12 months on: Cochrane Oral Health, Dundee Dental School, and Wikipedia – a project update

Cochrane Oral Health's Co-ordinating Editor Jan Clarkson talks to the Wikipedia Editing Team at Dundee Dental School

Cochrane Oral Health’s Co-ordinating Editor Jan Clarkson talks to the Wikipedia Editing Team at Dundee Dental School

Last summer, we blogged about the fantastic project to update articles about dentistry on Wikipedia, led by the students at Dundee Dental School.

The team have been doing excellent work to update Wikipedia with Cochrane evidence. The project has been running since January 2016, led by Dundee graduate Nour Geres. Continue reading

The Oral Health Group needs you!

PrioritiesWe are currently undertaking an exercise to prioritise areas of research for the future, and today we’ve launched a survey to find out about your oral health concerns.

The survey is open to everyone, and all feedback is welcome.

Which areas of oral health and dentistry do you think are most important? Issues you might want to think about could include:

  • Prevention of tooth decay
  • Care of children’s teeth
  • Oral hygiene products (toothpastes, mouthrinses, flossing)
  • Dentures or dental implants
  • Bleeding or inflamed gums
  • Sensitive teeth
  • Mouth ulcers
  • Mouth cancer
  • Tooth whitening
  • Wisdom teeth removal.
  • Facial or jaw pain

Follow the link to take part in our survey, we really want to hear from you! https://www.surveymonkey.com/s/FBTNHMB. The survey will close on 8 August 2014.

To find out more about our prioritization project, see http://ohg.cochrane.org/priority-reviews.

Making sense of the evidence

Photo for blog

Which strength of fluoride toothpaste is best for children? Cochrane plain language summaries help find the answers

The Cochrane Oral Health Group has launched a new section of its website to make evidence more user-friendly.

Making sense of the evidence for oral health decision making takes topics in dental health and links to the Cochrane plain language summaries of relevant reviews.

The first topic area is tooth decay, or dental caries. Do fluoride varnishes work? What strength of toothpaste should you use on your child’s teeth? Do plastic sealants prevent decay? All these questions and more are answered.

Look out for more topic areas, coming soon!

New title registered at the Cochrane Oral Health Group

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Photo by: babyparenting.about.com/

The Cochrane Oral Health Group registered one new title at their Editorial Meeting in April:

Interventions for preventing early childhood caries in pregnant women and mothers of infants up to 12 months old

This new review looks at early and maternal prevention of tooth decay in babies and is part of a larger project to improve oral health outcomes for children of migrant refugee communities.

 

Continue reading

Review of the month: critically ill patients can benefit from improved oral health

vap

C Cambridge University Hospitals NHS Foundation Trust

Critically ill people who need machines to help them breathe are at high risk for developing chest infections and pneumonia. This is known as ventilator-associated pneumonia, or VAP. Can a programme of oral care (such as mouthwashes, toothbrushing) help to prevent this life-threatening condition?

What was the research?

A systematic review of the evidence to find out whether oral health care can reduce the likelihood of a patient in intensive care on a ventilator developing pneumonia.

Who conducted the research?

The research was conducted by a team led by Zongdao Shi on behalf of the Cochrane Oral Health Group. Huixu Xie, Ping Wang, Qi Zhang, Yan Wu, E Chen, Linda Ng, Helen V Worthington, Ian Needleman and Susan Furness were also on the team.

What evidence was included in the review?

Data was extracted from 35 randomised controlled trials. A total of 5,374 patients participated in the trials. The trials looked at:

  1. Chlorhexidine antiseptic mouthrinse or gel compared with a placebo or usual care.
  2. Toothbrushing compared with no toothbrushing
  3. Powered compared with manual toothbrushing
  4. Oral care with other solutions.

Participants were all critically ill and needed assistance from hospital staff, who administered the oral care.

What did the evidence say?

The review found that chlorhexidine administered as a mouthrinse or gel reduces the odds of VAP by 40%. For every 15 people in hospital in intensive care, use of oral hygiene including chlorhexidine will prevent one person developing VAP. There was no evidence that chlorhexidine makes a difference to the numbers of patients who die in intensive care, or the length of their stay in the intensive care unit. There was no evidence that toothbrushing or oral care without toothbrushing affected the risk of developing VAP. Two studies showed some evidence of a reduction in VAP with povidine iodine antiseptic mouthrinse. There was not enough evidence of the effects of other oral care solutions, such as water, saline or triclosan.

How good was the evidence?

Only 14% of the studies included in this review were well conducted and described. Almost half of the included studies were at high risk of bias.

What are the implications for intensive care staff and the general public?

Effective oral hygiene care is important for ventilated patients in intensive care to reduce ventilator-associated pneumonia. There is evidence from this review that oral hygiene care incorporating chlorhexidine mouthrinse or gel is effective in reducing the development of ventilator-associated pneumonia in adult patients in intensive care. The definition of oral hygiene care varied among the studies included in this review but common elements include cleaning of the teeth and gums with a swab or gauze, removing secretions using suction and rinsing the mouth.

What should researchers look at in the future?

Although the included studies provided some evidence of the benefits of oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia, incomplete reporting of studies is a major limitation. Further trials of oral hygiene care (including use of manual or powered toothbrushes, or swabs) should report both measures of effectiveness of plaque removal and prevention of ventilator-associated pneumonia.

Link

Shi Z, Xie H, Wang P, Zhang Q, Wu Y, Chen E, Ng L, Worthington HV, Needleman I, Furness S. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD008367. DOI: 10.1002/14651858.CD008367.pub2.