Oral care after stroke: where are we now?

Mary Lyons, Craig Smith, Elizabet Boaden, Marian Brady, Paul Brocklehurst, Hazel Dickinson, Shaheen Hamdy, Susan Higham, Peter Langhorne, Liz Lightbody, Giles McCracken, Antonieta Medina-Lara, Lise Sproson, Angus Walls, Caroline Watkins

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Abstract

Purpose
There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia – a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice.

Methods
A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities.

Findings
Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care.

Discussion
Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae.

Conclusion
Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke.
Clinically relevant, feasible, cost –effective, evidence based oral care interventions to improve patient outcomes in stroke care are urgently needed.
Original languageEnglish
Pages (from-to)347-354
JournalEuropean Stroke Journal
Volume3
Issue number4
Early online date8 May 2018
DOIs
Publication statusPublished - 1 Dec 2018

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Keywords

  • stroke
  • oral health
  • oral hygiene
  • oral cavity
  • mouth
  • dental
  • pneumonia
  • quality of life
  • tooth-brushing

Cite this

Lyons, M., Smith, C., Boaden, E., Brady, M., Brocklehurst, P., Dickinson, H., Hamdy, S., Higham, S., Langhorne, P., Lightbody, L., McCracken, G., Medina-Lara, A., Sproson, L., Walls, A., & Watkins, C. (2018). Oral care after stroke: where are we now? European Stroke Journal , 3(4), 347-354. https://doi.org/10.1177/2396987318775206