title: Integrated oral health care for stroke patients - a scoping review.
abstract: OBJECTIVE
  To identify current evidence on the role of nurses and allied health professionals in the oral health management of stroke patients, detailing their current knowledge, attitudes and practices and the potential benefits of an integrated oral care programme.
  
  
  BACKGROUND
  Stroke has disabling oral health effects, such as dysphagia and hindered brushing due to upper limb hemiparesis. Together, these can increase bacterial load, increasing risk of pneumonia. In general management of stroke, nurses play a key role in early identification, assessment and referral, while occupational therapists, dieticians and speech pathologists are important in rehabilitation. While this should logically apply to the oral care of stroke patients, there is currently limited information, especially in Australia.
  
  
  METHODS
  Scoping review.
  
  
  METHODS
  A literature search was conducted using multiple databases regarding the oral health management of stroke patients by nondental professionals, and 26 articles were reviewed.
  
  
  RESULTS
  The Australian National Clinical Guidelines for Stroke accentuate the need for oral care following stroke and suggest how hospital staff need to be involved. Currently, there are no Australian studies. However, international literature suggests that lack of oral health knowledge by nurses and poor patient attitude are reflected in infrequent assistance with stroke patient oral hygiene. There is limited information regarding the benefits of nursing-driven oral hygiene programme in reducing pneumonia incidence, and only few studies show that involving nurses in assisted oral care reduces plaque. There are some suggestions that involving nurses and speech pathologists in oral rehabilitation can improve dysphagia outcomes.
  
  
  CONCLUSIONS
  Managing oral health poststroke is vital, and there is a need for an appropriate integrated oral care service in Australia.
  
  
  CONCLUSIONS
  Nondental professionals, especially nurses, can play a key role in the poststroke oral health management of stroke patients to reduce complications, especially pneumonia.
authors.affiliation: Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Sydney, NSW, Australia.|University of Sydney, Sydney, NSW, Australia.
authors.forename: Shilpi
authors.initials: S
authors.lastname: Ajwani
authors.affiliation: University of New South Wales, Sydney, NSW, Australia.
authors.forename: Sumedh
authors.initials: S
authors.lastname: Jayanti
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Burkolter
authors.affiliation: The George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Anderson
authors.affiliation: Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Sydney, NSW, Australia.|University of Sydney, Sydney, NSW, Australia.
authors.forename: Sameer
authors.initials: S
authors.lastname: Bhole
authors.affiliation: CoHORTE Research Group, Western Sydney University, Sydney, NSW, Australia.|South Western Sydney Local Health District, Sydney, NSW, Australia.|Ingham Institute Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Itaoui
authors.affiliation: University of Sydney, Sydney, NSW, Australia.|CoHORTE Research Group, Western Sydney University, Sydney, NSW, Australia.|South Western Sydney Local Health District, Sydney, NSW, Australia.|Ingham Institute Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Ajesh
authors.initials: A
authors.lastname: George
mesh_terms: D000488:Allied Health Personnel; D001315:Australia; D006801:Humans; D024802:Nurse's Role; D009909:Oral Health; D009910:Oral Hygiene / Q000451:nursing*; D019145:Rehabilitation Nursing / Q000379:methods*; D020521:Stroke / Q000451:nursing*; D000071939:Stroke Rehabilitation / Q000451:nursing*
keywords: non-oral health professionals; nurses; oral health; oral rehabilitation; stroke