Oral health status and care among hospitalised children: a prospective cohort study comparing admission and discharge

Children hospitalised for acute or chronic illnesses often experience a decline in oral health, an aspect frequently neglected in inpatient care. Factors such as medication use, dietary alterations, and interruption of regular hygiene routines can adversely affect oral conditions, emphasising the need for structured preventive measures. This study aimed to investigate the impact of hospitalisation on paediatric oral health by comparing oral hygiene behaviours and clinical parameters at admission and discharge, and by assessing the degree of attention given to oral care during the hospital stay. Children aged 0–17 years, admitted between November 2023 and April 2025 to all hospital wards of the IRCCS Istituto Giannina Gaslini Children’s Hospital (Genoa, Italy), hospitalised for more than three nights, were consecutively enrolled. Patients hospitalised in emergency and/or for dental reasons were excluded. Caregivers completed a structured questionnaire on medical history, diet, and oral hygiene practices. Three dental practitioners conducted standardised oral examinations (Decayed, Missing and Filled Teeth Index, Plaque Index, Modified Gingival Index, Index of Orthodontic Treatment Need, salivary pH, general assessment) at admission and discharge. At discharge, a second questionnaire explored the course of hospitalisation. 559 patients were enrolled. 90% of the patients (n = 503) completed both the admission and discharge oral examinations. A significant increase in the Plaque Index (p = 0.012) and Modified Gingival Index (p = 0.027) was observed, particularly among children aged 1–5 years. Oral hygiene practices significantly worsened in terms of frequency and use of hygiene aids (p < 0.001). Conversely, an improvement was found in subjective oral pain (p < 0.001) and in dietary habits, with a reduced intake of cariogenic beverages (p < 0.001) and foods, even if for the latter statistical significance was borderline (p = 0.051). The findings indicate that hospitalisation represents a sensitive period during which oral health is particularly at risk. It is essential to raise awareness among caregivers and hospital staff to help children maintain adequate oral hygiene throughout their stay. Moreover, hospitalisation should be regarded as a valuable opportunity to identify pre-existing oral health problems and to educate both patients and caregivers on preventive oral care.