RESEARCH ARTICLE


Changes in the Oral Moisture and the Amount of Microorganisms in Saliva and Tongue Coating after Oral Ingestion Resumption: A Pilot Study



Natsuki Kishimoto1, Roxana Stegaroiu2, *, Satoko Shibata2, Kayoko Ito3, Makoto Inoue4, Akitsugu Ohuchi5
1 Doctor's Program of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
2 Department of Oral Health and Welfare, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
3 Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
4 Department of Oral Health Science, Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
5 Department of Oral Health and Welfare, Division of Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan


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© Kishimoto et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514 Japan; Tel: +81-25-227-0547; Fax: +81-25-227-0547; E-mail: roxana@dent.niigata-u.ac.jp


Abstract

Background and Objective:

Tube feeding has been significantly associated with a higher rate of aspiration pneumonia that is mainly related to oral microorganisms and a reduced salivary flow. Thus, the difference in the mode of nutritional intake is expected to affect the oral environment, but this has not yet been fully clarified. The purpose of this study was to investigate, in tube-fed patients, changes in the oral moisture and the counts of microorganisms in saliva and tongue coating, which occur after oral ingestion resumption.

Methods:

Study participants were 7 tube-fed inpatients of the Niigata University Medical and Dental Hospital (72.7±8.5 years old) who received dysphagia rehabilitation at the Unit of Dysphagia Rehabilitation until oral ingestion resumption. Their oral health, swallowing, and nutrition status, oral mucosal moisture, amount of unstimulated saliva and the counts of microorganisms (total microorganisms, streptococci, Candida) in saliva and tongue coating were investigated and compared before and after the recommencement of oral intake.

Results:

Tongue coating, choking, oral mucosal moisture and amount of unstimulated saliva were improved significantly after resumption of oral ingestion. The other investigated parameters did not significantly change, except for the streptococci in tongue coating, which significantly increased 1 week after oral ingestion recommencement, but decreased thereafter.

Conclusion:

After oral intake resumption, oral mucosal moisture and amount of unstimulated saliva were improved. However, because of a transitory increase in the counts of streptococci with oral ingestion recommencement, it is important to appropriately manage oral hygiene in these patients, according to the changes in their intraoral microbiota.

Keywords: Dysphagia, dysphagia rehabilitation, oral ingestion resumption, oral microorganisms, oral mucosal moisture, unstimulated saliva.