Ab Malik N, Mohamad Yatim S, Abdul Razak F, Lam O L T, Jin L, Li L S W, McGrath C
Periodontology and Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
J Oral Rehabil. 2018 Feb;45(2):132-139. doi: 10.1111/joor.12582. Epub 2017 Nov 23.
Maintaining good oral hygiene is important following stroke. This study aimed to evaluate the effectiveness of two oral health promotion (OHP) programmes to reduce dental plaque levels following stroke. A multi-centre randomised clinical control trial was conducted among patients hospitalised following stroke in Malaysia. Patients were randomly allocated to two OHP groups: (i) control group who received the conventional method for plaque control-daily manual tooth brushing with a standardised commercial toothpaste, (ii) test group-who received an intense method for plaque control-daily powered tooth brushing with 1% Chlorhexidine gel. Oral health assessments were performed at baseline, at 3 months and 6 months post-intervention. Within- and between-group changes in dental plaque were assessed over time. Regression analyses were conducted on dental plaque levels at 6 months controlling for OHP group, medical, dental and socio-demographic status. The retention rate was 62.7% (54 of 86 subjects). Significant within-group changes of dental plaque levels were evident among the test group (P < .001) and the control group (P < .001). No significant between-group changes of dental plaque levels were apparent (P > .05). Regression analyses identified that baseline plaque levels (adjusted ß = 0.79, P < .001) and baseline functional dependency level (adjusted ß = -0.34, P < .05) were associated with dental plaques levels at the end of the trial (6 months). Both, "Conventional" and "Intense" oral health promotion programmes may successfully reduce dental plaque during stroke rehabilitation and are of comparable effectiveness. Baseline dental plaque levels and functional dependency level were key factors associated with dental plaque levels at follow-up at 6 months.
中风后保持良好的口腔卫生很重要。本研究旨在评估两种口腔健康促进（OHP）方案对降低中风后牙菌斑水平的有效性。在马来西亚，对中风后住院的患者进行了一项多中心随机临床对照试验。患者被随机分为两个OHP组：（i）对照组，采用传统的牙菌斑控制方法——每天使用标准化商用牙膏手动刷牙；（ii）试验组，采用强化牙菌斑控制方法——每天使用含1%氯己定凝胶的电动牙刷刷牙。在干预前、干预后3个月和6个月进行口腔健康评估。随时间评估组内和组间牙菌斑的变化。对6个月时的牙菌斑水平进行回归分析，控制OHP组、医疗、牙科和社会人口统计学状况。保留率为62.7%（86名受试者中的54名）。试验组（P <.001）和对照组（P <.001）的牙菌斑水平在组内均有显著变化。组间牙菌斑水平无显著变化（P >.05）。回归分析确定，基线牙菌斑水平（调整后的β = 0.79，P <.001）和基线功能依赖水平（调整后的β = -0.34，P <.05）与试验结束时（6个月）的牙菌斑水平相关。“传统”和“强化”口腔健康促进方案在中风康复期间都可能成功降低牙菌斑水平，且效果相当。基线牙菌斑水平和功能依赖水平是与6个月随访时牙菌斑水平相关的关键因素。
