Effects of Different Levels of Caregiver Training on Oral Hygiene After Stroke.

OBJECTIVES: To investigate the effects of caregiver training on poststroke oral hygiene and to identify appropriate structures for training programs. DESIGN: Single-blind prospective cohort study. SETTING: Haikou, China. PARTICIPANTS: Individuals in home care who have had a stroke (N = 150) and their caregivers (N = 150). Eligibility criteria were stable condition, no recent use of antibiotics or periodontal therapy, presence of Ramfjord teeth or neighboring substitutes, and satisfactory Montreal Cognitive Assessment and Burke Water Swallow Test scores. INTERVENTION: Limited (LOHI) or comprehensive (COHI) oral hygiene instructions. MEASUREMENTS: Plaque Index (PI) and Gingival Index (GI) scores (ranging from 0 to 3 for both). RESULTS: Twenty care recipients and their caregivers dropped out during the study. In the care recipient groups, PI and GI scores in the COHI group were lower than in the control and LOHI groups at the end of the second and third month (P < .001). Decline in PI and GI scores in the COHI group started from the first month (P < .001). In the caregiver groups, GI and PI scores in the COHI group were lower than in the control and LOHI groups after baseline (P < .001). Decline in PI and GI scores in the COHI group started from the second month (P < .001), although no group achieved clinically satisfactory levels. Multiple regression analysis revealed that care recipients' PI was correlated with caregivers' PI, number of sessions, and group allocation, as was care recipients' GI with caregivers' GI, number of sessions, and group allocation. CONCLUSION: Additional assessment of program components is necessary to produce clinically significant outcomes. Caregiver PI and GI scores may serve as objective measures of their oral hygiene skills, which can be improved with comprehensive instructions.