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Effectiveness of an Interdisciplinary Medical Hospital Admission Center: The Role of the Dental Section in the Interdisciplinary System for Perioperative Management of Patients Awaiting Surgery

  • Systems-Level Quality Improvement
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Abstract

Perioperative oral functional management (POFM) involves total oral management of a patient before surgery. Considerable benefits have been reported, but POFM remains scarce in medical settings. An interdisciplinary Medical Hospital Admission Center (MHAC) opened in our hospital in December 2014, and has since provided unified perioperative management for patients. This study reports on the clinical system and contributions of the systematized, standardized POFM applied through the MHAC. Patients awaiting surgery undergo oral screening before admission, with patients classified into three groups: red, needing surgical oral management (tooth extraction or other oral surgery) before surgery; yellow, needing non-surgical oral management before surgery, due to the planned surgery or the risk of tooth injury in connection with general anesthesia; or green, patients with good oral hygiene considered capable of suitable oral self-management. Patients categorized as red or yellow undergo POFM in the dental section of the MHAC before surgery. Almost all patients (88.8%) awaiting surgery now undergo preoperative oral screening, excluding emergent surgeries. In addition, oral screening is important for preventing tooth injury during endotracheal intubation for general anesthesia, and a need for preventive measures was identified in 6.1% of patients. No traumatic injuries of the teeth in connection with general anesthesia have occurred since the opening of the MHAC. Standardized POFM through an interdisciplinary MHAC thus seems extremely useful.

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References

  1. Barnes, C.M., Dental hygiene intervention to prevent nosocomial pneumonias. J Evid Based Dent Pract. 14(Suppl):103–114, 2014.

    Article  PubMed  Google Scholar 

  2. de Lacerda Vidal, C.F., Vidal, A.K., Monteiro Jr., J.G., Cavalcanti, A., Henriques, A.P., Oliveira, M., Godoy, M., Coutinho, M., Sobral, P.D., Vilela, C.A., Gomes, B., Leandro, M.A., Montarroyos, U., Ximenes, R.A., and Lacerda, H.R., Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: A randomized study. BMC Infect Dis. 17:112, 2017.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Elad, S., and Zadik, Y., Chronic oral mucositis after radiotherapy to the head and neck: A new insight. Support Care Cancer. 24:4825–4830, 2016.

    Article  PubMed  Google Scholar 

  4. Guggenheimer, J., Mayher, D., and Eghtesad, B., A survey of dental care protocols among US organ transplant centers. Clin Transplant. 19:15–18, 2005.

    Article  PubMed  Google Scholar 

  5. Gutierrez, J.L., Bagan, J.V., Bascones, A., Llamas, R., Llena, J., Morales, A., Noguerol, B., Planells, P., Prieto, J., and Salmeron, J.I., Consensus document on the use of antibiotic prophylaxis in dental surgery and procedures. Med Oral Patol Oral Cir Bucal. 11:E188–E205, 2006.

    PubMed  Google Scholar 

  6. Hoshikawa, Y., Tanda, N., Matsuda, Y., Katsumata, H., Notsuda, H., Watanabe, T., Niikawa, H., Noda, M., Sakurada, A., Kondo, T., and Okada, Y., Current status of preoperative professional oral care by dentists for elderly patients undergoing lung resection and occurrence of postoperative pneumonia. Kyobu Geka. 69:25–29, 2016.

    PubMed  Google Scholar 

  7. Michishita, C., Ikeda, E., Iida, M., Suzawa, Y., Murayama, Y., and Yamamoto, M., The effect of routine professional oral care on oral mucositis in hematologic chemotherapy patients. Gan To Kagaku Ryoho. 42:463–466, 2015.

    PubMed  Google Scholar 

  8. Nakamura, Y., Tagusari, O., Seike, Y., Ito, Y., Saito, K., Miyamoto, R., Nakano, K., and Shikata, F., Prevalence of periodontitis and optimal timing of dental treatment in patients undergoing heart valve surgery. Interact Cardiovasc Thorac Surg. 12:696–700, 2011.

    Article  PubMed  Google Scholar 

  9. Sato, Y., Motoyama, S., Takano, H., Nakata, A., Liu, J., Harimaya, D., Todo, N., Yoshino, K., Sasaki, T., Wakita, A., Kawakita, Y., Imai, K., Saito, H., Fukuda, M., and Minamiya, Y., Esophageal cancer patients have a high incidence of severe periodontitis and preoperative dental care reduces the likelihood of severe pneumonia after Esophagectomy. Dig Surg. 33:495–502, 2016.

    Article  PubMed  Google Scholar 

  10. Soutome, S., Yanamoto, S., Funahara, M., Hasegawa, T., Komori, T., Oho, T., and Umeda, M., Preventive effect on post-operative pneumonia of oral health care among patients who undergo esophageal resection: A multi-center retrospective study. Surg Infect (Larchmt). 17:479–484, 2016.

    Article  Google Scholar 

  11. Young, H., Hirsh, J., Hammerberg, E.M., and Price, C.S., Dental disease and periprosthetic joint infection. J Bone Joint Surg Am. 96:162–168, 2014.

    Article  PubMed  Google Scholar 

  12. CfDCa P, (2004) Guidelines for preventing health-care-associated pneumonia. 2003 recommendations of CDC and the healthcare infection control practices advisory committee MMWR 53:8-9.

  13. Council-CSIM, Evaluation of perioperative oral functional management by dentists. Meeting minutes of Central Social Insurance Medical Council. 256:5–54, 2013.

    Google Scholar 

  14. Yoneyama, T., Yoshida, M., Matsui, T., and Sasaki, H., Oral care and pneumonia. Oral Care Working Group. Lancet. 354:515, 1999.

    CAS  Google Scholar 

  15. Sato, J., Goto, J., Harahashi, A., Murata, T., Hata, H., Yamazaki, Y., Satoh, A., Notani, K., and Kitagawa, Y., Oral health care reduces the risk of postoperative surgical site infection in inpatients with oral squamous cell carcinoma. Support Care Cancer. 19:409–416, 2011.

    Article  PubMed  Google Scholar 

  16. Chen, J.J., Susetio, L., and Chao, C.C., Oral complications associated with endotracheal general anesthesia. Ma Zui Xue Za Zhi. 28:163–169, 1990.

    CAS  PubMed  Google Scholar 

  17. Chadwick, R.G., and Lindsay, S.M., Dental injuries during general anaesthesia: Can the dentist help the anaesthetist? Dent Update. 25:76–78, 1998.

    CAS  PubMed  Google Scholar 

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Correspondence to Akifumi Enomoto.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Enomoto, A., Morikage, E., Shimoide, T. et al. Effectiveness of an Interdisciplinary Medical Hospital Admission Center: The Role of the Dental Section in the Interdisciplinary System for Perioperative Management of Patients Awaiting Surgery. J Med Syst 41, 91 (2017). https://doi.org/10.1007/s10916-017-0733-4

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  • DOI: https://doi.org/10.1007/s10916-017-0733-4

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