UBC Theses and Dissertations
Evaluation of a comprehensive daily mouth care program for long-term care facilities Donnelly, Leeann Rachel
Objective: A randomized, controlled clinical trial involving 2 long-term care facilities was designed to test whether a comprehensive daily mouth care program for LTC facilities could reduce gingivitis, denture stomatitis and debris on teeth and dentures. A questionnaire was also used to assess an improvement in knowledge, behaviour and attitudes of nursing staff with respect to the provision of daily mouth care. Materials and Methods: A four month, random, controlled clinical trial of a comprehensive daily mouth care program for caregivers in a long-term care facility was evaluated using both a questionnaire conducted with caregivers and an oral examination of residents. Two, 51-bed extended long-term care facilities in Vancouver, British Columbia owned and operated by one individual were asked to participate in the evaluation of the program. The program was implemented in one site, while the other site acted as a negative control. Nine caregivers from the test site and 13 from the control site completed both the pre and post questionnaire related to mouth care knowledge, performance and attitude. Twenty-four residents from the test site and 19 from the control site gave consent and were available for oral examination at baseline, 1 and 4 months. Gingivitis was measured using the Modified Gingival Index, and denture stomatitis using Newton's Classification. The debris (food and plaque) was quantified using the Modified Debris Index. Results: No statistically significant change in the caregiver's knowledge, attitude or behaviour was found after the implementation of the program. At both the test and control site there was no improvement in mean debris on teeth or gingivitis scores. There was a statistically significant decrease in debris on dentures at the test site and a decrease in denture stomatitis that was not statistically significant. A decrease in debris on dentures and stomatitis was evident at the control site, but due to small numbers the findings could not be analyzed statistically. Conclusion: The comprehensive daily mouth care program used did not result in a decrease in debris on teeth or gingivitis in residents of a long-term care facility. A decrease in debris on dentures and stomatitis was evident indicating caregivers were better able to clean dentures than teeth. Although staff may appreciate the structure and guidance of a mouth care program it did not result in an improvement in clinical outcomes, attitude, knowledge or behaviour.
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