Purpose:To clarify the effectiveness of wiping during oral care by guardians at home, and factors associated with salivary bacterial count.
Method:The participants were 20 children with severe motor and intellectual disabilities (SMID) (mean age 5.5±3.8 years old) requiring both mechanical ventilator and tube-feeding. The survey was conducted during home-visit dental treatment. Guardians were instructed to do oral care (brushing their children's teeth for 2 minutes and wiping the inside of the oral cavity with gauze). They were taught how to wipe before oral care. Suction during brushing was carried out in case guardians performed brushing on a daily basis. The saliva was taken from the floor of the mouth, and the number of bacteria in saliva was measured by a bacteria detection apparatus (Panasonic Healthcare Co., Ltd.). Collection and measurement were conducted before brushing, after brushing, and after wiping. The correlations between the number of bacteria taken before brushing and information regarding patient characteristics such as method of feeding, use of mechanical ventilator, existence of tracheostomy, existence of continuous suction, and existence of swallowing were examined statistically.
Results:The number of bacteria in saliva decreased significantly from before and after brushing to after wiping. There was no significant correlation between the existence of suction during brushing and variation of salivary bacterial count before and after brushing. The independent variables shown by univariate analysis to have a significant relationship with salivary bacterial count before brushing were use of mechanical ventilator, existence of tracheostomy, and existence of swallowing. Multiple regression analysis identified existence of swallowing as an independent associated factor for salivary bacterial count.
Conclusion:Wiping was an effective method to decrease bacteria after brushing. Children who do not swallow had larger numbers of bacteria in saliva before brushing. These findings indicated that it is important for children who do not swallow to have their oral cavity wiped after tooth-brushing.