Handsome man brushing his teeth

Most people don’t realize just how crucial oral health is to overall health. The two are intimately linked, and much recent research has shown how poor oral health can dramatically reduce quality of life and even length of life for an aging population.

Stroke risk is one aspect of health that is impacted by poor oral health. People with poor oral health have a higher stroke risk. So many people who experience stroke already have poor oral hygiene. Since oral hygiene becomes more of a challenge after stroke, researchers have proposed that stroke survivors should receive coaching in oral hygiene as part of their recovery support.

Poor Initial Health

For this study, researchers looked at patients who were undergoing outpatient rehabilitation after having a stroke. Patients were eligible if they started during a particular six month period and met certain basic criteria. They had to have significant functional disability, but only mild cognitive impairment. They could not be edentulous (they had to have teeth) nor could they have a nasogastric feeding tube. And the patients needed to be able to follow a simple one-step command.

Researchers included 94 individuals with a mean age of 66.6 at the outset of the study. Although they were stroke survivors, they had initially very poor oral health and hygiene habits. Nearly 75% of these patients said they didn’t brush their teeth daily, and 95% said they hadn’t had a dental visit in the previou year. Not surprisingly, the initial survey showed that these patients had plaque in 95% of locations. Many had missing teeth, and 20% wore a denture.

These, clearly, were patients who needed help with their oral hygiene even before the additional challenges related to stroke.

Why Stroke Makes Oral Hygiene Harder

When people have a stroke, it can get much harder for them to maintain good oral health. That’s because stroke can impair:

  • Saliva flow
  • Lip control
  • Chewing effectiveness
  • Motor control

With reduced saliva and chewing efficiency, it’s more likely that plaque will build up on the teeth. And because impaired motor control makes it harder for stroke victims to clean their teeth, plaque levels can worsen significantly after stroke.

Successful Hygiene Programs

To see how effective hygiene programs could be for these stroke survivors, they were randomly assigned to one of two groups. One group got conventional oral hygiene instruction and support. They were taught how to brush their teeth and were given a manual toothbrush and toothpaste. They were instructed how to brush their teeth.

In the other group, patients were given advanced oral hygiene instruction and support: an electric toothbrush, antibacterial mouthwash, and were instructed on how to use them. Both groups were checked at three and then at six months.

The hygiene training had a major impact on the oral health of the stroke survivors.

Initially, patients had plaque in 95% of sites, but that dropped to 83.3% in the conventional care group, while gum bleeding dropped from 51.5% of sites to just 40%. The advanced care group did even better. Their plaque areas dropped from 95% to 52%. Bleeding gums dropped from 49% initially to 40% under conventional care and 33.3% in the advanced care and support group.

Protect Your Health with Oral Hygiene

This study shows that even after stroke people can learn oral hygiene habits that can help save their smile.

Part of good oral hygiene is working with a dentist who can coach and encourage you toward better habits. If you’re looking for a dentist in Valdosta, GA, please call (229) 242-5511 today for an appointment  with Dr. Nelson Clements.