Effects of sodium bicarbonate solution on tongue coating and oral hygiene in patients with heart failure: a randomized controlled trial.

BACKGROUND: So far, the impact of sodium bicarbonate solution on the oral health status of patients with chronic heart failure has not been comprehensively investigated.This study aims to evaluate the effectiveness of sodium bicarbonate solution gargling in improving the tongue coating, oral hygiene, and oral health status of patients with heart failure. METHODS: This prospective, randomized, controlled, single-blind study included 108 heart failure patients, randomly assigned to three groups (n = 36 each).Group A received standard oral hygiene care and underwent monitoring for 7 days. Group B received standard oral hygiene care plus twice-daily gargling with 5% sodium bicarbonate solution (once in the morning and once before bedtime) for 7 days. Group C similarly received standard oral hygiene care but performed gargling five times daily (upon waking, before bedtime, and within 30 min after each meal) for the same duration. The evaluation focused on tongue coating status, oral bacterial colony count, oral plaque index scores, and overall oral health status. RESULTS: During the first three days of the intervention, there were no significant differences in Winkel tongue coating index among groups A, B, and C (P > 0.05). However, from the fourth day onwards, the Winkel tongue coating index in groups B and C was significantly lower than that in group A (P < 0.05). By the sixth day, group C demonstrated significantly greater reduction in Winkel Tongue Coating Index scores compared to Group B (P < 0.05). On the seventh day of the intervention, statistically significant differences were observed in the number of oral bacterial colonies and dental plaque index among groups A, B, and C (P < 0.05). Significant differences in Beck Oral Assessment scores were observed among all three groups (A, B, and C) throughout the 7-day intervention period (P < 0.05). CONCLUSIONS: sodium bicarbonate solution improves tongue coating, oral hygiene, and overall oral health in HF patients with good tolerability and safety. TRIAL REGISTRATION: This study was retrospectively registered in the Chinese Clinical Trial Registry, Registration number ChiCTR2400094457. Reg Date20241223.