Effects of oral hygiene care on swallowing recovery in hospitalised patients with post-stroke dysphagia: a systematic review and meta-analysis.

Objective: To evaluate the effects of oral hygiene care on swallowing-related outcomes in hospitalised patients with post-stroke dysphagia (PSD).

Methods: A systematic literature search was conducted in MEDLINE, Embase, Web of Science, Scopus, CINAHL, CENTRAL and ClinicalTrials.gov up to May 2026. Randomised controlled trials (RCTs) and non-RCTs with a comparison group that reporting swallowing-related outcomes were included. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for non-RCTs. Where appropriate, meta-analyses were conducted using random-effects models to estimate mean differences (MDs), odds ratios (ORs) and risk differences (RDs) with 95% confidence intervals (CIs). The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Results: Nine studies, comprising 7 RCTs and two non-RCTs, were included, with risk-of-bias ratings ranging from low risk to some concerns for RCTs and moderate risk for non-RCTs. Oral hygiene care increased the odds of achieving independent oral intake compared with usual care (OR = 2.54, 95% CI, 1.80; 3.59; I2 = 0%), corresponding to a 13% absolute increase (RD = 0.13, 95% CI, 0.03; 0.23; I2 = 0%). Functional Oral Intake Scale (FOIS; scores 1-7), with higher scores indicating more independent and unrestricted oral intake, favoured oral hygiene care (MD = 0.40, 95% CI, 0.07; 0.72; I2 = 0%). Similarly, Gugging Swallowing Screen (GUSS; scores 0-20), assessing swallowing safety and dysphagia severity, favoured oral hygiene care (MD = 2.93, 95% CI, 1.01; 4.85; I2 = 0%). The certainty of the evidence for achieving independent oral intake was rated as high.

Conclusion: Oral hygiene care supports swallowing recovery in patients with PSD, particularly independent oral intake and should be considered an active component of dysphagia rehabilitation.