Effect of oral healthcare prevention program on oral hygiene in post-stroke patients: A systematic review and meta-analysis

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of dentistry Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI:10.1016/j.jdent.2025.105591

Eszter Uhrin , Júlia Moldvai , Brigitta Teutsch , Zsuzsanna Domokos , Bence Szabó , Péter Hegyi , Péter Hermann , Orsolya Németh

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Abstract

Objectives

The global burden of stroke is increasing every year. Residual impairments from stroke reduce the future independence of affected patients while also increasing their susceptibility to oral health-related diseases. Oral healthcare prevention programs (OHCP) are vital in maintaining acceptable oral hygiene during rehabilitation. Dysphagia among stroke elevates the risk of ingesting oral opportunistic pathogens, potentially leading to severe conditions.

Data Sources

A systematic search was conducted in three main databases (Medline, EMBASE, CENTRAL) until November 29th, 2022.

Study selection

We included randomized clinical trials that measure the effect of OHCP on oral health and oral opportunistic pathogens. After the systematic search (7608 articles), we conducted title/abstract selection by two independent authors, followed by full-text selection. In both cases, Cohen's kappa was calculated. Finally, we found 15 articles that were eligible for analysis.

Results

The plaque index showed a slight but non-significant reduction with the OHCP program (SMD= -2.77, CI:6.6–1.06). In terms of the risk of oral yeast detection, there was a statistically non-significant difference between the intervention and control groups at short-term and after a 3-month follow-up (RR: 1.06, 95 % CI: 0.20;5.69; RR:0.98 CI: 0.33; 2.93), respectively. For S.aureus and AGNB, there was no statistically significant difference in short-term evaluation (RR: 0.89 CI: 0.07; 11.99; RR:0.77 CI: 0.00; 888.18), respectively.

Conclusions

Current evidence did not identify that regular OHCP had a beneficial effect on oral pathogen-related diseases.

Prospero registration

CRD42022346788

Clinical Significance

Regular oral health care, including assistance from a dental hygienist in stroke units, is essential for preventing oral health-related diseases. Integrating into post-stroke rehabilitation can enhance overall quality of life and well-being.

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口腔保健预防计划对脑卒中后患者口腔卫生的影响：系统回顾和荟萃分析。

目的：全球卒中负担每年都在增加。脑卒中的残余损伤降低了受影响患者未来的独立性，同时也增加了他们对口腔相关疾病的易感性。口腔保健预防计划（OHCP）对于在康复期间保持可接受的口腔卫生至关重要。中风患者的吞咽困难增加了摄入口服机会性病原体的风险，可能导致严重的疾病。数据来源：系统检索三个主要数据库（Medline、EMBASE、CENTRAL），检索时间截止到2022年11月29日。研究选择：我们纳入了测量OHCP对口腔健康和口腔机会致病菌影响的随机临床试验。系统检索（7608篇）后，由两位独立作者进行标题/摘要选择，然后进行全文选择。在这两种情况下，科恩的kappa都是计算出来的。最后，我们找到了15篇符合分析条件的文章。结果：斑块指数在OHCP方案下有轻微但不显著的降低（SMD= -2.77, CI:-6.6-1.06）。在口腔酵母菌检测风险方面，干预组与对照组在短期随访和3个月随访时差异无统计学意义(RR: 1.06, 95% CI: 0.20;5.69；Rr:0.98 ci: 0.33；分别为2.93)。金黄色葡萄球菌与AGNB的短期评价差异无统计学意义(RR: 0.89 CI: 0.07；11.99;Rr:0.77 ci: 0.00；分别为888.18)。结论：目前的证据并没有确定常规的职业健康护理对口腔病原体相关疾病有有益的影响。临床意义：定期的口腔卫生保健，包括中风单位牙科保健师的协助，对于预防口腔相关疾病至关重要。融入脑卒中后康复可以提高整体生活质量和幸福感。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.