title: Randomized clinical trial of oral health promotion interventions among patients following stroke.
abstract: OBJECTIVE
  To evaluate the effectiveness of oral health promotion interventions on clinical oral health.
  
  
  METHODS
  Single-blind randomized controlled trial conducted over 3 weeks of in-hospital rehabilitation.
  
  
  METHODS
  Stroke rehabilitation ward in Hong Kong.
  
  
  METHODS
  Patients with stroke (N=102) admitted to the rehabilitation ward.
  
  
  METHODS
  Patients were randomly assigned either: (1) oral hygiene instruction, (2) oral hygiene instruction and chlorhexidine mouthrinse, or (3) oral hygiene instruction, chlorhexidine mouthrinse, and assisted brushing.
  
  
  METHODS
  Dental plaque, gingival bleeding, and oral functional status were assessed at baseline and review. Development of infectious complications were also monitored during the clinical trial.
  
  
  RESULTS
  Poor oral hygiene and an overall neglect of oral hygiene practices were observed at baseline. Reductions in dental plaque were significantly greater in the 2 groups receiving chlorhexidine compared with the group receiving oral hygiene instruction alone (P<.001). Reductions in gingival bleeding scores were 3- to 4-fold greater in groups receiving chlorhexidine. No cases of pneumonia were observed during the course of the clinical trial.
  
  
  CONCLUSIONS
  The oral health condition of patients may be safeguarded after acute stroke with the use of chlorhexidine mouthrinse in conjunction with a standard mechanical plaque removal tool, such as an electric toothbrush. These interventions are acceptable to the majority of patients, and their administration poses a minimal burden to rehabilitation ward staff.
authors.affiliation: Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
authors.forename: Otto L
authors.initials: OL
authors.lastname: Lam
authors.forename: Anne S
authors.initials: AS
authors.lastname: McMillan
authors.forename: Lakshman P
authors.initials: LP
authors.lastname: Samaranayake
authors.forename: Leonard S
authors.initials: LS
authors.lastname: Li
authors.forename: Colman
authors.initials: C
authors.lastname: McGrath
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000008:administration & dosage; D003774:Dental Plaque Index; D004185:Disability Evaluation; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006723:Hong Kong; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage; D009910:Oral Hygiene; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
chemical_list: D009067:Mouthwashes; D002710:Chlorhexidine