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Implications of PEG-tube Feeding for Oral Health
Madison Changon 27 November 2012
Transcript of Implications of PEG-tube Feeding for Oral Health
Conclusion Scope of Presentation Methods of providing artificial nutrition via the gastrointestinal tract
Gastrostomy & Jejunostomy
Endoscopic, Radiological inserted What is Enteral Feeding? Percutaneous Endoscopic Gastrostomy
A surgical procedure to place a feeding tube inside the stomach through the skin under the guidance of an endoscope
Swallowing dysfunction and airway protection
Convenient and cosmetically acceptable What is a PEG? Low caries activity
Alterations to the oral indigenous microbiota
Excessive plaque and calculus build-up
Oral hypersensitivity Implications on Oral Health Gastrointestinal complication
Nausea & Vomiting
Constipation Aspiration pneumonia PEG site
Buried bumper syndrome
Inadvertent removal Risks and complications Abundant calculus, low caries activity, oral hypersensitivity
Oral health may have significant consequences in terms of general health
Education and oral care plans for PEG-tube feeding patients Summary Neuromuscular impairments compromise protective airway reflexes
Bacteroids, Porphyromonas and Fusobacterium species
20% to 30% of PEG-fed patients Oral health care Body should be vertically symmetrical with neutral head flexion
Ultrasonic scaler, handpieces and airwater syringes should be limited and for all procedures
High-and low volume suctioning -/+ gauze 79 years old
MH: COPD. AF. DM Type II. Hypertensive disease
PEG-inserted - Stricture of oesophagus due to GORD and severe HSV oesophagiti
EO: Independently mobile Patient Case: Mr M Questions Dicks JL, Banning JS. Evaluation of calculus accumulation in tube-fed, mentally handicapped patients: the effects of oral hygiene status. Spec Care in Dent 11:104-6, 1991
Finucane TE, Bynum JPW. Use of tube feeding to prevent aspiration pneumonia. Lancet 348:1421-4, 1996
Klein FK, Dicks JL. Evaluation of accumulation of calculus in tube-fed, mentally handicapped patients. J Am Dent Assoc 108:352-4, 1984
Langmore SE, Terpenning MS, Schork A, et al. Predicators of aspiration pneumonia: how important is dysphagia? Dysphagia 13:69-81, 1998.
Littleton NW, Carter CH, Kelley RT. Studies of oral health in persons nourished by stomache tube. II. Acidogenic properties and selected bacterial components of plaque material. Arch Oral Biol 12:601-9, 1967.
Pearce CB and Duncan HD. Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: its indications and limitations. References (cc) photo by medhead on Flickr Dr Juliet Gray
Dr Adrianne Scott
Vicky Youngson Acknowledgements