How To Clean The Back Of Your Tongue Without Throwing Up

• Research commodity
• Open Access
• Published: 12 February 2022

Cleaning the palate and tongue without nausea: a mixed methods report exploring the appropriate depth and direction of oral care

BMC Oral Health volume 21, Article number:67 (2021) Cite this article

Abstract

Background

Information technology is advisable to clean the palate and tongue thoroughly during oral intendance to protect against nosocomial infections. However, improper cleaning may crusade nausea. To date, no robust data are available regarding how to implement this procedure properly. Furthermore, traditional cotton balls, forceps and normal saline are still used in clinical in People's republic of china. This mixed methods study aimed to explore the advisable depth and management of cleaning methods for palates and tongues without causing nausea and the factors influencing cleaning depth and discomfort in traditional oral care.

Methods

Our report recruited students (n = 276) from a medical academy. The first phase was a quantitative study, in which forceps were slowly inserted into their throats until the gag reflex was triggered, and and then, the insertion depth was measured. Afterward that, participants were randomly divided into two groups. In group A, palates and tongues were cleaned coronally and so sagittally, with the converse order used for grouping B. The extent of nausea was measured. Additionally, the qualitative information were types of discomfort other than nausea reported past the participants.

Results

The tolerable depths (without causing nausea) for cleaning the palate and tongue were 6.75 ± one.07 cm and vi.92 ± 1.xi cm, respectively. Participants of male person sexual activity and with high BMI (overweight/obese) were associated with greater tolerable cleaning depth. The extent of nausea caused by cleaning both the palate and the tongue sagittally was college than that elicited by coronal cleaning (p = 0.025 and p = 0.003, respectively). Other discomforts included itching, saltiness and coldness.

Decision

It is appropriate to increase the cleaning depth of the palate and tongue for adult males and overweight/obese individuals. Moreover, coronal cleaning causes lower levels of nausea, and traditional oral care appliances should be improved.

Peer Review reports

Background

Oral health greatly affects general health [1]. Ane of the effective approaches to maintain oral health is oral care, which has been evidenced to maintain oral health by reducing bacteria in the oral cavity [2]. As routine care, oral care is an constructive measure to reduce the risk for infection [3], decrease the incidence of pneumonia [4], prevent the occurrence of mucositis [v] and significantly improve the quality of life of the patient [three]. Information technology has been reported that approximately one in ten cases of death caused by pneumonia in residents of nursing homes for the elderly could be prevented by improving oral hygiene [6]. Nonetheless, providing oral care deeply or improperly may cause nausea, which is associated with the gag reflex.

Nausea is a physiological defence reflex [1], and the prevalence of self-reported gagging during dental treatment is viii.2% [7]. Frequent gagging is fifty-fifty related to correlative fright [i] and hinders the receipt of adequate dental care [viii]. Many stock-still areas can trigger the gag reflex, commonly including the faucial pillars, the base of the tongue, and the soft palate, uvula, and posterior pharyngeal wall [9]. Since there are fixed areas that tin can trigger the gag reflex, and tongue cleaning has been recommended for the comeback of oral health [10], it is reasonable to measure the depth at which this response is triggered, which could help to avert the gag reflex caused by oral care and keep the mouth as clean as possible. Withal, at that place is limited literature that specifically addresses the depth of oral cleaning [11] and insufficient testify to date on factors influencing gag reflex sensitivity, such as sexual practice [12]. In improver, the difficult palate and tongue cannot be covered by a single cotton brawl in one footstep due to their width; thus, they require repeated dorsum and forth movements during cleaning. There are 2 means of cleaning, as illustrated in Fig. 1: sagittally and coronally; even so, which of these is less probable to cause nausea in patients has not been reported to engagement.

Fig. ane

Cleaning the oral cavity sagittally and coronally

Full size image

The purpose of this mixed method study is to investigate oral care methods, including appropriate cleaning depth and direction without nausea, and to illuminate the factors related to the appropriate cleaning depth and discomfort of traditional oral care. Current inquiry only considers the oral hygiene effect but neglects cleaning methods, and this written report attempted to fill this gap.

Methods

Report design

This was a mixed methods study that included two parts: quantitative enquiry and qualitative research [13].

