Nursing home acquired pneumonia (NHAP) is a critical health experience that accounts for considerable morbidity, mortality, and costs to nursing homes (NHs) and the health care system. While studies have demonstrated a link between oral helth and NHAP, comprehensive assessment of oral health status in NH residents has not been done, little is known about oral care provided by formal caregivers, and evidence based protocols for oral care to reduce NHAP have not been developed. The purpose of this study is to test procedures surrounding the collection of oral health indices in a NH population, as pilot dat for developing and testing an intervention aimed at reducing NHAP.

Specific aims of this pilot study are to:

1. test the feasibility of obtaining data measuring the oral health of NH residents, including plaque measurements on dentures and dental surfaces, presence of respiratory pathogens in the oral cavity, state of natural teeth, saliva flow, and the presence of salivary IgA levels;
2. describe the types and frequency of oral care provided by nursing assistants to cognitively-impaired NH residents through the use of surveys; and
3. determine the relationship between oral health indices and dentate status. The specific aims will be accomplished using a prospective, descriptive design. NH residents (n=39) and certified nursing assistants (n=50) from 2 NHs will participate. Efforts will be made to recruit NH subjects to reflect the three types of dentitions (dentate, mixed dentition, and dentures only). Data to be collected from NH residents include indices of oral helath (including those listed in specific aim 1), functional status, cognitive status, reported oral health regimens, and NHAP incidence. CNAs wil participate through completing a survey regarding practices of oral care provision to NH residents. Descriptive data will be examined, and correlational and multiple regression analysis will be used to understand the relationships among variables.