What dentists should know about nursing’s dirty secret and oral care

“You’re not healthy without good oral health” (C Everett Koop, Surgeon General USA 2000)

“The mouth is the mirror of the body, but often overlooked in healthcare” (anonymous)

Eddi Cohen, R.N., B.S., MICN, CCRN, CFRN (ret), MRCNA Clinical Nurse Consultant, Sydney Australia

Poor oral health and periodontal disease is known to increase risks for respiratory infections, diabetes, stroke and cardiovascular disease1. Despite this awareness, poor oral hygiene continues to play a significant role in pneumonia rates among nursing home residents, particularly those at risk for aspiration.

Aspiration pneumonia, which is typically caused by anaerobic organisms (commonly S. aureus, P. aeruginosa or one of the enteric species) arises from the gingival crevice and seen in both the community and institutionalised settings. Pneumonia develops when pathogens are aspirated from the oropharyngeal cavity and other sites (GI tract, sinuses) into the lower airway.

Increased risks for aspiration pneumonia occur when a sequence of periodontal disease, dental decay and poor oral hygiene is compounded by the presence of dysphagia, feeding problems and poor functional status all of which are found in vulnerable dependent persons.

Part I and Part II of the articles were published in Australasian Dentist Issues 37 and 38, Nov / Dec 2010 and Mar ‘ Apr 2011 respectively.

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