Removability of a Newly Developed Oral Care Gel to Simulated Dry Phlegm and Debris

Objectives: Some dependent older adults have a lot of dry phlegm and debris leading to the presence of bacteria firmly adhered to the oral and pharyngeal mucosa. This must be removed completely and safely to maintain oral hygiene and general health. We developed a new oral care gel, Okuchi-Wo- Arau-Gel® (OG) that softens dry phlegm and debris allowing them to be removed easily and safely. The aim of this study was to evaluate the removability of simulated dry phlegm and debris in vitro using the OG.<br> Methods: In this experiment, standardized bovine thrombus (test soil) was used as simulated dried sputum or residue to compare the ability of OG and three commercial gels, Viva-Jellwet® (VJ), Refrecare® (RC), and Biotene OralBalance® gel (BT), to remove bovine thrombus. The test soil was covered with 0.5 mL of each gel, which was suctioned with a probe 1 min after (Experiment I) and 10 min after (Experiment II), spreading. The test soils were photographed with a digital camera and the digital images were analyzed in Photoshop. The pixel numbers of test soil were compared after suctioning, and a decrease in pixels was calculated as the removal value. Additional apparent viscosity and pH experiments were performed to confirm the physical properties of the research gels.<br> Results and discussion: The OG and VJ had a significantly higher removal value than the other gels in Experiment I. The OG had a significantly higher removal value than the other gels in Experiment II. The apparent viscosity of the OG and VJ was significantly lower than that of RC and BT. The pH of the gel ranged from 6.19 to 7.15. The OG and VJ retained more water than RC and BT and penetrated the test soils more easily. Additionally, the OG component had a higher removal rate in the test soils than VJ because it contained a surfactant.<br> Conclusions: In this in vitro study, the OG exhibited a greater ability to remove test soils compared with VJ, RC, and BT. The results indicate that the OG and VJ might be more effective than other gels at removing dry phlegm and debris from the oral and pharyngeal mucosa, whereas RC and BT have better anti-evaporation properties. We think that selecting gels by purpose is one way to improve the quality of oral care.