BACKGROUND: Patients\' health outcomes can be positively affected by the oral care provided by intensive care unit (ICU) nurses. Providing effective oral care for intubated patients is a challenging task. The purpose of this study was to examine the knowledge, attitudes, and practices(KAP) of oral care among ICU nurses for intubated patients, as well as the underlying factors that influence these behaviors.
METHODS: This cross-sectional survey was conducted on 200 nurses from adult ICUs in referral hospitals located in the central eighth area of healthcare management in Iran. The timeframe for data collection was April to June in 2023. Data were collected by questionnaires which consisted of four sections: demographic information, knowledge, attitudes and practices of oral care for intubated patients. The Pearson Correlation Coefficient was employed to determine the correlation between KAP and its main variables, which were distributed normally.
RESULTS: The result showed that nurses were 32.19 ± 6.23 years old, with an average total work experience of 8.91 ± 5.54 years and an average ICU work experience of 5.89 ± 4.31 years. The mean KAP score were17.66 ± 3.04, 15.46 ± 4.23, and 7.57 ± 2.21, respectively. The knowledge of nurses was significantly impacted by their level of education (p = 0.04), and an increase in work experience each year was associated with improved attitudes among nurses (p = 0.04). A significant association was found between the nurses\' oral care practice, knowledge (p = 0.03), and attitude (p = 0.04).
CONCLUSIONS: This study revealed that ICU nurses possess a moderate level of knowledge, a higher-than-average level of practice, and they have a favorable attitude towards giving oral care to intubated patients. Therefore, providing continuous education about oral care is essential for ICU nurses.

BACKGROUND: This work explored the effects of cognitive behavior therapy (CBT)-based comprehensive nursing intervention (CNI) mode in arch expansion to treat patients with orthodontic osteodilated arch (OOA).
OBJECTIVE: To explore the application effect of CBT-based CNI model in orthodontic expansion arch treatment.
METHODS: Using convenient sampling method, 81 patients with OOA were selected and rolled into a control group (Ctrl group, 40 cases) and an observation group (Obs group, 41 cases). During the treatment, patients in the Ctrl group received routine nursing intervention mode, and the those in the Obs group received CBT mode on the basis of this. Before and after intervention, the incidence of oral mucositis, the mastery rate of correct arch expansion method, self-rating anxiety scale score, soft scale index, and plaque index were compared for patients in different groups. In addition, satisfaction and complications were comparatively analyzed.
RESULTS: Incidence of oral mucositis in the Obs group was lower (14.6% vs 38.5%), and the mastery rate of correct arch expansion method was obviously higher (90.2% vs 55.0%) was obviously higher (all P < 0.05). Meanwhile, the soft scale index and plaque index in the Obs group were much lower (P < 0.05). The compliance (90.24%) and satisfaction (95.12%) in the Obs group were greatly higher (P < 0.05).
CONCLUSIONS: The CBT-based CNI mode greatly improved the mastery rate of correct arch expansion method during arch expansion in treating patients with OOA and enhanced the therapeutic effect of arch expansion and the oral health of patients, improving the patient compliance.

UNASSIGNED: Oral care-related challenges are well documented in the autistic community; dental care remains one of the most prevalent unmet health needs among autistic individuals. This review examined interventions designed to improve oral health in autistic individuals from children and adult populations. Through a systematic process, 36 studies were identified. These studies focused on improving home-based oral care skills and routines and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated different types of techniques for facilitating oral care practice, including preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management. Using an evidence-based rubric, we reviewed the methodological quality of the studies and found that most were only \"adequate\" (n = 8) or \"weak\" (n = 23) in reporting their evidence. This review has two key findings: (1) there is support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits; and (2) distraction or sensory-reducing interventions may also improve experiences in the dental clinic. Only one study purposefully recruited autistic adults, and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for more studies investigating the impact of oral care-related interventions for autistic individuals of all ages and identifies a gap in interventions for autistic adults and those from minoritized populations.

