Impact of Poor Oral Health on Aspiration Pneumonia in Elderly Patients

Running head: MASTER IN NURSING
Master in nursing
Name of the student:
Name of the University:
Author’s note

1MASTER IN NURSING
Topic: Poor oral health leads to aspiration pneumonia in elderly patients
Introduction:
The oral cavity of humans is a complex microenvironment where variety of
microorganisms competes for space and nutrition. However, the oral environment changes for
toothless people compared to those who have teeth. Elderly people mostly use dentures and poor
oral hygiene practices changes the mouth flora that is common in dentate person (Jaiswal et al.,
2014). Hence, poor oral health leads to devastating health consequences and risk of local and
systemic illness. In case of older adults, aspiration pneumonia is the most common consequence
of aspiration pneumonia. Aspiration pneumonia is a disease characterized by misdirection of
oropharyngeal contents due to dysphagia and initiation of infectious response in the lungs due to
massive secretion of oral bacterial flora. Poor lung defense mechanism, swallowing and feeding
problem and neurological problems are medical risk factor of aspiration pneumonia. In addition,
dental decay and poor oral hygiene are dental risk factors the disease (Manabe et al., 2015).
Since, elderly patients with long term care often have unmet oral hygiene and oral care needs,
reviewing current evidence related to the topic is necessary to improve skills of care giver in
daily oral care and assessment of oral hygiene status of elderly patient (Müller, 2015).
Purpose
The main purpose of this assignment is to conduct a literature review on impact of oral
hygiene on risk of aspiration pneumonia in elderly patients and assess oral hygiene practices
implemented by elderly patient or their carer. . Another goal of literature review is to find out
solutions to prevent aspiration pneumonia and death in elderly patient.
Search strategy:

2MASTER IN NURSING
To get relevant research articles related to the topic, updated and peer-review research
articles were retrieved from health care related databases like PubMed, CINAHL and Medline.
The key terms used to retrieve research articles included ‘aspiration pneumonia in elderly
patient’, ‘poor oral hygiene and aspiration pneumonia’ and ‘oral hygiene in elderly and risk of
aspiration of pneumonia. The criteria for selecting article were as follows:
 All articles must be published within 2012 to 2018
 All articles must have elderly people as the study population
 All studies must discuss about the impact of oral health on aspiration pneumonia only and
no other diseases
 The research must be published in English language
 The research done in other population group except elderly people will not be taken for
literature review.
Based on the above inclusion and exclusion criteria, relevant articles related to the topic were
taken. In addition, final list of articles were taken by reviewing the abstract and title of the
articles and then screening the whole to find relevance to the research topic and study question.
Literature review:
Poor oral hygiene is recognized as a critical factor that increases risk of aspiration
pneumonia in elderly people. Apart from oral care implemented by nurse in hospital setting,
evidence has suggested that many patients deny removing dentures at night thus increasing the
risk of pneumonia in elderly patient (Coker et al. 2017). This was confirmed by a study by
Iinuma et al. (2015) which used prospective study design to investigate about oral health
behavior and incidence of pneumonia in community living very elderly people. The oral health