Current State and Challenges of Dental Intervention in Aspiration Pneumonia Management from the Perspective of Hospitalists: A Cross-Sectional Survey in Japan

从住院医师的角度看牙科干预在吸入性肺炎治疗中的现状与挑战:一项日本横断面调查

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Abstract

PURPOSE: The incidence of aspiration pneumonia is increasing in the rapidly aging population of Japan. Although dental care is crucial, little is known about the collaboration between hospitalists and dental professionals. Therefore, this study aimed to clarify the state of dental involvement in aspiration pneumonia management and identify challenges that need to be addressed. PATIENTS AND METHODS: An observational cross-sectional survey was administered to hospitalists in the Japanese Society of Hospital General Medicine between August and November 2023. We collected data via an anonymous, self-administered web-based questionnaire. Baseline data (eg, age, hospital type, presence of an oral surgery department, number of full-time dentists, and presence of dental hygienists) and dental referral practices were analyzed. RESULTS: Of the 352 respondents, 305 (86.7%) were male, and the median age was 48 years. An oral surgery department was present in the workplaces of 234 (66.4%) respondents, and 141 (40.1%) referred patients to dental services. Referrals were significantly associated with the presence of an oral surgery department (50.4% vs 19.5%, P<0.001), full-time dentists (50.7% vs 20.8%, P<0.001), dental hygienists (49.8% vs 20.0%, P<0.001), and university hospitals (52.6% vs 35.3%, P<0.001). The most common reasons for referrals were oral health care (89.4%), denture adjustment (60.2%), and swallowing assessment (43.3%). Conversely, non-referral reasons included reliance on other professionals (45.0%), lack of referral habits (43.1%), and the absence of onsite dentists (41.2%). CONCLUSION: Access to dental resources and regular oral assessments in the management of aspiration pneumonia benefit both hospitals and patients. Hospitals and patients benefit from accessible dental resources and routine oral assessments. Strengthening referral habits and expanding dental staff may improve the outcomes of patients with aspiration pneumonia.

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