UNASSIGNED: Chemotherapy-induced mucositis is inflammation that develops in the oral mucosal due to anticancer treatment. Mucositis has negative consequences that may lead to distress in pediatric patients, resulting in escalated expenses, diminished quality of life, hindrance in cancer therapy, and decreased survival rates. However, despite the numerous methods, oral care protocols are suggested for implementation in the pediatric population despite a lack of high-level evidence studies, particularly regarding which appropriate oral care agents should be administered.
UNASSIGNED: This systematic review aimed to identify the effect of oral care intervention in mucositis management among pediatric cancer patients.
UNASSIGNED: Studies were published between 2014 and 2023 from five databases: PubMed, Embase, Medline, ScienceDirect, and Scopus. They were identified using a search strategy to identify relevant studies that identify oral care interventions for managing mucositis in children with cancer. This study used the Joanna Briggs Institute (JBI) critical appraisal tools to assess the quality of the studies and followed the recommended reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.
UNASSIGNED: Eight studies met the inclusion criteria, including seven RCTs and one quasi-experimental study. Oral care interventions involving tooth brushing, mouthwash, and lip care are performed entirely or partially. The frequency of oral care ranges from two to six times daily, and the duration of intervention is from 5 days to six weeks. Oral care interventions using honey, olive oil, Aloe Vera, Andiroba, and salivary enzyme toothpaste are beneficial to lower the severity of mucositis, reduce pain, minimize mucositis duration, and reduce the use of analgesics, but not significantly improve the child\'s quality of life. However, Caphosol mouthwash did not significantly reduce mucositis.
UNASSIGNED: Our study highlights that oral care intervention using effective agents integratively, including honey, olive oil, Aloe vera, Andiroba, and salivary enzyme toothpaste, is essential to manage chemotherapy-induced mucositis among children.
UNASSIGNED: PROSPERO registration number was CRD42023456278.

OBJECTIVE: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the risk of secondary oral cancer following hematopoietic cell transplantation (HCT).
METHODS: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets to generate a short manual about the best standard of care.
RESULTS: Studies described a 7-16-fold higher risk of secondary oral cancer (mainly squamous cell carcinoma) in allogeneic HCT (alloHCT) recipients, particularly in those who developed chronic graft versus host disease (cGVHD). Risk increases over time and is influenced by several risk factors. In autologous HCT, oral cancer risk seemed only slightly elevated.
CONCLUSIONS: Clinicians should be aware of the higher oral cancer risk in alloHCT survivors, and emphasize the importance of lifelong oral cancer surveillance (at least every 6-12 months) and avoiding cancer promoting lifestyle factors in an empathic way, particularly of those with (a history of) cGVHD. Post-HCT for Fanconi anemia or dyskeratosis congenita, education and rigorous follow-up is even more crucial. In case of suspected oral lesions in the presence of oral mucosal cGVHD, a GVHD intervention may facilitate diagnosis. Suspected lesions should be biopsied. More research is needed on the role of HPV in oral cancer post-HCT.

Introduction: Surveys distributed among intensive care unit (ICU) nurses reveal a significant need for dental care, with many acknowledging poor oral hygiene management. Poor oral health in ICU patients is linked to systemic problems, including aspiration pneumonia, necessitating pre-intervention assessments for bacterial diseases and dental risks. This study aims to evaluate the oral health status of ICU patients across three institutions through retrospective analysis. Methods: This retrospective study assessed the oral health status of ICU patients, using computed tomography (CT) images from three institutions over ten years. Through CT images, the oral status was evaluated in terms of total and lost tooth count and the presence of oral lesions (periapical lesions, cysts and tumors, caries, tartar, moderate to severe periodontal bone loss, tooth fractures). Variables included gender, age, the duration of ICU stay, and types of ICU. Statistical analysis was performed using chi-square tests, independent-sample t-tests, and logistic regression analysis. Results: Of the 450 participants, 430 were analyzed, revealing a prevalence of oral lesions in 67.0% of subjects. The prevalence of oral lesions was higher in males (71.5%) than females (57.7%, p = 0.006), and higher in those aged 40 and above (72.1%) compared to those under the age of 40 (47.8%, p < 0.001). This study found significant differences in oral health status based on gender, age, and ICU type, with surgical ICU patients generally having better oral health. Risk factors for oral lesions included gender, age, and duration of ICU stay. Conclusions: Most ICU patients have at least one oral lesion, regardless of the reason for their ICU admission. In particular, male ICU patients aged 40 and above have a higher prevalence of oral lesions, necessitating careful oral health assessment and treatment.

Oral health is critical for total body health and well-being; however, little improvement in oral health status has occurred in the U.S. over the past 20 years. Tooth decay and gum disease remain highly prevalent, with more than 90% and 50% of adults suffering from these conditions, respectively. To combat this lack of improvement, alternative approaches to dental care are now being suggested. One such alternative therapy is probiotics for oral care. In the oral cavity, probiotic strains have been shown to reduce levels of oral pathogens, inhibit the formation of dental caries, and reduce the levels of bacteria that cause halitosis. However, as the oral care probiotic market expands, many products contain bacterial species and strains with no documented health benefits leading to confusion and mistrust among consumers and clinicians. This confusion is enhanced by the regulatory status of probiotic products which puts the onus of safety and efficacy on the manufacturer rather than a central regulatory body. The overarching goal of this review is to provide consumers and clinicians with documented evidence supporting (or refuting) the health benefits of oral care probiotics marketed for sale in the United States. This includes defining what constitutes an oral care probiotic product and a strain level analysis of candidate probiotics from the genera Streptococcus, Lactobacillus, Bifidobacterium, and Bacillus. Additionally, prebiotics and postbiotics will be discussed. Finally, a set of considerations for consumers and clinicians is provided to empower probiotic product decision making. Together, this review will improve understanding of oral care probiotics marketed in the US for dental professionals and consumers.

