title: The impact of hospitalization on oral health: a systematic review.
abstract: BACKGROUND
  Poor oral health of hospitalized patients is associated with an increased risk of hospital-acquired infections and reduced life quality.
  
  
  OBJECTIVE
  To systematically review the evidence on oral health changes during hospitalization.
  
  
  METHODS
  Cochrane library, Medline, OldMedline, Embase and CINAHL without language restrictions.
  
  
  METHODS
  Observational longitudinal studies.
  Two independent reviewers screened studies for inclusion, assessed the risk of bias and extracted data. Risk of bias was assessed using the Newcastle-Ottawa assessment scale. A narrative synthesis was conducted.
  
  
  RESULTS
  Five before and after studies were included. The data suggest a deterioration in oral health following hospitalization with an increase in dental plaque accumulation and gingival inflammation and a deterioration in mucosal health.
  
  
  CONCLUSIONS
  While before and after studies are at a general risk of bias, other specific study characteristics were judged to have a low risk of bias. However, methodological issues such as unvalidated outcome measures and the lack of assessor training limit the strength of the evidence.
  
  
  CONCLUSIONS
  Hospitalization is associated with a deterioration in oral health, particularly in intubated patients.
authors.affiliation: Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Terezakis
authors.forename: Ian
authors.initials: I
authors.lastname: Needleman
authors.forename: Navdeep
authors.initials: N
authors.lastname: Kumar
authors.forename: David
authors.initials: D
authors.lastname: Moles
authors.forename: Elisa
authors.initials: E
authors.lastname: Agudo
mesh_terms: D003428:Cross Infection / Q000209:etiology; D003773:Dental Plaque / Q000209:etiology; D005891:Gingivitis / Q000209:etiology; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D009909:Oral Health; D009910:Oral Hygiene; D011788:Quality of Life; D012307:Risk Factors