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Tatuskar PV, Karmakar S, Walavalkar NN, Vandana KL. Effect of ozone irrigation and powered toothbrushing on dental plaque, gingival inflammation, and microbial status in institutionalized mentally challenged individuals: A double-blinded, randomized, controlled clinical trial. J Indian Soc Periodontol 2023; 27:315-319. [PMID: 37346863 PMCID: PMC10281302 DOI: 10.4103/jisp.jisp_69_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 02/11/2023] [Accepted: 02/19/2023] [Indexed: 06/23/2023] Open
Abstract
Aim This study compares and evaluates the efficacy of ozonated water irrigation (OZI) and powered toothbrushing on the oral health and microbial status of mentally challenged individuals. Materials and Methods Thirty individuals of age range 15-30 years with a mild-to-moderate level of mental retardation (MR) and gingival inflammation participated in this double-blind randomized controlled clinical trial. Total duration of the study was 45 days consisting of two clinical phases (phase I, i.e., aided) and phase II, i.e. unaided) of the duration of 21 days in each phase, with a washout period of 3 days between the two phases. With a split-mouth design, sites from each subject were randomly allocated into two treatment groups: Powered Toothbrushing (PB) and OZI were randomly done for each half side of the mouth of each subject. Subgingival plaque samples were collected from sites of both the treatment groups and sent for microbial analysis. Clinical and microbial parameters were measured before and after the treatment. Results Significant improvement of the clinical and microbial parameters was found in both treatment groups. However, intergroup differences in the parameters were statistically nonsignificant. Conclusion OZI could serve as an alternative or adjunct to powered toothbrushes for people with MR.
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Affiliation(s)
| | - Shaswata Karmakar
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kuipers S, Boonstra N, Kronenberg L, Keuning-Plantinga A, Castelein S. Oral Health Interventions in Patients with a Mental Health Disorder: A Scoping Review with Critical Appraisal of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158113. [PMID: 34360406 PMCID: PMC8346069 DOI: 10.3390/ijerph18158113] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 12/21/2022]
Abstract
Poor oral health affects quality of life and daily functioning in the general population and especially in patients with mental health disorders. Due to the high burden of oral health-related quality of life in patients with a mental health disorder, it is important for nurses to know how they can intervene in an early phase. The aim of this systematic scoping review was to identify and appraise oral health interventions in patients with a mental health disorder. A systematic scoping review with a critical appraisal of the literature was conducted using the Joanna Briggs Institute (JBI) methodology for scoping reviews and their checklists. MEDLINE, CINAHL, PsycINFO and reference lists were searched from their inception until December 2020. Results: Eleven quantitative studies were included in the review: four randomized controlled trials, six quasi-experimental studies and one cohort study. Studies focused on interventions for patients (n = 8) or focused on patients together with their professionals (n = 3). Four types of oral health interventions in mental health were found: (I) educational interventions; (II) physical interventions; (III) interventions combining behavioural and educational elements and (IV) interventions combining educational and physical elements. All studies (n = 11) had an evaluation period ≤12 months. Nine studies showed an effect on the short term (≤12 months) with regard to oral health knowledge, oral health behaviour, or physical oral health outcomes (e.g., plaque index). Two studies showed no effects on any outcome. Overall, the methodological insufficient to good. Conclusion: Four types of interventions with positive effects (≤12 months) on oral health knowledge, oral health behaviour, and physical oral health outcomes in different diagnostic patient groups were found. Due to the heterogeneity in both interventions, diagnostic groups and outcomes, one golden standard oral health intervention cannot be advised yet, although the methodological quality of studies seems sufficient. Developing an integrated oral health toolkit might be of great importance in mental health considering its potential effect on oral health-related quality of life.
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Affiliation(s)
- Sonja Kuipers
- Research Group Healthcare & Innovation in Psychiatry, Department of Healthcare, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, 8900 CG Leeuwarden, The Netherlands; (N.B.); (A.K.-P.)
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands;
- Correspondence: ; Tel.: +31-652-690-627
| | - Nynke Boonstra
- Research Group Healthcare & Innovation in Psychiatry, Department of Healthcare, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, 8900 CG Leeuwarden, The Netherlands; (N.B.); (A.K.-P.)
- KieN VIP, Oosterkade 72, 8911 KJ Leeuwarden, The Netherlands
| | - Linda Kronenberg
- Dimence Mental Health Care, Burgemeester Roelenweg 9, 8021 EV Zwolle, The Netherlands;
| | - Annette Keuning-Plantinga
- Research Group Healthcare & Innovation in Psychiatry, Department of Healthcare, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, 8900 CG Leeuwarden, The Netherlands; (N.B.); (A.K.-P.)
