Oral Health Care for Post-Stroke Dysphagia Patients: A Systematic Review of Best Evidence

Abstract

Abstract This systematic review aims to synthesize the best available evidence on oral health care for patients with post‑stroke dysphagia, and to provide an evidence‑based framework for clinical nursing staff to reduce the risk of aspiration pneumonia. Following PRISMA guidelines, we systematically searched computerized decision systems, guideline websites, professional association websites, and comprehensive databases from inception to December 2025 for clinical decisions, guidelines, evidence summaries, best practices, expert consensuses, systematic reviews, and meta‑analyses. Three researchers trained in evidence‑based methodology independently evaluated literature quality, extracted data, and graded the evidence. Seventeen publications were included (10 guidelines, 3 expert consensuses, 1 clinical decision aid, and 3 evidence summaries), yielding 21 pieces of best evidence across four domains: team formation, screening and assessment, nursing interventions, and health education. Key evidence includes nurse‑led multidisciplinary collaboration, standardized oral and swallowing assessments, twice‑daily oral care with a soft‑bristled toothbrush, cautious use of chlorhexidine mouthwash, and systematic caregiver training before discharge. This systematic review provides a comprehensive, nurse‑centred framework; a multidisciplinary approach, structured interventions, and caregiver education are essential to lower aspiration risk and improve patient outcomes.