Oral care after stroke: Where are we now?

Lyons, M. et al. (2018) Oral care after stroke: Where are we now? European Stroke Journal, 3(4), pp. 347-354. (doi:10.1177/2396987318775206)

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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.

Item Type:Articles
Additional Information:This work was supported by a NIHR CRN/British Association of Stroke Physicians stroke writing group grant.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Langhorne, Professor Peter
Authors: Lyons, M., Smith, C., Boaden, E., Brady, M. C., Brocklehurst, P., Dickinson, H., Hamdy, S., Higham, S., Langhorne, P., Lightbody, C., McCracken, G., Medina-Lara, A., Sproson, L., Walls, A., and Watkins, D. C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Stroke Journal
Publisher:SAGE Publications
ISSN:2396-9873
ISSN (Online):2396-9881
Published Online:08 May 2018
Copyright Holders:Copyright © 2018 European Stroke Organisation
First Published:First published in European Stroke Journal 3(4): 347-354
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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