The interest in research on oral care in intensive care unit (ICU) patients has emerged largely from the 2000s onward after years of being a rather ignored topic in health science. Since, the focus has been on its potential contribution to preventing pneumonia by eliminating contaminated oral pathogens that might invade the lower respiratory tract. Accumulating evidence of the effectiveness of oral care with chlorhexidine gluconate (CHG) in preventing ventilator-associated pneumonia (VAP) or postoperative pneumonia [1,2] has led to adopting CHG oral care as the gold standard for intubated patients. Recently, however, potential adverse effects of CHG on the oral mucosa [3] and reduced bacterial susceptibility [4] have been reported, as well as an even more alarming potential association of CHG oral care with an increased risk of mortality [5][6][7][8]. Although the latter association results from retrospective studies or meta-analyses, righteous calls for caution and for a thorough re-evaluation of the established gold standard have been launched [9,10].It is not unlikely that the findings presented above could instigate questioning the safety of oral care in the ICU. Additionally, doubt could be casted on its value as the beneficial effect on the risk of VAP of other oral hygiene measures not involving CHG, such as swabbing and toothbrushing, is not supported by the evidence [11].Oral care does, however, not need to reduce the risk of pneumonia to be pivotal. As in healthy individuals, mouth care is an indispensable basic hygiene requirement for each ICU patient, intubated or not. Appropriate oral care counters discomfort caused by xerostomia, a sore mouth or ulcerated lips, and promotes oral health by preventing caries and decay of teeth, bacterial or candidal stomatitis, gingivitis, and periodontitis which has been associated with systemic diseases such as bacteraemia, rheumatoid arthritis and cardiovascular diseases, including stroke [12]. Oral health is therefore just as important an endpoint of oral care as VAP prevention. A potential risk reduction in pneumonia should rather be considered as a favourable side effect of oral care and not as the primary goal.Moreover, oral care aiming at oral health does not necessarily involve CHG use. Toothpaste and an appropriate brush adequately clean teeth and gums. The oral cavity can be cleansed mechanically and/or chemically with non-CHG containing mouthwashes, and saliva substitutes, stimulants and moisturizing gels are not CHGbased [13]. There are no substantiated arguments to question the legitimacy of oral care for safety concerns due to potential CHG-associated harm.The above plea for proper daily oral care may not seem to leave room for doubting the viewpoint that less daily oral care in the ICU could be more. However, there are no evidence-based standards available to date that define the interventions, methods and frequency to provide ICU patients with optimal oral health. In the clinical environment, this lack of evidence is reflected by a huge variety of pra...