| Medical Issues Triggered by poor Oral Care |
| The Cloonan Corporation |
Answer
The
®
| Is a Patented product |
Medical Issues Triggered by
Poor Oral Care
Poor Oral Care
Gingivitis is a bacterial disease precipitated by the accumulations of bacteria along the
gingival (gum) of the teeth. The primary cause is bacterial plaque and the clinical signs are
seen as redness around the necks of the teeth and the bleeding of the gingival either
spontaneous or induced. The bleeding gums may progress to Bacterial Endocarditis causing
heart valve damage in a patient who has an artificial hip prosthesis.
Rampant tooth, gum, and bone infection is very common in the Diabetic patient with poor oral
care. Common clinical signs include; foul mouth odor, mobile teeth, rapidly decaying teeth,
deep pockets around the teeth, purulent exudate (pus) in the tissues, teeth shifting or drifting
and bone loss around the teeth.
Many patients being treated for cardiovascular disease take diuretics or antihypertenisives,
many of which cause Xerostomia (dry mouth). This condition reduces the salivary flow, lowers
the pH of the oral fluids and accentuates the growth of bacteria, viruses, yeast and fungus. This
leads to tooth decay, gum disease and mucosal lesions (mouth ulcers). Mouth ulcers in the
oral cavity may cause pain, swelling and the inability to chew or swallow. This leads to
malnutrition and contributes to gastrointestinal diseases.
Bacterial plaque and food debris can easily be aspirated during endotracheal intubation
procedures in preparation for general anesthesia. Accumulated bacteria can lead to serious
infections such as ventilator-associated pneumonia (VAP). The CDC estimates the incidence
of VAP to be from 10 to 65 percent.
According to the National Institutes of Health (NIH), the rate of respiratory infection among
critically ill patients corresponds to the presence of disease causing bacteria in the mucosal
areas of the mouth, gums and teeth. This bacteria is aspirated into the lungs. Also, the
decrease in saliva that many ICU patients experience can contribute to infection.
“They are now attributing oral pathogens to heart disease, premature labor and osteoarthritis,”
said Janis M. Yates, PhD, RN, Principal Investigator of an oral hygiene study at the NIH
Clinical Center, in Bethesda,MD. “Recent research shows a lot of infections come from the
mouth…and if the patients are intubated, they have a 20 times higher risk of getting an
infection.”
gingival (gum) of the teeth. The primary cause is bacterial plaque and the clinical signs are
seen as redness around the necks of the teeth and the bleeding of the gingival either
spontaneous or induced. The bleeding gums may progress to Bacterial Endocarditis causing
heart valve damage in a patient who has an artificial hip prosthesis.
Rampant tooth, gum, and bone infection is very common in the Diabetic patient with poor oral
care. Common clinical signs include; foul mouth odor, mobile teeth, rapidly decaying teeth,
deep pockets around the teeth, purulent exudate (pus) in the tissues, teeth shifting or drifting
and bone loss around the teeth.
Many patients being treated for cardiovascular disease take diuretics or antihypertenisives,
many of which cause Xerostomia (dry mouth). This condition reduces the salivary flow, lowers
the pH of the oral fluids and accentuates the growth of bacteria, viruses, yeast and fungus. This
leads to tooth decay, gum disease and mucosal lesions (mouth ulcers). Mouth ulcers in the
oral cavity may cause pain, swelling and the inability to chew or swallow. This leads to
malnutrition and contributes to gastrointestinal diseases.
Bacterial plaque and food debris can easily be aspirated during endotracheal intubation
procedures in preparation for general anesthesia. Accumulated bacteria can lead to serious
infections such as ventilator-associated pneumonia (VAP). The CDC estimates the incidence
of VAP to be from 10 to 65 percent.
According to the National Institutes of Health (NIH), the rate of respiratory infection among
critically ill patients corresponds to the presence of disease causing bacteria in the mucosal
areas of the mouth, gums and teeth. This bacteria is aspirated into the lungs. Also, the
decrease in saliva that many ICU patients experience can contribute to infection.
“They are now attributing oral pathogens to heart disease, premature labor and osteoarthritis,”
said Janis M. Yates, PhD, RN, Principal Investigator of an oral hygiene study at the NIH
Clinical Center, in Bethesda,MD. “Recent research shows a lot of infections come from the
mouth…and if the patients are intubated, they have a 20 times higher risk of getting an
infection.”
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
Services to maintain oral hygiene
include; brushing the teeth,
cleaning the dentures, mouth, and
tongue and applications of
medications as prescribed.
Bacterial plaque is a mat of
densely packed
microorganisms that are
tenaciously attached to the
teeth. Factors enhancing the
rate of bacterial plaque
formation include a diet high in
refined sugars, inadequate oral
hygiene, malaligned teeth and
impaired salivary flow. The
plaque bacteria convert
ingested sugars to weak
organic acids lowering the pH to
4.0 or lower. These acids
diffuse through the plaque and
into the tooth (demineralization)
leaching Calcium and
Phosphate from the enamel and
eventually causing collapse of
the tooth structure and the
formation of a cavity. If not
treated, these acids continue to
cause destruction within the
tooth. This may result in a tooth
abcess with associated pain
and swelling and eventually
progress to osteomyelitis (
infection of the bone).
include; brushing the teeth,
cleaning the dentures, mouth, and
tongue and applications of
medications as prescribed.
Bacterial plaque is a mat of
densely packed
microorganisms that are
tenaciously attached to the
teeth. Factors enhancing the
rate of bacterial plaque
formation include a diet high in
refined sugars, inadequate oral
hygiene, malaligned teeth and
impaired salivary flow. The
plaque bacteria convert
ingested sugars to weak
organic acids lowering the pH to
4.0 or lower. These acids
diffuse through the plaque and
into the tooth (demineralization)
leaching Calcium and
Phosphate from the enamel and
eventually causing collapse of
the tooth structure and the
formation of a cavity. If not
treated, these acids continue to
cause destruction within the
tooth. This may result in a tooth
abcess with associated pain
and swelling and eventually
progress to osteomyelitis (
infection of the bone).
In the majority of the Skilled
Nursing Facilities, the
traditional oral hygiene protocol
is labor intensive, time
consuming ( 20 to 30 minutes),
and requires the use of
toothettes, toothbrush, emesis
basin and towels for cleanup.
This is why oral hygiene is not
performed daily on each
patient. This situation leads to a
bacterial infection, which results
in tooth decay, gum disease
and secondary infection. This
can ravage a patient who is
immuno-compromised already.
Surgeon General David
Satcher, M.D., Ph.D., said that
good oral health and general
health are inseparable. He
stressed the importance of
daily oral hygiene. The Federal
Law OBRA 87 ( The Nursing
Home Reform Act of 1987 )
covers Oral Hygiene (42 CFR
Part 483.25). This means
maintaining the mouth in a
clean and intact condition and
treating oral pathology such as
ulcers of the mucosa.
References
1. JADA, Volume 127, 1998
2. JADA, Volume 130, 1999
3. Medical Microbiology 1994, Mosby
4. Periodontology 1994, Thieme Publishing,N.Y.
5. NIDCR News May 25, 2000
6. Greater Philadelphia Advance for Nurses July 5, 2004
1. JADA, Volume 127, 1998
2. JADA, Volume 130, 1999
3. Medical Microbiology 1994, Mosby
4. Periodontology 1994, Thieme Publishing,N.Y.
5. NIDCR News May 25, 2000
6. Greater Philadelphia Advance for Nurses July 5, 2004
For more information on
Richard A. Cloonan, D.D.S.
see Autobiography
Richard A. Cloonan, D.D.S.
see Autobiography