Changes in bacterial number at different sites of oral cavity during perioperative oral care management in gastrointestinal cancer patients: preliminary study

Abstract

Objective The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery.Material and Methods We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices. Specifically, patients received professional tooth cleaning (PTC), scaling, tongue cleaning, and self-care instruction regarding tooth brushing from a dental hygienist a day before the operation. Professional oral health care was also performed by a dental hygienist two and seven days after surgery. Oral bacteria numbers were determined using a bacterial counter with a dielectrophoretic impedance measurement method.Results The number of bacteria at all three examined sites were significantly higher in the open surgery group when compared to the laparoscopic surgery group on the second postoperative day. Relevantly, bacterial count in samples from the gingiva of the upper anterior teeth remained greater seven days after the operation in patients who underwent open surgery. Furthermore, the dry mouth index level was higher in the open surgery group when compared to the laparoscopic surgery group on postoperative days 2 and 7.Conclusions Even with regular oral health care, bacterial numbers remained high in the upper incisor tooth gingiva in gastrointestinal cancer patients who received open surgery. Additional procedures are likely needed to effectively reduce the number of bacteria in the gingival area associated with the upper anterior teeth.

Perioperative changes in oral bacteria number in patients undergoing cardiac valve surgery

“…In contrast, the bacteria count on the tongue surface was persistently high and did not remarkably vary throughout the perioperative period. Our results are consistent with those of previous reports [19,20]. Sachdeo et al reported that bacteria counts were highest on the dorsal surface of the tongue and lowest on the labial vestibules and palate in edentulous older adults [25].…”

“…The bacteria numbers on the tooth surface and buccal vestibule returned to baseline values 4 days after surgery, when patient consciousness was presumably higher and oral feeding was restarted in the absence of severe postoperative complications. Kawano reported that oral bacteria increased 2 days after surgery in patients with gastrointestinal cancer [19], which was consistent with the present study. Findings of postoperative oral bacteria increase also support the results of previous reports regarding the effect of perioperative oral management on reduction of postoperative infections [22,23].…”

“…Although recent reports have described the importance of perioperative oral hygiene management, quantitative changes in oral bacteria remain unclear. One study reported an increase in oral bacteria in gastrointestinal cancer patients submitted to open surgery [19], but little is known about oral bacteria count changes in patients submitted to heart surgery, who have a greater likelihood of extended endotracheal intubation. In this study, 1) changes in oral bacteria count during the perioperative period in patients receiving heart valve surgery and 2) differences in bacteria counts between such patients with endotracheal intubation and after extubation were examined.…”

Detection of oral bacteria on the tongue dorsum using PCR amplification of 16S ribosomal RNA and its association with systemic disease in middle-aged and elderly patients

“…Additionally, dry mouth is common among the elderly, and it may lead to oral diseases including dental caries, oral candidiasis and swallowing disorders (3). Importantly, oral health care can aid to remove dental plaques, moisturize the oral cavity, relieve mucosal inflammation, and promote oral hygiene by reducing oral bacterial numbers (2,4). Thus, regular oral care serves a vital role in the maintenance of oral health, which may result in a decreased risk of systemic disease in elderly subjects.…”

The Effectiveness and Impact of Preoperative Dental Hygiene Care on the Incidence of Postoperative Pneumonia after Esophagectomy: An Interventional Prospective Study

“…These swab samples were processed using a Bacterial Counter (Panasonic Healthcare Co., Ltd., Tokyo, Japan) according to the manufacturer's instructions. This device measures the dielectrophoretic impedance in the aqueous medium washing the cotton swab to quantify the amount of microbes trapped in the cotton swab (14,15). If possible, this quanti cation of the oral cavity microbial load was repeated three times for each patient: the rst and the second samples were retrieved before and immediately after oral hygiene care, and the third was retrieved in the early hours of the day the surgery was performed.…”