The oral hygiene status of people with dysphagia: a descriptive study.

Abstract

The aim of the study was to assess and describe the oral hygiene problems of adults admitted to a sub-acute rehabilitation hospital who presented with dysphagia. A descriptive, cross-sectional survey study design was followed and took place at a sub-acute rehabilitation hospital, based in the private sector. The 40 participants, 57.50% (n=23) male and 42.50% (n=17) female, were identified using non-probability, purposive sampling and underwent various assessments during the two phases of data collection. Phase I consisted of three steps: (1) assess the swallow function of participants, using the Mann Assessment of Swallow Ability (MASA), (2) screening the oral hygiene of participants with confirmed dysphagia, using an adapted version of the Oral Health Assessment Tool to identify any oral hygiene problems, and (3) sample the oral microbia to detect bacteria not considered part of the normal oral flora. Phase II of the study refers to the descriptive and statistical analysis of the data. A high likelihood for aspiration was a common feature for most participants who presented with dysphagia (42.50%). The main swallowing problems were related to lingual strength, the ability to manage saliva, bolus clearance and effectiveness of the cough. A high prevalence of deficient oral hygiene and oral colonization (62.50%) was found. The most commonly occurring bacteria groups and species were: (1) Candida albicans and (2) respiratory pathogens, e.g. Klebsiella pneumoniae and Staphylococcus aureus growth. The oral hygiene status of people who presented with dysphagia showed that it increases the likelihood for poor oral hygiene, which creates favourable environments for bacteria to flourish, as well as the prevalence of pathogenic oral bacteria, which is associated with the development of aspiration pneumonia. The management of oral health issues for persons with dysphagia should receive greater attention during hospitalization.