Hospital dental hygienist intervention improves activities of daily living, home discharge and mortality in post-acute rehabilitation

Aim: To examine the effects of oral management provided by dental hygienists (DH) on patient outcomes in post-acute rehabilitation.

Methods: We carried out a retrospective cohort study with 1056 patients newly admitted to a post-rehabilitation hospital in Japan. DH care was defined as two or more consecutive instances of oral management provided by a ward DH during hospitalization. The primary outcome was the motor domain of Functional Independence Measure score at discharge. Other outcomes included the rate of home discharge; length of stay, all-cause in-hospital mortality, and oral, swallowing and nutritional status at discharge. Propensity score matching was carried out to control and adjust for patients' backgrounds to compare outcomes between patients who did or did not receive DH care.

Results: Of 1056 patients enrolled (mean age 71 years; 52.0% women; 73.1% with oral problems), 415 (39.3%) received DH care. Multivariate analyses using pair-matched patients showed that DH care was significantly associated with higher motor domain of Functional Independence Measure score at discharge (β = 0.281, P = 0.041), shorter length of stay (β = 0.446, P = 0.044), higher rate of home discharge (odds ratio 1.202, 95% confidence interval 1.026-1.491, P = 0.037) and lower mortality (hazard ratio 0.818, 95% confidence interval 0.738-0.952, P = 0.037) after adjusting for potential covariates.

Conclusions: DH oral management improves patient outcomes, including activities of daily living, home discharge and in-hospital mortality in post-acute rehabilitation. Early detection of oral problems, early oral treatment by dental professionals, and cooperation between medical and dental professionals should be implemented. Geriatr Gerontol Int 2019; 19: 189-196.