Oral health screening may decrease aspiration pneumonia risk for adults with dementia in residential aged care

Many adults with dementia in residential aged care are dependent on others for feeding and oral care. Langmore and colleagues in the United States have shown this co-related dependency is a strong predictor for aspiration pneumonia due to pathological oral microorganisms from saliva, tooth decay, and an unclean mouth migrating into the lungs and the inability of adults to cough and clear the aspirated material. The subsequent lung infection frequently results in hospitalisation and increasing frailty. One potential strategy to prevent this cascade is to screen the oral function of adults when they move into care. We present findings from Stage 1 of an NNIDR-funded oral health project where an interdisciplinary team screened 142 residents using the Oral Health Assessment Tool (OHAT), the Mini-Nutritional Assessment (MNA), the Yale Swallow Protocol, and the EuroQOL-5D-3L. Residents’ diagnoses, age, gender, prescribed medications, and clinical signs of potential aspiration were documented from medical files. Of the residents, 78% warranted referral to a dentist; 57% were at risk for malnourishment; 13% were actually malnourished; and 70% failed or refused the swallow protocol, indicating difficulty with, or apprehension about, swallowing thin liquids safely. Self-reported quality of life ranged from 34-95% (M = 65%). The collaborative team of a speech pathologist, dentist, nutritionist and pharmacist was instrumental in assisting nurses and carers to screen for, identify, and address issues in oral health and function. Residents are being tracked to determine the outcome of reduced aspiration pneumonia risk and results will be known soon.