title: Effect of a home telecare program on oral health among adults with tetraplegia: a pilot study.
abstract: METHODS
  one group pre- and post-test design.
  
  
  OBJECTIVE
  The primary aim was to examine both the short- and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia.
  
  
  METHODS
  Eight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using personal computer-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15-30 min sessions across 3 months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Löe-Silness gingival index (LSGI) was conducted at baseline, 6 and 12 months.
  
  
  RESULTS
  From baseline to 6 months, participants showed statistically significant differences (that is, improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (that is, improvement, z=2.03; P=0.04) in their LSGI scores.
  
  
  CONCLUSIONS
  This study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at 6 and 12 months among adults with tetraplegia.
authors: Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors: H K
authors: HK
authors: Yuen
mesh_terms: D000328:Adult; D003742:Dental Devices, Home Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000517:prevention & control; D009909:Oral Health / Q000193:education*; D009910:Oral Hygiene / Q000193:education* / Q000295:instrumentation; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011782:Quadriplegia / Q000150:complications*; D013119:Spinal Cord Injuries / Q000150:complications; D017216:Telemedicine / Q000379:methods*; D049269:Videoconferencing