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To the Editor: Risk factors for pneumonia in older people include impaired cognitive function and limited ability to perform activities of daily living (ADLs). Silent aspiration due to a depressed swallowing reflex, which is mediated via substance P (SP), is another known risk factor.¹ We recently reported that long-term oral care reduced the risk of pneumonia among elderly Japanese nursing home patients.² However, it is not known whether intensive oral care affects these risk factors for pneumonia.

Methods

Forty elderly nursing home patients with dysphagia due to cerebrovascular disease were randomly assigned to either aggressive oral care or to usual treatment. The 20 patients in the intervention group (11 men, 9 women; mean age, 75 years) had their teeth and gingiva cleaned by caregivers with a toothbrush and distilled water after every meal for 1 month. The other 20 patients (10 men, 10 women; mean age, 76 years) performed their own . . . [Full Text of this Article]

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