Oral healthcare is one of the most missed aspects of fundamental care. Failure to provide reliable and effective daily oral healthcare for older patients can lead to hospital-acquired pneumonias, longer hospital stays, increased health costs, and poor patient experience. The objective of this study was to codesign, implement, and evaluate an oral healthcare intervention for older adults in a geriatric unit. This mixed methods implementation project combined the hospital\'s quality improvement processes with the i-PARIHS knowledge translation framework. Multilevel facilitation guided the development of multidisciplinary implementation strategies, which were co-designed, tailored, and implemented at the ward and organizational level, targeting: awareness/engagement; clinical guideline development; building workforce capacity; access to appropriate products; patient awareness and support; utilization of multidisciplinary/dental referral pathways; and systematizing oral healthcare documentation. Gaps between evidence-based and current oral healthcare practice were identified through audits of practice and interviews with patients. Interviews and surveys with staff evaluated the feasibility and acceptability of the oral healthcare intervention and the success of implementation strategies. At the conclusion of the project, awareness, attitudes, and capacity of staff had increased, however, we could not demonstrate change in multidisciplinary oral healthcare practices or improvements for individual patients. Despite mixed success, the project informed discussions about including oral healthcare as a national healthcare standard for the acute care sector in Australia. Attempts to address oral healthcare may have started locally, but its impact was through policy change, which will empower health practitioners and managers to support practice change more widely.

Patients undergoing palliative care often develop debilitating oral conditions, including xerostomia. These conditions may significantly impact patients\' quality of life. Despite the high prevalence and adverse impact of xerostomia, effective management strategies remain unclear. This scoping review was performed to elucidate effective interventions for xerostomia in patients undergoing palliative and end-of-life care. A comprehensive search strategy was employed to identify relevant studies up to August 2023. Full-text primary articles focusing on xerostomia in patients receiving palliative care were included in the review. Eleven articles were selected for analysis, and data were extracted by six reviewers. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Among the 11 studies, interventions ranged from oral care to saliva substitutes and methods to stimulate saliva secretion. The primary method of assessing xerostomia was the performance of subjective evaluations using visual analog scale scores or numerical rating scale scores. Various interventions including oral care regimens, topical treatments, and mixed efficacy outcomes were reported. Notably, only one study directly measured the saliva volume, highlighting a reliance on subjective endpoints in most studies. Although no definitive conclusions can be drawn regarding the most effective intervention, oral care was a preferred option for managing xerostomia in patients undergoing palliative care. Additionally, adjunctive treatments such as ice cubes, saline, and moisturizers showed promise but require further investigation. Objective measures should be incorporated into future intervention trials to complement subjective assessments and provide a comprehensive evaluation of xerostomia management strategies in this patient population.

UNASSIGNED: To understand the oral health attitudes, knowledge, and practices among non-dental professionals caring for patients with spinal cord injuries, as well as the barriers and facilitators to oral care across acute and rehabilitation hospital settings.
UNASSIGNED: This study was a descriptive qualitative study. Nine focus groups with spinal cord injury clinicians from two Sydney hospitals were conducted (n = 35). A thematic analysis was undertaken.
UNASSIGNED: Four themes were constructed: understanding the impact of spinal cord injuries on oral health and wellbeing; limited support in the spinal cord injury unit to promote oral care; strategies that enable oral care promotion; and recommendations to expand scope in oral care and education. Although most clinicians considered oral health to be important there was a lack of guidelines to support standardised oral care practices. Barriers included lack of time, limited oral care resources, low priority and difficulty in accessing treatment. Staff were receptive to an integrated, multidisciplinary approach to oral care.
UNASSIGNED: This Australian first study provides insight into spinal cord injury clinicians\' knowledge and practices of oral care. The findings will help guide future research in developing appropriate models of care to promote oral health among patients with spinal cord injuries.
Individuals with a spinal cord injury are at an increased risk of irregular oral hygiene practices and poor oral health compared to those without a spinal cord injuryProviding access to training and development of a model of care for oral health promotion to support non-dental health professionals working with individuals with a spinal cord injury can improve access to early intervention oral health careImplementing targeted training for staff, developing clear guidelines or protocols, and piloting an integrated multidisciplinary model of care could be potential future solutions to close this gap in care.