Oral sponges or foam swabs are used to maintain oral hygiene in hospital and long-term care patients who cannot tolerate brushing with a regular toothbrush.¹ This includes patients undergoing cancer treatment, patients who are intubated, the elderly, and people at risk for bleeding in the mouth.^1-3 Concerns about the effectiveness of foam swabs in these patient populations have been expressed.^1-3 Additionally, safety concerns pertaining to the use of oral sponges have been noted in the literature^1,4,5 and contributed to the rationale for a Canadian study on patients in long-term care.⁴ Members of the research group had made note of two critical incidents that demonstrated the choking hazard risk associated with the use of sponge swabs. In these incidents, the sponge end of the swab had separated from the stick and dropped to the back of the patient’s throat. The choking hazard presented with foam swabs was also described in a medical device alert from the UK government.⁵ It was stated that the alert was to take effect in May 2012 after a patient died from choking after the foam head of an oral swab detached from the stick.

The purpose of this report is to evaluate the clinical effectiveness, cost-effectiveness, and guidelines for the use of soft toothbrushes compared to foam swabs for oral care in hospitals, residential care, or group home populations.