Poor mouth care causes as many as half the cases of pneumonia in nursing home residents and other people with physical and cognitive impairment. Bacteria that cause pneumonia live in dental plaque, from which they’re released into the saliva and then aspirated into the lungs. This is no small problem, as over two million episodes of nursing-home acquired pneumonia occur every year, many of which require hospitalization and result in death. Recent research indicates that as many as half of these infections -- and deaths -- could be avoided with good mouth care.
That’s not all. Poor mouth care also leads to poor nutrition, both by promoting tooth loss and by causing gingivitis (gum inflammation due to chronic infection). Gingivitis is uncomfortable, and chronic pain from gingivitis can lead to agitation. In addition, inflammation in the mouth makes diabetes harder to control and may even be linked to heart attacks.
Bottom line: good mouth care benefits both older adults and the people who provide their care.
Studies have shown that mouth care in persons with cognitive and physical impairment is often done inconsistently or not at all. And the older persons most likely to not receive mouth care -- persons with severe disabilities or advanced dementia -- are also the most susceptible to pneumonia, poor oral intake, and other problems related to poor oral hygiene. So the question is not “should” mouth care be improved, but “how.”
The University of North Carolina at Chapel Hill (UNC) developed and studied the outcomes of Mouth Care Without a Battle©, which provides basic mouth care techniques and strategies to care for people with cognitive and physical impairment. Oral health was significantly improved by the nursing assistants who provided mouth care in accordance with this program.