Participants

The sample size was estimated using the formula \({northward=\left({t}_{\blastoff /2}S/\delta \right)}^{2}\) [14]. A total of 266 subjects were calculated based on the values of Southward = 1, δ = 0.12, and α = 0.05. Ultimately, 276 sophomores (mean age = 19.63 ± 0.75 years; age range = 18–22 years; 42 men) were recruited from a school (hateful height = 163.82 ± 6.80 cm; height range = 149.5–189 cm; mean weight = 57.77 ± x.09 kg, weight range = 39–130 kg). All participants were informed about what their involvement would consist of and the objectives of this report.

The inclusion criteria were expert health, practiced oral hygiene, and voluntary participation; there were no exclusion criteria in this study. Prior to the study, this inquiry was canonical past the Ideals Committee at the School of Nursing, Nanjing Medical University, China (2020-SR-146).

Experimental procedure

Training

The experiment began ii hours afterwards participants had eaten a meal, and all basic data and data were recorded by investigators. To identify the factors influencing cleaning depth without causing nausea, demographic characteristics, such as age, sex, top, and weight (using HNH-219 Blazon; Omron), were nerveless first. The errors of height and weight were in the 0.1 cm and 0.1 kg ranges, respectively. Body mass alphabetize (BMI) was calculated equally weight divided by height squared (kg/g²). Overweight and obesity, normal weight and underweight were divers as BMI values > 24, 18.5–24, and < 18.five, respectively.

Three researchers were trained to implement the research. In this study, dispensable plastic forceps (length, from shaft knot to tip, 15 cm), dry cotton wool balls (diameter, 3 cm), and disposable sterile dressing kits (using Deyi Kang A-10) were used to measure the cleaning depths of the palate and tongue without causing nausea. Cotton balls were soaked in 0.nine% saline solution and squeezed until they were half-dry. The bore of the wet cotton balls was approximately 1.5 cm subsequently being squeezed, and the forceps held the centre of the wet cotton fiber ball. Participants were asked to open their rima oris so that in that location were two finger widths betwixt the upper and lower incisors (open mouth moderately).

Measurement of cleaning depths of the palate and tongue without causing nausea

To measure the greatest tolerable cleaning depth for the palate, forceps with a saline cotton ball were inserted into the participant's oral cavity at the maxillary cardinal incisor and guided slowly down to the pharynx along the palate. When the participants could no longer tolerate the insertion or the gag reflex was triggered, they would inform the examiner by raising their easily. The examiner marked the forceps at the position of the maxillary central incisor and then removed the forceps from the participants' mouths. The insertion distance of the forceps from the cotton ball to the marker was measured using a mm ruler. The mean value of three measurements was recorded equally the cleaning depth for the palate without causing nausea. A similar procedure was followed to measure the depth at which the tongue could exist cleaned.

Measurement of nausea extent acquired by coronal and sagittal cleaning

A randomized crossover trial was designed to mensurate the extent of nausea acquired by cleaning the palate and tongue coronally and sagittally. Notes with groups were curtained in an opaque envelope, and participants were randomly grouped by cartoon lots before the measurement. A total of 134 participants were allocated to group A and 142 to grouping B. In group A, participants' palates and tongues were offset cleaned coronally so sagittally inside their tolerable cleaning depth. Conversely, participants in group B were first cleaned sagittally and and so coronally. All participants' palates were cleaned starting time, followed past their tongues. After cleaning, the participants rated the extent of nausea they felt using a visual analogue scale (VAS) [15], which ranged from 0 (not at all) to ten (very strong). To rule out the consequence of cleaning time on nausea, we measured it using a stopwatch from mouth opening to mouth closing.

Recording of other discomforts during the cleaning of the palate and tongue

To evaluate the comfort of Chinese traditional oral intendance tools and the solutions used, participants were asked to write down other discomforts they felt during cleaning in an open-ended question: What other discomforts do you feel besides nausea? Summative content assay [sixteen], an approach used to identify and quantify fundamental words by rereading the text, was implemented independently past two researchers.

Statistical analysis

The data regarding cleaning depth without causing nausea were near normally distributed and were, therefore, described as the means and standard deviation. Data regarding nausea extent are described equally medians and interquartile ranges, as they were non normally distributed. The independent t-test, ANOVA, and multiple linear regression were used to assess differences in cleaning depth without causing nausea (both palate and tongue) betwixt the sexes, and co-ordinate to height and BMI, pairwise comparisons betwixt these groups were evaluated past an LSD test. Height was stratified co-ordinate to the median height. The Wilcoxon rank-sum examination was used to compare the two directions of palate and tongue cleaning (sagittally and coronally). All data analyses were conducted using IBM SPSS version 22.0 (IBM Corp., Armonk, NY, USA). The p < 0.05 was considered statistically significant.

