Effectiveness of Oral Rinsing Solutions on Mucus, Odor, and Plaque in the Hospitalized Elderly in Taiwan

Aspiration pneumonia in nursing literature-a mapping review

Introduction

Aspiration pneumonia (AP) is an infection of the lungs caused by inhalation of material. The reported incidences vary across literature and clinical populations and is associated with high morbidity and mortality. Management of AP is best carried out by a multidisciplinary team.

Methods

This aim of this review was to collate and describe the available evidence on AP to develop a greater understanding of the concept of AP as it is represented in the nursing literature. As a collaborative team, we undertook the six stages of a systematic mapping review. We searched for the term aspiration pneumonia in 200 peer reviewed nursing journals across 10 databases, over a ten-year period (2013-2023).

Results

In this review, 293 papers were coded. Dysphagia, oral health and tube feeding emerged as the most frequent risk factors for AP, and the most reported factors for preventing this condition. Mortality was the most commonly described consequence of AP, followed by hospitalisations and morbidity. Multiple management approaches were reported including dysphagia assessment, risk evaluation, oral care and texture modification of food and fluids. The role of nurses and interprofessional collaborations were described.

Discussion

Despite limited evidence related to the topic of AP in the nursing literature, the complexity of the causes, prevention, management and consequences of AP emerged. Certain factors, such as dysphagia, oral health, and tube feeding, were described under prevention, cause and management of AP. The importance of multidisciplinary approach in the management and prevention of AP was presented.

Use and efficacy of mouthwashes in elderly patients: A systematic review of randomized clinical trials

INTRODUCTION

A higher prevalence of oral problems has been observed in the elderly population. One of the treatment options for some of these pathologies is the administration of mouthwashes combined with mechanical removal techniques. Besides, each type of oral rinse treats certain oral diseases, and it should be selected for each specific situation.

OBJECTIVE

To determine the use and efficacy of mouthwashes in the elderly as a treatment for various pathologies, to indicate the most common kinds of mouth-rinses used, the diseases treated with them, their efficacy in each treatment, and their effectiveness when they are combined with other treatments.

MATERIAL AND METHODS

The review has been carried out following the PRISMA 2020 Statement. Individualized bibliographic searches were performed in five databases. Randomized clinical trials are included in patients over 60 years old where mouthwashes were administered to treat or prevent specific diseases. The PICO question aimed to assess what type of mouthwashes elderly patients use, what they use them for, and their efficacy. Study selection, data extraction, and quality analysis were achieved using the RoB-2 guide.

RESULTS

Thirteen articles were chosen to perform the qualitative analysis. The bibliometric analysis was carried out. We have eleven randomized controlled clinical trials and two uncontrolled. The mouthwash more used was chlorhexidine, followed by essential oils and fluorides. The most studied pathologies were a periodontal disease, caries, candidiasis, denture stomatitis, and xerostomia. Chlorhexidine used weekly is effective as antiplaque and antigingivitis. Fluorides effectively prevent and reverse caries; nystatin and essential oils to treat candidiasis; and pilocarpine rinse to manage xerostomia.

CONCLUSIONS

The included studies show that mouthwashes are widely extended in the elderly population, and each sort is specifically designed for treating a particular condition.

Oral status of older people in medium to long-stay health and social care setting: a systematic review

Background

Older patients who spend long periods hospitalized or those who are in a situation of institutionalization represent a risk group in this regard, as many of them suffer a degree of dependence and need help to perform the basic tasks of personal care. It is therefore important to learn more of the oral health status of this group of patients in order to make a proper assessment of the situation and to develop protocols for its management. The purpose of the study was to conduct a systematic review to ascertain the oral health status of older people patients admitted to institutions or hospitalized for a long period of time.

Methods

a systematic review of the literature published in two different databases (PubMed, Embase and Cochrane Library) was carried out, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or hospital center for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were evaluated in some way. The selected articles were subjected to a thorough analysis.

Results

The search strategy covered 1.014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was, a sample of 773 patients most of them were women with an average age older than 70 years old.

Conclusions

The oral health of patients aged more than 65 is worse than that of the rest population. Long hospital stays or being institutionalized in a residence makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programs for the personnel responsible.