Oral Hygiene Reduces the Mortality from Aspiration Pneumonia in Frail Elders

Historically, the oral hygiene routine for frail elders who live in institutions was equivalent to placing a set of full dentures in a glass of water with an effervescent denture cleanser. Rarely, the mouth was rinsed and the oral mucosa or even the tongue was scrubbed. Nowadays, more and more natural teeth are retained until later in life, leading to an increased prevalence of fixed and partial dental prostheses among elders. Such dentitions require more sophisticated and time-consuming cleansing procedures that often exceed the competence of the caring staff and the time frame for oral hygiene in a patient’s individual nursing plan. The elders themselves may be uncooperative or show little motivation, especially when more severe general health issues overshadow the concerns for the mouth. Furthermore, they may lack dexterity and vision to perform oral hygiene measures adequately without assistance. Consequently, we often find a substantial bacterial load in elder persons’ mouths, which presents a considerable risk for infections and periodontal disease. Some 20 y ago, colleagues from Japan associated for the first time bacteria from the oropharyngeal tract with the incidence of aspiration pneumonia, thus introducing an additional aspect underlining the importance of oral health for the general well-being of elderly and fragile adults.