Effect of a home telecare program on oral health among adults with tetraplegia: a pilot study

Study design: one group pre- and post-test design. Objectives: The primary aim was to examine both the short-and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia. Methods: Eight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using personal computer-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15 - 30 min sessions across 3 months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Loe-Silness gingival index (LSGI) was conducted at baseline, 6 and 12 months. Results: From baseline to 6 months, participants showed statistically significant differences (that is, improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (that is, improvement, z=2.03; P=0.04) in their LSGI scores. Conclusion: This study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at 6 and 12 months among adults with tetraplegia.