title: Oral Care and Mortality in Older Adults with Pneumonia in Hospitals or Nursing Homes: Systematic Review and Meta-Analysis.
abstract: The objectives of the study were to compare the effect of intensified oral care interventions given by dental or nursing personnel on mortality from healthcare-associated pneumonia (HAP) in elderly adults in hospitals or nursing homes with the effect of usual oral care. Systematic literature searches were conducted in PubMed, the Cochrane Library, and the Health Technology Assessment database of the National Health Service Centre for Reviews and Dissemination (August 2015). Randomized controlled trials (RCTs) were considered for inclusion. Data were extracted and risk of bias was assessed independently and agreed on in consensus meetings. Five RCTs, with some or major study limitations, fulfilled the inclusion criteria. Based on meta-analyses, oral care interventions given by dental personnel reduced mortality from HAP (risk ratio (RR) = 0.43, 95% confidence interval (CI) = 0.25-0.76, P = .003), whereas oral care interventions given by nursing personnel did not result in a statistically significant difference in mortality from HAP (RR = 1.20, 95% CI = 0.97-1.48, P = .09), in elderly adults in hospitals or nursing homes from usual oral care. Oral care interventions given by dental personnel may reduce mortality from HAP (low certainty of evidence, Grading of Recommendations Assessment, Development and Evaluation (GRADE) ⊕⊕○○), whereas oral care interventions given by nursing personnel probably result in little or no difference from usual care (moderate certainty of evidence, GRADE ⊕⊕⊕○) in elderly adults in hospitals or nursing homes.
authors: Oral Care AB, Stockholm, Sweden. petteri.sjogren@oralcare.se.
authors: Petteri
authors: P
authors: Sjögren
authors: Department of Dental Medicine and Academic Centre of Gerodontics, Karolinska Institutet, Stockholm, Sweden.
authors: Inger
authors: I
authors: Wårdh
authors: Oral Care AB, Stockholm, Sweden.
authors: Mikael
authors: M
authors: Zimmerman
authors: Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Annica
authors: A
authors: Almståhl
authors: Department of Dental Medicine and Academic Centre of Gerodontics, Karolinska Institutet, Stockholm, Sweden.|Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Maude
authors: M
authors: Wikström
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D003813:Dentistry / Q000379:methods / Q000592:standards; D006707:Homes for the Aged / Q000592:standards; D006761:Hospitals / Q000592:standards; D006801:Humans; D009735:Nursing Homes / Q000592:standards; D009909:Oral Health / Q000592:standards / Q000706:statistics & numerical data; D011014:Pneumonia / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration
keywords: dentistry; elderly; nursing home; pneumonia; systematic review