The Effect of Dongchimi Juice Containing Kimchi Lactobacillus on the Oral Health of Patients at a Long-Term Care Hospital: Comparison with Chlorhexidine Solution

Seung-Ah Lee; Dongsuk Lee

doi:10.4040/jkan.2017.47.4.540

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Lee and Lee: The Effect of Dongchimi Juice Containing Kimchi Lactobacillus on the Oral Health of Patients at a Long-Term Care Hospital: Comparison with Chlorhexidine Solution

Original Article

J Korean Acad Nurs 2017;47(4):540-550.

Published online: 15 January 2017

DOI: https://doi.org/10.4040/jkan.2017.47.4.540

The Effect of Dongchimi Juice Containing Kimchi Lactobacillus on the Oral Health of Patients at a Long-Term Care Hospital: Comparison with Chlorhexidine Solution

Seung-Ah Lee¹, Dongsuk Lee^2,

¹Department of Nursing, Haetsal Care Hospital, Namyangju

²College of Nursing, Kangwon National University, Chuncheon, Korea

Address reprint requests to : Lee, Dongsuk College of Nursing, Kangwon National University, 1, Gangwondaehak-gil, Chuncheon 24341, Korea Tel: +82-33-250-8880 Fax: +82-33-259-5636 E-mail: ds1119@kangwon.ac.kr

Received 17 March 2017 Revised 6 August 2017 Accepted 6 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The aim of this study was to identify the effect of Dongchimi juice containing kimchi Lactobacillus as an oral hygiene agent and to compare it with that of chlorhexidine solution (0.12% dilution).

Methods

This study employed a pretest-posttest experimental design in which a single group of patients was exposed to two different treatments over a period of time. The study included 32 patients hospitalized at a longterm care hospital in Korea. Data were collected between August 12, 2016 and September 28, 2016. The patients first used chlorhexidine solution as an oral care agent for 1 week. After an interval of 2 weeks, they used Dongchimi juice for 1 week. Each agent was applied 2 times a day depending on the protocol. The oral status of the patients was measured using Beck's Oral Exam Guide (OEG) scores. The number of pathogens in the oral cavity was counted by culture, and the patients’ subjective satisfaction score for each oral agent was measured using a visual analogue scale. T-test and Mann-Whitney test were performed to identify significant differences between Dongchimi juice and chlorhexidine solution by using PASW Statistics for Windows, Version 18.0 (SPSS Inc., Chicago, IL, USA).

Results

The OEG score was not statistically different with the use of chlorhexidine solution and Dongchimi juice. However, decreasing number of pathogens and the subjective satisfaction score were higher with Dongchimi juice than with the chlorhexidine solution.

Conclusion

These findings support the use of Dongchimi juice containing kimchi Lactobacillus as an oral hygiene agent for Korean patients.

Keywords: Oral hygiene, Lactobacillus, Chlorhexidine, Long-term care

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Figure 1.

Research process.

Table 1.

General Characteristics and Oral-Health-Related Score (N=32)

	Characteristics (Score)	n (%)	M±SD
Age (yr)	47~64	8 (25.0)	71.03±11.22
	65~80	20 (62.5)
	81~92	4 (12.5)
Gender	Male	20 (62.5)
	Female	12 (37.5)
Disease	Spinal muscular atrophy	2 (6.3)
	Cranial nerve related	8 (25.0)
	Cardiac disorder	2 (6.3)
	Hypertension or diabetes	3 (9.4)
	Gastrointestinal malignancy	2 (6.3)
	Respiratory related	1 (3.1)
	Parkinsonism	3 (9.4)
	Dementia etc.	11 (34.4)
Diet	Regular diet	18 (56.3)
	Soft diet	2 (6.3)
	DMRD	6 (18.8)
	Tube feeding	6 (18.8)
Missing teeth 50% or higher	Yes	17 (53.1)
	No	15 (46.9)
Dentures	Yes	6 (18.8)
	No	26 (81.3)
Oral care score on ADL	Care giver's direction needed (2)	8 (25.0)	3.50±1.13
	Some assistance needed (3)	8 (25.0)
	Considerable assistance needed (4)	8 (25.0)
	Complete assistance needed (5)	8 (25.0)
Abilities for rinsing, spitting, swallowing	Cannot at all (3)	7 (21.9)	2.06±0.71
	Aspiration risk (2)	16 (50.0)
	Practicable (1)	9 (28.1)
Number of drugs related to dry mouth	0~1	19 (59.4)	1.31±0.93
	2~4	13 (40.6)

DMRD=Diabetes mellitus regular diet; ADL=Activity of daily living; M=Mean; SD=Standard deviation.

Table 2.

Homogeneity of Variables Measured before Treatment (N=32)

Variable	pre-CHX (M±SD or Median (IQR))	pre-DCM (M±SD or Median (IQR))	t or Z	p
OEG score	10.20±1.19	9.61±2.12	1.38	.173
Number of Pathogens	1 (1)	1 (1)	-0.56	.578

OEG=Oral Exam Guide; CHX=Chlorhexidine oral care; DCM=Dongchimi juice oral care; M=Mean; SD=Standard deviation; IQR=Interquartile range=The difference between quartile 3 and quartile 1.

Table 3.

Comparison of OEG Score, Number of Pathogens, Taste Score, and Degree of Feeling Refreshed after Treatment (N=32)

Variable	post-CHX (M±SD or Median (IQR))	post-DCM (M±SD or Median (IQR))	t or Z	p
OEG score	5.91±1.04	5.70±0.69	0.95	.345
Number of Pathogens	1 (1)	0 (1)	-1.97	.048
Taste score	15.63±15.01	83.28±16.44	-17.19	<.001
Degree of feeling refresh	63.36±14.89	82.48±18.04	-4.62	<.001

OEG=Oral Exam Guide; CHX=Chlorhexidine oral care; DCM=Dongchimi juice oral care; M=Mean; SD=Standard deviation; IQR=Interquartile range=The difference between quartile 3 and quartile 1.

Table 4.

Changes in OEG Score and Number of Pathogens before and after Each Treatment (N=32)

Variable	Treatment	Pretest	Posttest	t or Z	p
		(M±SD or Median (IQR))	(M±SD or Median (IQR))
OEG score	CHX	10.20±1.19	5.91±1.04	23.41	<.001
	DCM	9.61±2.12	5.70±0.69	13.17	<.001
Number of pathogens	CHX	1 (1)	1 (1)	-0.66	.508
	DCM	1 (1)	0 (1)	-2.00	.046

OEG=Oral Exam Guide; CHX=Chlorhexidine oral care; DCM=Dongchimi juice oral care; M=Mean; SD=Standard deviation; IQR=Interquartile range=The difference between quartile 3 and quartile 1.

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