Oral Care for the Institutionalized Elderly

Objectives: The number of elderly person has been rapidly increasing in many developed countries. The average life span for females in Japan has been the longest in the world since 1985 and for males since 1995. The increased life span for the elderly is potentially problematic for those who need long-term medical and dental cares. During the last decade, much attention has been paid toward the relationship between oral health and general health. The keen epoch-making study was that oral care reduced pneumonia in older patients in nursing homes (Lancet, 1999 & J Am Geriatr Soc, 2002). Methods: Three hundreds and sixty-six patients were randomly assigned to the groups with and without oral care. Dentists or dental hygienists provided professional care once a week for the group with oral care. Criteria for diagnosis of pneumonia were a new pulmonary infiltrate seen on a chest radiograph and one of the following features: cough, temperature greater than 37.8°C, or subjective dyspnea. Patients who had febrile days for more than 7 cumulative days during 2 years were assumed to be the patients with fever. Results: In 2-year observation, pneumonia, febrile days and death from pneumonia significantly decreased in the group with oral care and oral care was regarded to be beneficial in edentate and dentate patients. Conclusion: It is suggested that oral care may be useful in preventing pneumonia which is the most common cause of death from nosocomial infection in the older patients and may enhance their QOL of this institutionalized elderly population.