Results

Participants' characteristics

We recruited 276 participants, and their characteristics are summarized in Table 1.

Tabular array 1 Characteristics of participants (North = 276)

Total size table

Depth of palate cleaning without causing nausea

The mean depth at which the palate could be cleaned without causing nausea was six.75 ± 1.07 cm. Further results of univariate analyses are presented in Table 2. There was a significant difference in cleaning depth between males and females, with that for males being deeper than that for females. The univariate analysis also identified a pregnant difference according to BMI; as BMI increased, the cleaning depth of the palate increased. There were also significant differences among the three measurements (offset, second, and third), with pairwise comparisons, followed by ANOVA and LSD tests; all were statistically significant. At that place was a weak positive correlation betwixt height and mean cleaning palate cleaning depth (r = 0.150; p = 0.013); however, the difference in the cleaning depth of the palate between participants of different heights was not significant. A multiple linear regression model was used to evaluate the relationships amid depth of palate cleaning and sex or BMI, and the results indicated statistical significance (F = 9.688; p < 0.001) (Table iii).

Tabular array 2 Factors influencing the depth of cleaning of the tongue and palate without causing nausea: univariate analysis (Northward = 276)

Full size table

Tabular array three Factors influencing the depth at which the tongue and palate can be cleaned without causing nausea: multiple linear regression (N = 276)

Full size table

Depth of tongue cleaning without causing nausea

The depth at which the tongue could be cleaned without causing nausea was half-dozen.92 ± 1.11 cm. The results of further univariate analyses are presented in Tabular array two. Similar to the results for the palate, differences between natural language cleaning depth and sex, BMI or measuring time were all statistically significant. Once more, at that place was no statistically significant difference between participants of different heights. Multiple linear regression analysis showed that sex and BMI were associated with hateful cleaning depth (F = nine.449, P < 0.001). The results of farther multiple linear regression analyses are shown in Table three.

Extent of nausea acquired past the two palate cleaning directions

The degrees of nausea acquired past cleaning the palate coronally and vertically, according to VAS score, were one (0–2) and i (0–iii), respectively. The extent of nausea caused by sagittal cleaning was significantly higher than that caused by coronal cleaning (Wilcoxon rank-sum test: Z = − 2.248; p = 0.025). The scores for feelings of nausea for participants in both Groups A and B, where the two directions of cleaning were tested in a different order for each group, are shown in Tabular array four and demonstrate that the extent of nausea acquired past cleaning the palate was not influenced by cleaning guild. Although the departure in the elapsing of palate cleaning between the two groups was significant, there was no clinical significance. The results of stratified analysis showed that the extent of nausea acquired by sagittal cleaning was significantly higher than that elicited by coronal cleaning for females, participants with lower than median height, and participants with normal BMI (Table 5).

Table iv Nausea extent and cleaning time for the two directions for cleaning the palate and tongue

Full size table

Table five Stratified analysis of the extent of nausea caused by palate and tongue cleaning

Full size table

Extent of nausea caused by two natural language cleaning directions

The scores for the extent of nausea elicited by cleaning the tongue coronally and sagittally were 1 (0–iii) and 2 (0–three), respectively. The extent of nausea caused by sagittal cleaning was significantly higher than that caused past coronal cleaning (Wilcoxon rank-sum test: Z = − 2.990; p = 0.003). To rule out the influence of cleaning order, a randomized, crossover design was implemented, and the results indicate that the extent of nausea caused past cleaning the tongue was not influenced by the cleaning order (Table 4). The difference in the duration of natural language cleaning betwixt the two cleaning directions was statistically, just not clinically, significant. Furthermore, the results of stratified analyses showed that the extent of nausea caused by sagittal cleaning was significantly college among female participants, those with heights higher than medium, and participants with normal BMI (Table 5).

Other discomforts reported by participants

The open-ended question about discomfort other than nausea was completed by 149 (54.0%) participants. Among the 149 responses listed, itching acquired by cotton fibres (89.nine%) was the nearly frequently reported discomfort. In addition, 41 (27.5%) participants complained that the 0.9% saline solution was too salty for them, while seven (4.vii%) participants felt that the solution was too cold.

Discussion

The hateful depths at which the palate and natural language could exist cleaned without nausea were 6.75 ± 1.07 cm and 6.92 ± 1.eleven cm, respectively, and the two were positively correlated (t = 0.730, P < 0.001), suggesting that, in clinical practice, the aforementioned cleaning depth can be used for both the tongue and palate of an individual patient. Further univariate analyses showed that sex was the chief factor related to the tolerable depth of oral cleaning, with males able to tolerate deeper oral care, which may be attributable to innate differences in structural depths betwixt the sexes [17, 18]. Similarly, Mimgu Park et al. reported that males had a longer depth of the gag reflex, which is consistent with our results [viii]; the reason may be the longer maxillary arch size in males [19]. Therefore, men tin tolerate deeper oral care. Hence, our study recommends that when performing oral care for adult males, the cleaning depth tin exist suitably increased.

Top was some other factor that nosotros expected to influence the tolerable cleaning depth; however, we did not discover whatsoever pregnant differences in the tolerable cleaning depths for either palate or tongue between height categories, and this factor failed to enter the regression equation, suggesting that the difference in cleaning depth between individuals of dissimilar heights was less than expected. Therefore, based on our written report, we practice non recommend that cleaning depth be changed according to patient height.

As shown in Tables 2 and 3, the clan betwixt BMI and cleaning depth was college than expected, with BMI being a factor that significantly influenced tolerable cleaning depth. There is evidence that obese individuals accept a greater risk of regurgitation and pulmonary aspiration than underweight patients [20]. Hence, based on our results, nosotros recommend that the depth of cleaning of the tongue and palate should be increased for overweight/obese patients.

To reduce measurement errors, we tested tolerable cleaning depths for the tongue and palate 3 times. Unexpectedly, nosotros found that tolerable cleaning depths for the tongue and palate gradually and significantly increased with the lodge of measurement (first to 3rd), which could be related to increased tolerance of gagging reflexes in response to multiple stimuli. This finding suggests that multiple stimulation preparation could be used to increment tolerance depth in the dispensary, particularly for patients with an overactive gag reflex. In addition, previous studies accept proposed several useful methods for overcoming gag reflexes, including earplugs [21], relaxation, and distraction [22]. Moreover, some scholars accept suggested that the ideal instruments for measuring the gag reflex should include the use of different materials and exist applied with variable intensities, durations, and positions of stimuli [23]. 1 study used a standard disposable saliva ejector, with a stopper of heavy body addition silicone impression putty, as a device to measure out the gag reflex depth of their participants [12]. Considering that the most common type of oral care equipment used in China is forceps with cotton fiber balls [24], we used them for the measurement of cleaning depth in this investigation.

Our study compared the extent of nausea acquired by coronal and sagittal cleaning (Fig. 1). The results bear witness that the extent of nausea caused by sagittal cleaning was significantly higher than that caused by coronal cleaning, which is consistent with our clinical experience. This may be because, for coronal cleaning, the deep oropharynx is only accessed one time, where sagittal cleaning requires repeated insertions into the deep oropharynx, and it is possible that depth is not fairly controlled. Yet, these differences were merely significant amongst female participants and those with normal BMI, likely due to the sexual activity ratio and BMI range of our participants; the proportions of female person participants and those with normal BMI were 85% and 77%, respectively. Overall, based on our written report, we recommend that the tongue and palate should exist cleaned coronally.

When asked about types of discomfort other than nausea, subjects mentioned itching 134 times, with i research bailiwick saying, "The wool of the cotton ball passed through my oral mucosa, and it is truly itchy!" Another research subject said, "The cotton fiber wool on the cotton fiber ball hangs in the mouth, leaving so much fibre in my mouth." These results demonstrate that cotton balls were not as comfortable every bit expected; thus, new materials and tools should be used to replace this approach. Gauze pads are widely used in Israel [25] and take been proven to assist nurses implement more effective and gentle oral care [26]. In addition, a foam swab specifically designed for cleaning the natural language and palate has been reported in America; however, its cleaning effects take yet to be verified [xi].

