Non-Cochrane · intervention · PM42911873
Effects of oral hygiene care on swallowing recovery in hospitalised patients with post-stroke dysphagia: a systematic review and meta-analysis.
Pojmonpiti Sungkrit, Meersschaut Mariska, Batens Katja, et al. · European stroke journal · 2026 · PubMed · doi:10.1093/esj/aakag126
Findings
9 findings
| Population | ||||
|---|---|---|---|---|
| Hospitalised patients with post-stroke dysphagia within 6 months of stroke | Structured or individualised oral hygiene care | Usual care | Achieving independent oral intake Hospital · RCT-only sensitivity analysis | OR 2.61 [1.60, 4.24] GRADE not reported 4 studies |
| Hospitalised patients with post-stroke dysphagia within 6 months of stroke | Structured or individualised oral hygiene care | Usual care | Functional Oral Intake Scale score Hospital | MD 0.40 [0.07, 0.72] GRADE not reported 3 studies · 188 participants |
| Hospitalised patients with post-stroke dysphagia within 6 months of stroke | Structured or individualised oral hygiene care | Usual care | Gugging Swallowing Screen score Hospital | MD 2.93 [1.01, 4.85] GRADE not reported 2 studies · 85 participants |
| Hospitalised patients with post-stroke dysphagia within 6 months of stroke | Structured or individualised oral hygiene care | Usual care | Achieving independent oral intake Hospital | RD 0.13 [0.03, 0.23] High 5 studies · 301 participants |
| Hospitalised patients with post-stroke dysphagia within 6 months of stroke | Structured or individualised oral hygiene care | Usual care | Achieving independent oral intake Hospital | OR 2.54 [1.80, 3.59] 0.13 [0.03, 0.23] risk difference High 5 studies · 301 participants |
| Hospitalized patients with post-stroke dysphagia in the acute or subacute phase (within 6 months of stroke onset) | Oral hygiene care without adjunctive oral stimulation | Usual care (routine oral hygiene care or pre-implementation care) | Achieving independent oral intake (clinical swallowing test or tube feeding status) End of follow-up (10 to 28 days) · Hospital (acute care, neurology and rehabilitation units) · Adjunctive intervention: oral hygiene care without adjunctive oral stimulation | OR 2.43 [1.29, 4.57] GRADE not reported 4 studies · 201 participants |
| Hospitalized patients with post-stroke dysphagia in the acute or subacute phase (within 6 months of stroke onset) | Oral hygiene care (structured, standardized or individualized oral hygiene protocols, some with adjunctive oral stimulation) | Usual care (routine oral hygiene care or pre-implementation care) | Achieving independent oral intake (clinical swallowing test or tube feeding status) 1 to 2 weeks · Hospital (acute care, neurology and rehabilitation units) · Follow-up period: 1 to 2 weeks | OR 1.91 [0.11, 32.02] GRADE not reported 2 studies · 97 participants |
| Hospitalized patients with post-stroke dysphagia in the acute or subacute phase (within 6 months of stroke onset) | Oral hygiene care (structured, standardized or individualized oral hygiene protocols, some with adjunctive oral stimulation) | Usual care (routine oral hygiene care or pre-implementation care) | Achieving independent oral intake (clinical swallowing test or tube feeding status) 3 to 4 weeks · Hospital (acute care, neurology and rehabilitation units) · Follow-up period: 3 to 4 weeks | OR 2.75 [1.55, 4.89] GRADE not reported 3 studies · 204 participants |
| Hospitalized patients with post-stroke dysphagia recruited in the subacute phase (>7 days to 6 months after stroke) | Oral hygiene care (structured, standardized or individualized oral hygiene protocols, some with adjunctive oral stimulation) | Usual care (routine oral hygiene care or pre-implementation care) | Achieving independent oral intake (clinical swallowing test or tube feeding status) End of follow-up (10 to 28 days) · Hospital (acute care, neurology and rehabilitation units) · Stroke phase at recruitment: subacute | OR 2.43 [1.29, 4.57] GRADE not reported 4 studies · 201 participants |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chen 2019 Effect of an Oral Health Programme on Oral Health, Oral Intake, and Nutrition in Patients with Stroke and Dysphagia in Taiwan: A… PMID:31238591 | 2019 | this review only | not stated | not extracted yet |
| Chipps 2014 Pilot Study of an Oral Care Protocol on PostStroke Survivors DOI:10.1002/rnj.154 | 2014 | this review only | Achieving independent oral intake | not extracted yet |
| Gao 2018 DOI:10.12102/j.issn.1009-6493.2018.18.041 | NR | this review only | Achieving independent oral intake | not extracted yet |
| Huang 2025 Effects of oral care combined with neuromuscular electrical stimulation on clinical outcomes in the acute phase of acute ischemic stroke:… DOI:10.1186/s12984-025-01652-6 | 2025 | this review only | Gugging Swallowing Screen score | not extracted yet |
| Jai-ua 2026 Effectiveness of Oral Health Care in Stroke Patients with Dysphagia: A Quasi-Experimental Study DOI:10.12982/osr.2026.018 | 2026 | this review only | not stated | not extracted yet |
| Kothari 2026 Evidence‐Based Mouth and Oral Health Individualised Treatment Plan in Adults With Acquired Brain Injury: A Cluster Nonrandomized… DOI:10.1111/joor.70170 | 2026 | this review only | Achieving independent oral intake | not extracted yet |
| Li 2025 Effectiveness of the “CEME” oral health intervention program for preventing stroke-associated pneumonia in patients with post-stroke… DOI:10.1186/s12903-025-07190-w | 2025 | this review only | Functional Oral Intake Scale score | not extracted yet |
| Talley 2016 HAP prevention for nonventilated adults in acute care DOI:10.1097/01.numa.0000508259.34475.4c | 2016 | this review only | not stated | not extracted yet |
| Tang 2025 DOI:10.3761/j.issn.0254-1769.2025.11.008 | NR | this review only | Gugging Swallowing Screen score | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Hospitalized patients with post-stroke dysphagia in the acute and subacute phases (within 6 months after stroke onset) | Hospitalized patients with post-stroke dysphagia (n=9 studies; acute phase recruitment n=4, subacute n=5) |
| Intervention | Oral hygiene care | Structured, standardized or individualized oral hygiene care (n=9), with adjunctive oral stimulation in 3 |
| Comparison | Comparison group (usual care) | Usual care: routine oral hygiene care (n=8) or pre-implementation care (n=1) |
| Outcomes | Swallowing-related outcomes; independent oral intake as primary outcome | Independent oral intake (n=5); FOIS (n=3); GUSS (n=2); time to swallowing recovery (n=1); time to nasogastric tube removal (n=1); duration of nothing by mouth (n=1); tongue pressure (n=1); oral diadochokinesis (n=1); salivary function (n=1) |
| Study designs | RCTs and non-RCTs with a comparison group | 7 RCTs and 2 non-RCTs |
| Timing | Not specified | Within 2 weeks or during hospitalization (n=5); 3 to 4 weeks (n=4) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Partial Yes | no |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | RCT: Yes · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: No | RCT: Yes · NRSI: No | yes |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |