Fig. 1

Flow diagram. The patients received daily oral care during the following week. Matching transformation system (MA-T) gel: Oral care is provided daily by nurses using MA-T gel. Control: Oral care with water was provided daily. Daily oral care included tooth brushing twice daily by the nurses. Dental hygienists provided professional oral care. First, the total oral bacterial count, opportunistic bacterial count, and oral moisture score were measured (before). The oral cavity was gently swabbed with a sponge brush soaked in water. After swabbing, the total oral bacterial count and oral moisture score were measured (swabs). Furthermore, MA-T gel or water is applied to the lips, tongue, palate, and buccal mucosa once and cleaned using tufts and interdental brushes. After assisted brushing of the teeth, membranous material was removed using tweezers and gauze. Finally, the total oral bacterial count and oral moisture score were measured (Care). The MA-T gel was applied to the tongue and buccal mucosa. Thus, professional oral care consists of “assisted tooth brushing + removal of exfoliated epithelial film + application/no application of MA-T gel.”