- Health Sciences-Nursing Science & Education, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Stynke Castelein
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands;
- Lentis Research, Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, The Netherlands
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Wilson NJ, Lin Z, Villarosa A, Lewis P, Philip P, Sumar B, George A. Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review. BMC Public Health 2019; 19:1530. [PMID: 31729967 PMCID: PMC6858643 DOI: 10.1186/s12889-019-7863-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/29/2019] [Indexed: 02/06/2023] Open
Abstract
Background People with intellectual and developmental disability (IDD) have poor oral health and need support to maintain optimal oral health outcomes. Little is known about how, when and where to intervene for this population. Thus the aim of this review was to summarise the existing evidence surrounding improving oral health outcomes for people with IDD. Methods A scoping literature review was conducted focusing on ‘oral health’ and ‘intellectual disability’. Systematic searches of five electronic databases were conducted in line with the study aims and two authors independently examined all records for relevance, with consensus achieved by a third author. Results A small number of approaches and interventions were identified to support people with IDD to independently maintain optimal oral hygiene. Identified studies highlighted that caregivers play a vital role in the provision of oral health support, emphasising the effectiveness of educational interventions for caregivers. However, there was uncertainty regarding the efficacy of specific tooth brushing interventions for people with IDD. In cases of more severe IDD and/or dental-related behavioural problems, dental treatment under general anaesthesia was often both a necessary and effective method of oral health care provision. The findings also identified outreach and exclusive oral health services as successful strategies for increasing the limited access of people with IDD to oral care services. Conclusions A uniform approach to supporting oral health for people with IDD is unlikely to succeed. A system-based approach is needed to address the diverse needs of the population of people with IDD, their caregivers and service context. Further high quality evidence is required to confirm these findings.
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Affiliation(s)
- Nathan J Wilson
- School of Nursing and Midwifery, Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW, 2753, Australia.
| | - Zhen Lin
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW, 2753, Australia
| | - Amy Villarosa
- COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Penrith, Australia
| | - Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW, 2753, Australia
| | - Philcy Philip
- Bangalore Baptist Hospital, Bellary Road, Hebbal, Bangalore, Karnataka State, 560024, India
| | - Bashir Sumar
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Locked Bag 3, Richmond, NSW, 2753, Australia
| | - Ajesh George
- COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Penrith, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Translational Health Research Institute, Campbelltown, NSW, 2560, Australia
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Shih YH, Chang CHS. Teaching Oral Hygiene Skills to Elementary Students with Visual Impairments. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x0509900104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the effects of a program that taught oral hygiene skills to students with visual impairments using group instruction and individual coaching. The results showed that the program enhanced the oral hygiene skills of the three participants significantly, and its effectiveness lasted for at least two months after the instruction ended.
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Affiliation(s)
- Yeng-Hung Shih
- Resource classroom teacher, 73, Zhong-Yang North Road, Sec. 1, Taipei Municipal Pei-Tou Elementary School, Taipei 112, Taiwan
| | - Chien-Huey Sophie Chang
- Department of Special Education, National Taiwan Normal University, 162, Ho-ping East Road, Sec. 1, Taipei 106, Taiwan
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Akashi M, Kishimoto M, Kusumoto J, Yakushijin K, Matsuoka H, Komori T. Delayed Socket Healing After Dental Extraction in Patients Undergoing Myelosuppressive Chemotherapy for Hematological Malignancy: Incidence and Risk Factors. J Oral Maxillofac Surg 2018; 76:2057-2065. [PMID: 29932940 DOI: 10.1016/j.joms.2018.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/27/2018] [Accepted: 05/17/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE The purpose of this study was to measure the frequency and identify factors associated with delayed socket healing after dental extraction in patients undergoing myelosuppressive chemotherapy for hematologic malignancy. MATERIALS AND METHODS This prospective cohort study focused on delayed healing after extraction in patients with hematologic malignancy. Sockets with delayed healing were defined as those with intense pain and bone exposure 1 week postoperatively. Patients with and without delayed socket healing were compared using the Fisher exact test and Mann-Whitney U test with some variables. Receiver operating characteristics curve analysis was conducted to define cutoff values for delayed healing. RESULTS One hundred ninety-four dental extractions in 93 patients (median age, 64 yr; range, 20 to 85 yr) were analyzed. The incidence of delayed socket healing was 7.5% (7 of 93 patients). There was no postoperative bleeding. Older age, type of hematologic malignancy (acute leukemia), shorter time from dental extraction to initiation of chemotherapy, low platelet count or hemoglobin level, requirement for red blood cell concentrate or platelet transfusion, and use of an absorbable hemostatic agent were statistically associated with the occurrence of delayed socket healing. Platelet and hemoglobin cutoffs were 4.6 × 104/μL and 7.7 g/dL, respectively. CONCLUSIONS Although dental extraction can be safely performed in patients undergoing myelosuppressive chemotherapy for hematologic malignancy, oral surgeons should understand the potential risk for delayed socket healing. When considering dental extraction, patients with hematologic malignancy and low hemoglobin or platelet levels should be informed about the possibility of delayed socket healing.
