The patients fed themselves
or needed help in eating; no patient had feeding tubes. The
patients were randomly selected from the same floor and
nursing team in each nursing home. Randomization was
made from a random-numbers table, and the list was held
independently of the investigators. No dentist had been in
charge of the institution before the study. Four hundred
seventeen patients were randomly assigned to an oral care
group or a no oral care group in September 1996 and were
investigated for 2 years. Criteria for diagnosis of pneumonia
were a new pulmonary infiltrate seen on a chest radiograph
and one of the following features: cough, temperature
greater than 37.8
C, or subjective dyspnea. Two
radiologists who were not involved in the studies made the diagnosis
of pneumonia. However, 51 patients were excluded
from the analysis because they died from causes other than
pneumonia during follow-up. Of the remaining 366 patients,
184 (mean age
standard deviation (SD) 82.0
7.8, 148 women and 36 men) had received oral care at
study entry; 182 (mean age 82.1
7.5, 145 women and
37 men) had not received oral care (Table 1).