Feasibility, acceptability and efficacy of non-invasive application of chlorhexidine dental coating for seniors in the community: a randomized controlled study

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Abstract
Background: Poor oral health (caries and periodontal disease) in seniors is a health risk with minimal preventive care approaches evaluated. The objectives of this study were to: i) document the oral health status of a sample of Canadian seniors; and then ii) evaluate feasibility, acceptability and efficacy of non-invasive application of chlorhexidine for preventive oral health in the community. Methods: Dental examinations of 105 Ottawa seniors were followed by a randomized controlled study of 55 seniors with ³ 16 natural teeth and ³ 12 sites of bleeding on probing (BOP). Four treatments of either a chlorhexidine 10% w/v (active) or purified water (placebo) were applied over a 9-week period. Study sites included a hospital, seniors’ community centre, medical practice and long-term care facility. Treatments were applied by a hygienist or a nurse in 10-15 minutes, without dental cleaning or scaling. The primary endpoint was change in oral inflammation (BOP). Results: The sample had more decayed, missing or filled teeth (DMFT) and more periodontal disease than reported in the 2007-2009 Canada Health Measures Survey. BOP was reduced almost 2-fold more in the active group compared to placebo although significant in both groups (active: 7.91%, p<0.001; placebo: 4.1%, p=.018). The difference between groups in reducton of BOP failed to reach significance (p = 0.06) likely due to early stoppage of recruitment. Conclusion: A four-dose application of chlorhexidine significantly decreased oral inflammation as measured by BOP. The program of non-invasive preventive care in community settings is feasible, clinically impactful, and well received.

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