Cochrane · intervention · CD012416

Oral care measures for preventing nursing home‐acquired pneumonia

Cao, Y, Liu, C, Lin, J, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library

Oral Health Dental public health and special care3 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 2 · 22.2%Ungraded 4 · 44.4%Very low 1 · 11.1%Low 2 · 22.2%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Residents of any age in nursing homes and other long‐term care facilities (e.g. rehabilitation units, medical care facilities), regardless of oral health status (e.g. edentulous or dentate, with or without dentures, with or without physical or intellectual disabilities, with or without mechanical ventilation, with or without alternative feeding route). We excluded participants with pneumonia or respiratory infection at baseline.	6244 randomised participants (not including 14 participants excluded as not meeting eligibility criteria after cluster randomisation). 5976 participants available for analysis after exclusions. Mean age ranged from 79 to 88 years in four studies that reported demographics, and the proportion of males ranged from 21% to 40%.
Intervention	Oral care measures versus no treatment, placebo, usual care, or any other oral care measure (head‐to‐head trials) for prevention of NHAP. Intervention group: participants receiving one or more clearly defined oral care measures, such as professional oral care (dentists, dental hygienists, nurse‐assisted tooth brushing), oral rinse, or swab and topical decontamination with antiseptics, regardless of frequency, dosage, or formulation.	Professional oral care (n=6)
Comparison	Placebo/No treatment/Usual care (including self‐care)/Any other oral care measure (or combination or oral care measures)	Usual oral care (n=6)
Outcomes	Incidence, incidence proportion, or prevalence of NHAP of any severity; Mortality (pneumonia‐associated); Mortality (all‐cause); Change in systemic antibiotic use; Adverse reactions to interventions (both local and systemic); Incidence or prevalence of fever; Change in data on economics (costs or cost‐effectiveness) and quality of life; Oral health indices	Incidence rate of NHAP (n=1); Incidence proportion of NHAP (n=1); Hazard ratio for NHAP (n=3); Mortality pneumonia‐associated (n=3); Mortality all‐cause (n=3); Adverse reactions to interventions (n=1); Incidence or prevalence of fever (n=2); Change in data on economics and quality of life (n=1); Oral health indices (n=2)
Study designs	Parallel randomised controlled trials (RCTs) assessing the effects of oral care measures in residents of nursing and other long‐term care facilities. We included cluster‐RCTs, for which the unit of randomisation was the care facility. We excluded cross‐over studies.	NR
Timing	Not specified	8‐month follow‐up (n=1); 18‐month follow‐up (n=1); 24‐month follow‐up (n=3); Variable follow‐up with mean 1.13 years (n=1)

Search date: 12 May 2022. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; CINAHL EBSCO; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov; World Health Organization International Clinical Trials Registry Platform