title: Efficacy of chlorhexidine swabbing in oral health care for people with severe disabilities.
abstract: Chlorhexidine is effective when used as an oral rinse, but many disabled people cannot use such a protocol. A double-blind cross-over study tested the efficacy of applying chlorhexidine with a sponge-swab, in a sample of 76 severely disabled adults, drawn from diverse rehabilitation settings. Two randomly assigned groups applied 10 mL 0.12% chlorhexidine gluconate (Peridex, Procter & Gamble) or 10 mL placebo, using a "Toothette" (Halbrand) once daily, 5 times per week for 10 weeks. All subjects received 10 mL 0.05% NaF, applied similarly but separately from the test/placebo agent. Pre- and post-trial measures included perceived level of function and oral status, that is, DMFS, plaque, calculus, pocket depth, and tooth stain. The protocol received high levels of compliance and acceptance. Compared with placebo, swabbing with chlorhexidine resulted in consistent, and, in part, significant improvements in plaque, gingivitis, and periodontal pocket depth. Side effects of chlorhexidine, that is, tooth stain and calculus, were relatively minor. Perceived improvements in dental health were associated with improved physical health, appearance, and mouth odor. The results indicate that chlorhexidine swabbing is a useful oral disease preventive protocol for persons with disability.
authors.affiliation: Department of Oral Medicine, University of Washington, Seattle.
authors.forename: D J
authors.initials: DJ
authors.lastname: Stiefel
authors.forename: E L
authors.initials: EL
authors.lastname: Truelove
authors.forename: M M
authors.initials: MM
authors.lastname: Chin
authors.forename: L S
authors.initials: LS
authors.lastname: Mandel
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003728:Dental Calculus / Q000517:prevention & control; D003730:Dental Care for Persons with Disabilities; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000517:prevention & control; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005891:Gingivitis / Q000628:therapy; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017060:Patient Satisfaction; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy
chemical_list: C010882:chlorhexidine gluconate; D002710:Chlorhexidine