Association of dry tongue to pyrexia in long-term hospitalized patients

Background: The oral care of hospitalized elderly patients is thought to have a preventive effect on aspiration pneumonia, which is one of the main causes of fever. Although the decreased secretion of saliva is frequently observed in elderly people, no study has examined how a dry oral cavity affects aspiration. Objective: This study was performed to assess the association of dry tongue to pyrexia. As the main outcome measure, pyrexia of hospitalized patients with dry tongue was adjusted for dysphagia and other variables. Methods: We performed a 6-month cohort study on 106 hospitalized patients. Tongue dorsum moisture was measured using a simple method with a membrane filter (L-Salivo®) at baseline examination. Dysphagia and other covariates which could cause fever were also examined. Pyrexia of the subjects during the 6-month study period was analyzed with baseline data of dry tongue adjusted for dysphagia and other variables. Results: Patients with a dry tongue (odds ratio 5.76; 95% confidence interval 1.72-19.30; p = 0.005) and those with severe dysphagia (odds ratio 19.47; 95% confidence interval 5.13-73.88; p < 0.0001) had an increased risk of having ≥2 febrile days in multivariate analysis. Conclusion: The result suggests that a dry tongue dorsum is a significant risk factor for pyrexia, independent of dysphagia. Checking for a dry tongue and dysphagia can be useful for identifying patients who need intensive oral care.