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      Dental Hygienists’ Practice in Perioperative Oral Care Management According to the Japanese Dental Hygienists Survey 2019

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          Abstract

          Perioperative oral care management is effective in the prevention of postoperative complications, and dental hygienists play an important role. The aim of this study was to elucidate the practice and substantial role of dental hygienists in perioperative oral care management. The Japan Dental Hygienists Association conducted a survey of the employment status of Japanese dental hygienists in 2019. Questionnaires were distributed to all 16,722 members, and 8932 were returned (collection rate: 53.4%). A total of 3560 dental hygienists were working at dental clinics and 1450 (38.2%) were performing perioperative oral care management. More than 90% of them implemented conventional oral care practice. Less than half of the dental hygienists implemented treatment concerning oral functions. Only 9.9% of dental hygienists recognized shortened hospital stay as an effect of perioperative oral care management. Dental hygienists who implemented both nutritional instruction and training of swallowing function or mouth rinsing instructions recognized the shortened hospital stay effect. Overall implementation of perioperative oral care management led to shortened hospital stay. Implementation of perioperative oral care management required knowledge and skills related to systemic health conditions. A stepwise educational program is necessary for perioperative oral care management to become commonplace for dental hygienists.

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          Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia.

          Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients.
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            Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities.

            Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture wearing when teeth are lost may indirectly contribute to maintaining or improving ADL, mediated by recovery of swallowing function and nutritional status. © 2012 John Wiley & Sons A/S.
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              Effect of professional oral health care on the elderly living in nursing homes.

              We evaluated the effectiveness of professional oral health care (POHC) given by dental hygienists once a week for 24 months to 141 elderly persons needing daily care and living in 2 nursing homes. Elderly subjects with POHC and without POHC living in 2 nursing homes were examined for 24 months to detect any fevers of 37.8 degrees C or more and the prevalence of fatal aspiration pneumonia. The numbers of Staphylococcus species and Candida albicans in swab samples from oral cavities were compared between the POHC group and the non-POHC group. The amounts of methylmercaptan exhaled in the POHC group were determined and compared with those in the non-POHC group. The prevalence of fevers of 37.8 degrees C or more in the subjects receiving POHC was significantly lower than in the non-POHC group (P < .05). We found that the ratio of fatal aspiration pneumonia in the POHC group during the 24 months was significantly lower than in the non-POHC group (P < .05). Numbers of C albicans species in samples obtained from the oral cavity after 6 months of POHC were significantly lower than those in the non-POHC group (P < .01). POHC resulted in the reduction of the presence of Staphylococcus but not to a statistically significant extent. The amounts of methylmercaptan exhaled by the POHC group were significantly less than those of the non-POHC group (P <.05). This study showed that POHC administered by dental hygienists to a group of elderly patients needing daily nursing care was associated with a reduction in prevalence of fever and fatal pneumonia.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                26 December 2020
                January 2021
                : 18
                : 1
                : 114
                Affiliations
                [1 ]Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; hanada-n@ 123456tsurumi-u.ac.jp
                [2 ]Japanese Dental Hygienists’ Association, Tokyo 169-0071, Japan; yohara@ 123456tmig.or.jp (Y.O.); nori@ 123456pm-ms.tepm.jp (N.T.)
                [3 ]Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan
                [4 ]Department of Endodontology, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; yamamoto-y@ 123456tsurumi-u.ac.jp (Y.Y.); hosoya-n@ 123456tsurumi-u.ac.jp (N.H.)
                [5 ]Department of Operative Dentistry, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; okada-a@ 123456tsurumi-u.ac.jp
                Author notes
                Author information
                https://orcid.org/0000-0002-0814-0572
                https://orcid.org/0000-0002-1294-256X
                https://orcid.org/0000-0002-9130-7256
                Article
                ijerph-18-00114
                10.3390/ijerph18010114
                7795937
                33375276
                c40184bf-5e36-4889-9099-af07d24b1506
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 19 November 2020
                : 23 December 2020
                Categories
                Article

                Public health
                dental hygienist,perioperative oral care management,oral care practice
                Public health
                dental hygienist, perioperative oral care management, oral care practice

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