Effects of oral care with tongue cleaning on coughing ability in geriatric care facilities: a randomised controlled trial

Methods for preventing aspiration pneumonia are needed soon in order to reduce mortality from aspiration pneumonia and promote the health of the elderly. The aim of this randomised controlled trial was to examine whether oral care with tongue cleaning improves coughing ability in elderly individuals living in geriatric care facilities. Participants comprised of 114 residents of 11 group homes and private nursing homes in Aso City in Kumamoto Prefecture. Participants were randomly assigned to either (i) a group that underwent routine oral care with tongue cleaning (intervention group; n = 58) or (ii) a group that underwent routine oral care alone (control group; n = 56). Coughing ability was evaluated by measuring peak expiratory flow (PEF) before and after 4 weeks of intervention. Before the intervention, PEF did not differ significantly between the intervention group (1·65 ± 1·11 L s^-1 ) and control group (1·59 ± 1·05 L s^-1 ; P = 0·658). However, on termination of the intervention, PEF was significantly higher in the intervention group (2·54 ± 1·42 L s^-1 ) than in the control group (1·90 ± 1·20 L s^-1 ; P = 0·014). After the intervention, PEF had increased significantly in both groups; however, this increase was significantly greater in the intervention group (0·90 ± 0·95 L s^-1 ) than in the control group (0·31 ± 0·99 L s^-1 ; P < 0·001). Oral care with tongue cleaning led to increased PEF, suggesting improved coughing ability. Oral care incorporating tongue cleaning appears to be important for preventing aspiration pneumonia.