Oral care intervention in people with and without dementia living in residential aged care

Name: Effect of oral care intervention on type and load of oral bacteria in people with and without dementia living in residential care This project evaluates changes in the type and load of bacteria in adults in residential aged care, before and after a 6-week period of daily oral care. One non-invasive oral swab will be taken from each of four places in the mouth: the tongue surface, hard palate, gum line, and cheek before and after the 6-week period of daily oral care. The oral swabs will be taken, face-to-face, from each individual resident by nurses, or care staff under their supervision, who know each resident well. Participating residents will be placed in one of two groups: (I) experimental (2-minutes of teeth cleaning after meals or daily cleaning of dentures), and (ii) control (usual/standard care). Residents in the experimental group will be given an Oral B electric toothbrush that is set on low intensity and timed to brush for 2 minutes, indicating a change in quadrant (upper right teeth, lower right teeth, upper left teeth, lower left teeth) every 30 seconds. This electric toothbrush also can be used to clean dentures. If residents are apprehensive about using the electric toothbrush, they will be given a regular soft-bristled toothbrush and assisted to brush for 2 minutes using strategies such as brushing to a favourite recorded song. A fluoridated toothpaste will be used; the brand, mouth feel, and taste may differ to address residents' preferences. Teeth brushing will be done twice per day, following breakfast and the evening meal. Staff do not feel they can accommodate brushing after lunch. The use of the electric toothbrushes will be monitored through an App which is downloaded to an android telephone. Data will be downloaded following every 30 brushings (15 days) by a designated staff nurse. Care staff who are working with each resident will assist them as needed in the teeth brushing and/or denture cleaning. Denture cleaning will be done each night before sleep. Care staff will be asked to document, on a daily care sheet, if dentures also are cleaned before breakfast, following residents' request. Residents in the control (usual care) group will be assisted by care staff to brush their teeth following breakfast and dinner, and/or clean their dentures each day. The duration of the teeth brushing will not be timed but observations suggest that it will be notably less than 2 minutes/time. The care staff will indicate on a daily care sheet what type of oral care was provided each day and when dentures were cleaned. The mode of delivery for residents in both the experimental and control groups will be face-to-face and for a period of 6 weeks. The oral care will take place in each resident's room.