The impact of hospitalization on oral health: a systematic review

J Clin Periodontol. 2011 Jul;38(7):628-36. doi: 10.1111/j.1600-051X.2011.01727.x. Epub 2011 Apr 7.


Background: Poor oral health of hospitalized patients is associated with an increased risk of hospital-acquired infections and reduced life quality.

Objectives: To systematically review the evidence on oral health changes during hospitalization.

Data sources: Cochrane library, Medline, OldMedline, Embase and CINAHL without language restrictions.

Study eligibility criteria: Observational longitudinal studies.

Data appraisal and synthesis methods: Two independent reviewers screened studies for inclusion, assessed the risk of bias and extracted data. Risk of bias was assessed using the Newcastle-Ottawa assessment scale. A narrative synthesis was conducted.

Results: Five before and after studies were included. The data suggest a deterioration in oral health following hospitalization with an increase in dental plaque accumulation and gingival inflammation and a deterioration in mucosal health.

Limitations: While before and after studies are at a general risk of bias, other specific study characteristics were judged to have a low risk of bias. However, methodological issues such as unvalidated outcome measures and the lack of assessor training limit the strength of the evidence.

Conclusion: Hospitalization is associated with a deterioration in oral health, particularly in intubated patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Cross Infection / etiology
  • Dental Plaque / etiology
  • Gingivitis / etiology
  • Health Status*
  • Hospitalization*
  • Humans
  • Oral Health*
  • Oral Hygiene
  • Quality of Life
  • Risk Factors