The 2d most commonly reported discomfort, following itching, was saltiness, which was mentioned 41 times. This indicates that the salinity of the 0.9% NaCl solution exceeds that of people'southward daily diet and causes discomfort. Physiological saline has been recommended in textbooks for many years equally a common oral care solution and is believed to contribute to oral cleansing and sterilization; however, there is deficient bear witness to back up its efficacy. With regard to safety, saline has no negative effects on patient oral mucosa [27]; therefore, the apply of saline for oral intendance warrants farther exploration.

In add-on, a few participants mentioned coldness as a discomfort. This suggests that oral intendance at room temperature can be tolerated by most people; however, there are also some subjects sensitive to temperature. Some researchers in China have tried heated oral care solutions to meliorate comfort for patients during oral care, and they suggested that a specific temperature range could be selected by the patient according to their daily habits [28].

The strengths of this written report include exploring the depth and direction of oral cleaning, which has not been researched before, providing valuable information for nurses to provide oral care using more than scientific cleaning depth and direction.

Limitation

Participants recruited in this study were healthy, and their boilerplate age was just 19.63 years. Due to the crucial roles of age and health in the gag reflex, the results of this study may not be representative of the overall situation for clinical patients. Farther report is required to confirm these results in the clinic.

Conclusion

This study found that the greatest tolerable cleaning depths for the palate and tongue, without causing nausea, were six.75 ± ane.07 cm and vi.92 ± 1.xi cm, respectively. It is advisable to increment these values when performing oral care for developed males and overweight/obese individuals. Multiple stimulation training is brash for patients with an overactive gag reflex to decrease their gag reflex sensitivity. The extent of nausea caused past sagittal cleaning was college than that caused past coronal cleaning, and saline-soaked cotton assurance tin cause different kinds of discomfort. To improve oral care practice, further investigations should use gag reflex cess tools and oral intendance standards with consideration of the health status of the patients.

Availability of data and materials

Data is available upon asking. Contact e-mail service: zhouyf@njmu.edu.cn.

References

1. Randall CL, Shulman GP, Crout RJ, McNeil DW. Gagging and its associations with dental care-related fright, fear of pain and behavior nearly handling. J Am Paring Assoc. 2022;145(v):452–8. https://doi.org/10.14219/jada.2013.50.

   Commodity  Google Scholar

2. Booker S, Murff S, Kitko L, Jablonski R. Oral fissure intendance to reduce ventilator-associated pneumonia. Am J Nurs. 2022;113(10):24–31. https://doi.org/x.1097/01.NAJ.0000435343.38287.3a.

   Article  PubMed  Google Scholar

3. Elad S, Raber-Durlacher JE, Brennan MT, et al. Basic oral intendance for hematology-oncology patients and hematopoietic stem cell transplantation recipients: a position newspaper from the joint task force of the Multinational Association of Supportive Intendance in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT). Back up Care Cancer. 2022;23(1):223–36. https://doi.org/10.1007/s00520-014-2378-x.

   Article  PubMed  Google Scholar

4. Liu C, Cao Y, Lin J, Ng 50, Needleman I, Walsh T, et al. Oral intendance measures for preventing nursing home-acquired pneumonia. Cochrane Database Syst Rev. 2022;nine(ix):CD012416. https://doi.org/x.1002/14651858.CD012416.pub2.

   Article  PubMed  Google Scholar

5. Pereira IF, Firmino RT, Meira HC, Practice Egito Vasconcelos BC, DE Souza Noronha VRA, Santos VR. Radiation-induced oral mucositis in Brazilian patients: prevalence and associated factors. In Vivo. 2022;33(2):605–ix. https://doi.org/10.21873/invivo.11517.

   Commodity  PubMed  PubMed Central  Google Scholar

6. El-Solh AA. Association between pneumonia and oral care in nursing home residents. Lung. 2022;189(3):173–lxxx. https://doi.org/ten.1007/s00408-011-9297-0.

   Article  PubMed  Google Scholar

7. van Houtem CM, van Wijk AJ, Boomsma DI, Ligthart 50, Visscher CM, de Jongh A. Cocky-reported gagging in dentistry: prevalence, psycho-social correlates and oral wellness. J Oral Rehabil. 2022;42(7):487–94. https://doi.org/x.1111/joor.12289.

