C.} and Vikki Milne",
    note = "dc.publisher: John Wiley &amp; Sons, Ltd. This review highlights the paucity of evidence relating to oral care interventions for stroke patients. Evidence specific to stroke care settings is urgently needed to evaluate effectiveness of oral care interventions.",
    year = "2011",
    doi = "10.1002/14651858.CD003864.pub2",
    language = "English",
    journal = "Cochrane Database of Systematic Reviews",
    issn = "1469-493X",
    publisher = "John Wiley & Sons Inc.",
    number = "7",

    }

    Staff-led interventions for improving oral hygiene in patients following stroke. / Brady, Marian C.; Furlanetto, Denise; Hunter, Romana; Lewis, Steff C.; Milne, Vikki.

    In: Cochrane Database of Systematic Reviews, No. 7, 2011.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Staff-led interventions for improving oral hygiene in patients following stroke

    AU - Brady, Marian C.

    AU - Furlanetto, Denise

    AU - Hunter, Romana

    AU - Lewis, Steff C.

    AU - Milne, Vikki

    N1 - dc.publisher: John Wiley &amp; Sons, Ltd. This review highlights the paucity of evidence relating to oral care interventions for stroke patients. Evidence specific to stroke care settings is urgently needed to evaluate effectiveness of oral care interventions.

    PY - 2011

    Y1 - 2011

    N2 - Background For people with limitations due to neurological conditions such as stroke, the routine practice of oral care may become a challenge. Evidence-based supported oral care intervention is essential for this patient group. Objectives To compare the effectiveness of staff-led oral care interventions with standard care for ensuring oral hygiene for individuals after a stroke. Search strategy We searched the trials registers of the Cochrane Stroke Group and Oral Health Group (August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), CINAHL (1982 to February 2006), Research Findings Electronic Register (February 2006), National Research Register (Issue 1, 2006), ISI Science and Technology Proceedings (August 2005), Dissertation Abstracts and Conference Papers Index (August 2005). We scanned reference lists from relevant papers and contacted authors and researchers in the field. Selection criteria We identified randomised controlled trials that evaluated one or more interventions designed to improve oral hygiene. Trials based on a mixed population were included, provided it was possible to extract the data specific to the individuals post stroke. Data collection and analysis Two review authors independently classified identified trials according to the inclusion and exclusion criteria, assessed the trial quality and extracted data. Clarification was sought from study authors when required. Main results Eight eligible randomised controlled trials were identified but only one provided stroke-specific information. It compared an oral health care education training programme (OHCE) delivered to nursing home care assistants to delayed training intervention in the control group. Comparisons were made at one and six months after the intervention, using the primary outcome measures dental plaque and denture plaque, and three secondary outcomes. The data available for the 67 individuals with a stroke (obtained from the larger cluster randomised controlled trial) showed that denture plaque scores were significantly reduced up to six months (P < 0.00001) after the intervention. Staff knowledge (P = 0.0008) and attitudes (P = 0.0001) towards oral care also improved significantly. Authors' conclusions Based on one study with a small number of stroke survivors, providing oral care training for carers in a nursing home setting improves their knowledge of and attitudes towards the provision of oral care. In turn, residents' dentures were cleaner, though other oral hygiene measures did not change. Further evidence relating to oral care interventions is severely lacking, in particular with reference to care in hospital for those following stroke. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 7. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

    AB - Background For people with limitations due to neurological conditions such as stroke, the routine practice of oral care may become a challenge. Evidence-based supported oral care intervention is essential for this patient group. Objectives To compare the effectiveness of staff-led oral care interventions with standard care for ensuring oral hygiene for individuals after a stroke. Search strategy We searched the trials registers of the Cochrane Stroke Group and Oral Health Group (August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), CINAHL (1982 to February 2006), Research Findings Electronic Register (February 2006), National Research Register (Issue 1, 2006), ISI Science and Technology Proceedings (August 2005), Dissertation Abstracts and Conference Papers Index (August 2005). We scanned reference lists from relevant papers and contacted authors and researchers in the field. Selection criteria We identified randomised controlled trials that evaluated one or more interventions designed to improve oral hygiene. Trials based on a mixed population were included, provided it was possible to extract the data specific to the individuals post stroke. Data collection and analysis Two review authors independently classified identified trials according to the inclusion and exclusion criteria, assessed the trial quality and extracted data. Clarification was sought from study authors when required. Main results Eight eligible randomised controlled trials were identified but only one provided stroke-specific information. It compared an oral health care education training programme (OHCE) delivered to nursing home care assistants to delayed training intervention in the control group. Comparisons were made at one and six months after the intervention, using the primary outcome measures dental plaque and denture plaque, and three secondary outcomes. The data available for the 67 individuals with a stroke (obtained from the larger cluster randomised controlled trial) showed that denture plaque scores were significantly reduced up to six months (P < 0.00001) after the intervention. Staff knowledge (P = 0.0008) and attitudes (P = 0.0001) towards oral care also improved significantly. Authors' conclusions Based on one study with a small number of stroke survivors, providing oral care training for carers in a nursing home setting improves their knowledge of and attitudes towards the provision of oral care. In turn, residents' dentures were cleaner, though other oral hygiene measures did not change. Further evidence relating to oral care interventions is severely lacking, in particular with reference to care in hospital for those following stroke. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 7. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

    U2 - 10.1002/14651858.CD003864.pub2

    DO - 10.1002/14651858.CD003864.pub2

    M3 - Article

    JO - Cochrane Database of Systematic Reviews

    JF - Cochrane Database of Systematic Reviews

    SN - 1469-493X

    IS - 7

    ER -