Effect of oral healthcare prevention program on oral hygiene in post-stroke patients: A systematic review and meta-analysis

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OBJECTIVES: The global burden of stroke is increasing every year. Residual impairments from stroke reduce the future independence of affected patients while also increasing their susceptibility to oral health-related diseases. Oral healthcare prevention programs (OHCP) are vital in maintaining acceptable oral hygiene during rehabilitation. Dysphagia among stroke elevates the risk of ingesting oral opportunistic pathogens, potentially leading to severe conditions. DATA SOURCES: A systematic search was conducted in three main databases (Medline, EMBASE, CENTRAL) until November 29th, 2022. STUDY SELECTION: We included randomized clinical trials that measure the effect of OHCP on oral health and oral opportunistic pathogens. After the systematic search (7608 articles), we conducted title/abstract selection by two independent authors, followed by full-text selection. In both cases, Cohen's kappa was calculated. Finally, we found 15 articles that were eligible for analysis. RESULTS: The plaque index showed a slight but non-significant reduction with the OHCP program (SMD= -2.77, CI:6.6-1.06). In terms of the risk of oral yeast detection, there was a statistically non-significant difference between the intervention and control groups at short-term and after a 3-month follow-up (RR: 1.06, 95 % CI: 0.20;5.69; RR:0.98 CI: 0.33; 2.93), respectively. For S.aureus and AGNB, there was no statistically significant difference in short-term evaluation (RR: 0.89 CI: 0.07; 11.99; RR:0.77 CI: 0.00; 888.18), respectively. CONCLUSIONS: Current evidence did not identify that regular OHCP had a beneficial effect on oral pathogen-related diseases. PROSPERO REGISTRATION: CRD42022346788 CLINICAL SIGNIFICANCE: Regular oral health care, including assistance from a dental hygienist in stroke units, is essential for preventing oral health-related diseases. Integrating into post-stroke rehabilitation can enhance overall quality of life and well-being.

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