   Article  PubMed  Google Scholar

8. Park 1000, Byun J, Jung J, Choi J. The correlation of gagging threshold with intra-oral tactile and psychometric profiles in good for you subjects: a pilot study. J Oral Rehabil. 2022;47(5):591–8. https://doi.org/10.1111/joor.12940.

   Article  PubMed  Google Scholar

9. Akarslan ZZ, Biçer AZ. Utility of the gagging problem assessment questionnaire in assessing patient sensitivity to dental treatments. J Oral Rehabil. 2022;39(12):948–55. https://doi.org/10.1111/j.1365-2842.2012.02321.x.

   Commodity  PubMed  Google Scholar

10. Matsui M, Chosa N, Shimoyama Y, Minami Yard, Kimura S, Kishi M. Furnishings of tongue cleaning on bacterial flora in tongue blanket and dental plaque: a crossover study. BMC Oral Wellness. 2022;xiv(ane):4. https://doi.org/10.1186/1472-6831-xiv-4.

    Commodity  PubMed  PubMed Key  Google Scholar

11. Yates S, Gollins GJ. Oral care tin can be a matter of life and death. Drugs Today. https://www.americannursetoday.com/oral-care-tin can-be-a-matter-of-life-and-expiry/. Accessed November 2008.

12. Karibe H, Okamoto A, Kato Y, Shimazu Thou, Goddard G. Reliability, validity, and sex differences in a quantitative gag reflex measurement method. J Oral Rehabil. 2022;45(x):798–804. https://doi.org/10.1111/joor.12687.

    Article  PubMed  Google Scholar

13. Östlund U, et al. Combining qualitative and quantitative research within mixed method research designs: a methodological review. Int J Nurs Stud. 2022;48(iii):369–83.

    Commodity  Google Scholar

14. Li LM, Huang YQ. Clinical epidemiology. 2022.

15. Imai K, Kitakoji H, Sakita M. Gastric arrhythmia and nausea of motion sickness induced in healthy Japanese subjects viewing an optokinetic rotating drum. J Physiol Sci. 2006;56(five):341–5. https://doi.org/10.2170/physiolsci.RP005306.

    Article  PubMed  Google Scholar

16. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Wellness Res. 2005;fifteen(nine):1277–88. https://doi.org/ten.1177/1049732305276687.

    Article  PubMed  Google Scholar

17. Louly F, Nouer PR, Janson K, Pinzan A. Dental arch dimensions in the mixed dentition: a study of Brazilian children from ix to 12 years of age. J Appl Oral Sci. 2022;19(2):169–74. https://doi.org/10.1590/s1678-77572011000200014.

    Article  PubMed  PubMed Central  Google Scholar

18. Akkoç B, Arslan A, Kök H. Automatic gender determination from 3D digital maxillary molar plaster models based on the random forest algorithm and discrete cosine transform. Comput Methods Programs Biomed. 2022;143:59–65. https://doi.org/ten.1016/j.cmpb.2017.03.001.

    Article  PubMed  Google Scholar

19. Lee SJ, Moon SC, Kim TW, Nahm DS, Chang YI. Tooth size and arch parameters of normal occlusion in a big korean sample. Korean J Orthod. 2004;6:473–80.

    Google Scholar

20. Mahajan 5, Hashmi J, Singh R, Samra T, Aneja South. Comparative evaluation of gastric pH and book in morbidly obese and lean patients undergoing elective surgery and effect of aspiration prophylaxis. J Clin Anesth. 2022;27(5):396–400. https://doi.org/x.1016/j.jclinane.2015.03.004.

    Commodity  PubMed  Google Scholar

21. Cakmak YO, Ozdogmus O, Günay Y, et al. An earplug technique to reduce the gag reflex during dental procedures. Forsch Komplementmed. 2022;21(2):94–viii. https://doi.org/x.1159/000362140.

    Article  PubMed  Google Scholar

22. Elbay M, Tak Ö, Şermet Elbay Ü, Kaya C, Eryılmaz G. The use of low-level light amplification by stimulated emission of radiation therapy for controlling the gag reflex in children during intraoral radiography. Lasers Med Sci. 2022;31(2):355–61. https://doi.org/10.1007/s10103-016-1869-z.

