Ventilator-associated pneumonia and oral health

Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial

“…Our first hypothesis is that oral antisepsis may be effective only if used by patients with good oral health status because large microbial populations present in dental plaque and periodontal pockets are inaccessible to topical antiseptics, and this explains why chlorhexidine was more effective in patients undergoing elective cardiac surgery and practicing meticulous oral hygiene than in critical patients, who are usually intubated in an emergency situation and have poor oral health status. Therefore, we believe that good oral hygiene should be practiced by critical patients to promote the microbicidal activity of the antiseptic applied to the oral cavity. In this clinical trial, dental treatment prevented approximately 56% of lower RTIs compared with the control group (adjusted relative risk, 0.44; 95% confidence interval, 0.20–0.96; P = 0.04), as previously reported.…”

“…It is assumed that, in most cases, RTIs begin with the colonisation of the lower respiratory tract by pathogenic bacteria from the oral cavity, and an important risk factor for RTIs is poor oral health. A pioneering study conducted by our research group demonstrated that dental treatment performed by a dentist in a general ICU was effective in preventing lower RTIs.…”

Effectiveness of a Dental Care Intervention in the Prevention of Lower Respiratory Tract Nosocomial Infections among Intensive Care Patients: A Randomized Clinical Trial

“…In this sense, poor oral health and poor oral hygiene are considered relevant risk factors for nosocomial LRTI. 9,10 Despite being supported by a strong rational logic, oral antisepsis as a preventive measure against LRTI has yielded figure 1. Flowchart of inclusion process in the study.…”