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Affiliation(s)
- Masaya Akashi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Megumi Kishimoto
- Graduate Fellow, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junya Kusumoto
- Graduate Fellow, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Lecturer, Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Matsuoka
- Associate Professor, Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahide Komori
- Professor and Chairman, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Osakabe L, Utsumi A, Saito B, Okamatsu Y, Kinouchi H, Nakamaki T, Hironaka S. Influence of Oral Anaerobic Bacteria on Hematopoietic Stem Cell Transplantation Patients: Oral Mucositis and General Condition. Transplant Proc 2018; 49:2176-2182. [PMID: 29149979 DOI: 10.1016/j.transproceed.2017.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/22/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Oral mucositis (OM) caused by infection facilitated by myelosuppression and immunosuppression can be controlled through oral care. We investigated changes in oral anaerobic bacterial flora during the onset of OM with hematopoietic stem cell transplantation (HSCT). METHODS This study included 19 patients who underwent HSCT. All received professional oral care before initiating the preparative regimen. We assessed OM, oral health and obtained microbial samples from the oral cavity during 5 assessment points: before initiating the preparative regimen; the day before HSCT (day 1); and at 7, 14, and 30 days after HSCT. Microbial species were identified by using a mass spectrometer. RESULTS The number of patients with serious OM increased initially after HSCT and decreased thereafter. Many Streptococcus species were identified before HSCT, but these gradually decreased and were replaced by coagulase-negative staphylococci. An increase in Candida species after HSCT and the identification of Enterococcus species were significantly associated with OM. Nutritional status recovery and prognosis were significantly worse in patients who developed OM. CONCLUSIONS To the best of our knowledge, this study is the first which shows that anaerobic bacteria were identified in patients' oral flora before and after HSCT by using a mass spectrometer. These results indicate that Enterococcus species and Candida species may have been associated with OM. OM affected the patients' improvement in nutritional status and their prognosis. We concluded that it is important to provide more complete oral care instructions and interventions to prevent these bacterial infections.
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Affiliation(s)
- L Osakabe
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
| | - A Utsumi
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan.
| | - B Saito
- Department of Medicine, Division of Hematology, Showa University School of Medicine, Tokyo, Japan
| | - Y Okamatsu
- Dentistry and Oral Surgery, Showa University Hospital, Tokyo, Japan; Division of Community Based Comprehensive Dentistry, Department of Special Needs Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - H Kinouchi
- Dentistry and Oral Surgery, Showa University Hospital, Tokyo, Japan
| | - T Nakamaki
- Department of Medicine, Division of Hematology, Showa University School of Medicine, Tokyo, Japan
| | - S Hironaka
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
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Escribano-Hernández A, García-Garraus JM, Hernández-García I. Evaluation of satisfaction among relatives of mentally disabled patients who were users of a dental care protocol under general anaesthesia. Med Oral Patol Oral Cir Bucal 2012; 17:e83-8. [PMID: 21743429 PMCID: PMC3448194 DOI: 10.4317/medoral.17069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 01/21/2011] [Indexed: 11/22/2022] Open
Abstract
Objectives: In the field of action of disease associated with dependence the Third Health Plan of Castilla y León
aims specifically at promoting the adjustment of health assistance to the needs of disabled people, according to
their situation.
Our objectives were:
General: To know the satisfaction level among relatives or caregivers of people who were treated according to a protocol
of dental care for mentally disabled people.
Specific: To know if satisfaction is related to any sociodemographic characteristics of patients or to their pathology.
Study design: Cross-sectional study by telephone survey, set in the Primary Health Area of Salamanca.
The target population includes relatives or caregivers of mentally disabled patients who were sent to the hospital
for treatment under general anaesthesia after being attended in Primary Dental Care Units, from 1st of June/2005
to 31st of May/2006.
Social and demographic variables and patients’ diseases, as well as level of satisfaction with the service, were
studied through a survey.
Results: 67.4% of patients’ relatives or caregivers answered the survey, among whom 94.7% (C.I. 95%: 89-100%)
were quite or very satisfied with the service in general.
Conclusion:The protocol has high acceptance despite its difficulties and it has achieved considerable improvements
in several aspects of patients’ life. This level of satisfaction was not related to any sociodemographic or
clinical patient characteristics.