    Article  PubMed  Google Scholar

23. van Linden van den Heuvell GF, de Boer B, Ter Pelkwijk BJ, Bildt MM, Stegenga B. Gagging trouble cess: a re-evaluation. J Oral Rehabil. 2022;42(7):495–502. https://doi.org/10.1111/joor.12280.

    Article  PubMed  Google Scholar

24. Qu X, Xie H, Zhang Q, Zhou X, Shi Z. A survey on oral care practices for ventilator-assisted patients in intensive care units in 3A hospitals of mainland Communist china. Int J Nurs Pract. 2022;21(6):699–708. https://doi.org/10.1111/ijn.12282.

    Article  PubMed  Google Scholar

25. DeKeyser Ganz F, Fink NF, Raanan O, Asher K, Bruttin M, Nun MB, Benbinishty J. ICU nurses' oral-care practices and the electric current all-time evidence. J Nurs Scholarsh. 2009;41(2):132–viii. https://doi.org/10.1111/j.1547-5069.2009.01264.ten.

    Article  PubMed  Google Scholar

26. Hitz Lindenmüller I, Lambrecht JT. Oral intendance. Curr Probl Dermatol. 2022;40:107–15. https://doi.org/10.1159/000321060.

    Article  PubMed  Google Scholar

27. Özden D, Türk G, Düger C, Güler EK, Tok F, Gülsoy Z. Effects of oral care solutions on mucous membrane integrity and bacterial colonization. Nurs Crit Care. 2022;19(ii):78–86. https://doi.org/10.1111/nicc.12057.

    Article  PubMed  Google Scholar

28. Zhou XQ, He YR. The improvement of oral care fluid temperature in oral intendance application. Chinese Community Doctors. 2022;23:150. https://doi.org/x.3969/j.issn.1007-614x.2014.23.98.

    Article  Google Scholar

Download references

Acknowledgements

Not applicative.

Funding

This written report is supported past Nanjing Medical University, Jiangsu, China (Grant No. JX21831803/004); Jiangsu Commission of Wellness, China (Grant No. Z2018013). The authors declare that they have no financial relationship with the organizationthat sponsored the research, and the funding trunk was non involved instudy design, data collection, analysis and writing of the study.

Writer information

Affiliations

1. School of Nursing, Nanjing Medical University, 140 Hanzhong Road, Nanjing, 210000, Jiangsu, People's Commonwealth of Mainland china

   Yang Cheng, Yu-feng Zhou, Ya-ping Ding, Ying Xing, Enfang Shan & Hang Sun

Contributions

YC completed the statistical assay and wrote the draft of the paper. YZ designed the trial and participated as the research supervisor, edited and corrected the research manuscript. YD designed the trial and collected the data. YX collected the data and participated in statistical analysis. ES participated as the research supervisor, edited and corrected the enquiry manuscript. HS collected the data. All authors critically reviewed and approved the manuscript prior to submission. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yu-feng Zhou or Ya-ping Ding.

Ethics declarations

Ethics blessing and consent to participate

All participants volunteered for the written report, were informed about the telescopic of the study and provided written consent. The study was approved by the Local Committee for Research and Ethics in Health Research of Nanjing Medical University.

Consent for publication

Not applicative.

Competing interests

The authors declare that they have no competing interests.

Additional data

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Admission This commodity is licensed under a Creative Eatables Attribution four.0 International License, which permits utilize, sharing, adaptation, distribution and reproduction in any medium or format, as long as you requite appropriate credit to the original author(s) and the source, provide a link to the Artistic Commons licence, and signal if changes were made. The images or other third party material in this article are included in the commodity's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article'south Creative Eatables licence and your intended utilise is not permitted past statutory regulation or exceeds the permitted use, y'all will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/iv.0/. The Artistic Eatables Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Cheng, Y., Zhou, Yf., Ding, Yp. et al. Cleaning the palate and tongue without nausea: a mixed methods study exploring the appropriate depth and direction of oral care. BMC Oral Wellness 21, 67 (2021). https://doi.org/10.1186/s12903-021-01414-5

Download citation

• Received: 26 July 2022

• Accepted: 28 January 2022

• Published: 12 February 2022

• DOI : https://doi.org/10.1186/s12903-021-01414-five

Keywords

• Oral care
• Oral cleaning depth
• Oral cleaning direction
• Not-nausea

Source: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-021-01414-5

Posted by: poeinen1981.blogspot.com

Share this post