Nevertheless, accessibility aspects and communication with patients may still be improved. Key words: Health care surveys, dental care for disabled, patient satisfaction.
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Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. ACTA ACUST UNITED AC 2004. [DOI: 10.1111/j.1479-6988.2004.00009.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. ACTA ACUST UNITED AC 2004. [DOI: 10.11124/jbisrir-2004-378] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. ACTA ACUST UNITED AC 2004; 2:1-89. [PMID: 27820001 DOI: 10.11124/01938924-200402030-00001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this systematic review was to report on the best available evidence relating to oral hygiene for adults with dementia in residential aged care facilities, including: INCLUSION CRITERIA: This review considered any randomised or non-randomised controlled studies, cohort studies, case-control studies, multiple time series studies, uncontrolled studies, descriptive studies and opinions of respected authorities (including theses and other publications) related to residents with dementia living in residential aged care facilities in Australia and overseas; community-dwelling adults with dementia; and special needs adult populations (for preventive oral hygiene care strategies and interventions).The review considered studies and publications designed to:1 quantify the oral health status of older adults living in residential aged care facilities;2 quantify the oral health status of adults with dementia living in the community and in residential aged care facilities;3 evaluate tools used to assess the oral health of residents by staff and carers working in residential aged care facilities;4 evaluate preventive oral hygiene care strategies and interventions used in special needs adult populations (including adults with dementia); and5 evaluate oral health care training and oral hygiene care provision, staff and carers working in residential aged care facilities.Dental outcome measures of interest were those relating to the prevalence, incidence, experiences and increments of oral diseases and conditions including: denture problems, coronal and root caries, periodontal diseases (plaque accumulation, gingivitis, loss-of-attachment), oral mucosal conditions, xerostomia and salivary gland hypofunction, tooth loss, difficulty chewing, behavioural problems and pain/discomfort. Related characteristics and outcomes of interest included: medical conditions, medications, cognitive status, functional status, nutritional status and sociodemographics. SEARCH STRATEGY The aim of the search was to locate relevant English-language studies and publications appearing between 1980 and 2002. The search utilised a two-step approach, involving an initial search of electronic databases using combinations of key words followed by a second extensive search carried out using the identified key words. This was supplemented with a secondary search of the references cited in the identified studies. Electronic database searched were: Cinahl, Embase, Psycinfo, Medline and Current Contents. METHODOLOGICAL QUALITY All selected studies were critically appraised by two reviewers prior to inclusion in the review. RESULTS In regards to relevance, incidence, experiences, and increments of oral diseases and conditions, possible risk factors identified included: saliva dysfunction, polypharmacy, comorbid medical conditions, swallowing and dietary problems, increased functional dependence, need for assistance with oral hygiene care, and poor access and utilisation of dental care.Evidence on the use of assessment tools by carers to evaluate residents' oral health showed that successful assessment of residents with and without dementia by nursing staff requires appropriate staff training by a dental professional. Coupled with appropriate training, an oral assessment screening tool designed for residents with dementia has been successfully used by nursing and care staff to identify residents requiring further review by dental professionals. Expert opinion in the field indicates that oral assessment screenings by a staff member and then by a dentist would ideally be undertaken upon admission to a facility, and regularly thereafter by staff and/or dentists as required.Clinicians and researchers suggested that oral hygiene care strategies to prevent oral diseases and conditions were found to be effective in preventing oral diseases, and thus are relevant for use in the resident with dementia.In regards to the provision of dental treatment and ongoing management of oral diseases and conditions, the use of adjunctive and preventive aids were found to be effective when introduced in conjunction with a staff training program:Expert opinion suggests that behaviour management techniques will increase the potential of performing oral hygiene care interventions. CONCLUSIONS This review suggests that the training of staff in the form of a comprehensive practically oriented program addressing areas such as oral diseases, oral screening assessment, and hands-on demonstration of oral hygiene techniques and products is likely to have a positive impact on the management of oral hygiene care within residential aged care facilities. The review also identified that regular brushing with fluoride toothpaste, use of therapeutic fluoride products and application of therapeutic chlorhexidine gluconate products are validated by research as effective for the general population and some populations with special needs.
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Affiliation(s)
- Alan Pearson
- 1The Joanna Briggs Institute, Adelaide, South Australia, Professor of Nursing, La Trobe University, Melbourne, Victoria, and Adjunct Professor, The University of Adelaide, Adelaide, South Australia, Australia 2Preventive and Community Dentistry, The University of Iowa, Iowa City, Iowa, USA Associate Professor Jane Chalmers, Preventive and Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA 52242-1010, USA
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