New oral hygiene care regimen reduces postoperative oral bacteria count and number of days with elevated fever in ICU patients with esophageal cancer

Abstract

Using a controlled pre/post study design, we investigated the effects of professional mechanical cleaning of the oral cavity with benzethonium chloride, interdental brushes, and hydrogen peroxide on the number of oral bacteria and postoperative complications among esophageal cancer patients in an intensive care unit. Before surgery, 44 patients with esophageal cancer were recruited at Okayama Hospital from January through August 2015. The control group (n = 23) received routine oral hygiene care in the intensive care unit. The intervention group (n = 21) received intensive interdental cleaning with benzethonium chloride solution and tongue cleaning with hydrogen peroxide. The number of oral bacteria on the tongue surface and plaque index were significantly lower in the intervention group than in the control group on postoperative days 1 and 2 (P < 0.05). Additionally, the number of days with elevated fever during a 1-week period was significantly lower in the intervention group than in the control group (P = 0.037). As compared with routine oral hygiene, a new oral hygiene regimen comprising benzethonium chloride, interdental brushes, and hydrogen peroxide significantly reduced the number of oral bacteria and days with elevated fever in patients with esophageal cancer.

Relationship between acetaldehyde concentration in mouth air and characteristics of microbiota of tongue dorsum in Japanese healthy adults: a cross-sectional study

“…A rapid bacterial detection apparatus (PHC Holdings Co., Ltd., Tokyo, Japan) that consisted of the elements necessary for dielectrophoretic impedance measurement (DEPIM) was used. 15 , 16 These elements included an electrode chip to capture bacteria, a cell-retaining sample solution, an alternating current circuit for dielectrophoresis, and an impedance measurement circuit. Measurement was initiated by placing the sample solution (approximately 5 mL) and electrode chip inside the device and pressing a button.…”

“… 15 The collection pressure was about 21 g, and a 1-cm span was sampled by rubbing the swab back and forth three times. 16 …”

Quasi-Randomized Trial of Effects of Perioperative Oral Hygiene Instruction on Inpatients with Heart Diseases Using a Behavioral Six-Step Method

“…Sample size was estimated assuming a 1.0 × 107 (SD, 1.3 × 107) cfu/mL or greater reduction in the numbers of oral bacteria on the tongue in the intervention compared with the control group [16]. Based on the data, we determined that 28 inpatients per group would be necessary to provide 80% power with an alpha of 0.05 in two-tailed and unpaired t-tests.…”

“…Postoperative, professional oral hygiene care can reduce the number of oral bacteria on the tongue [16], the numbers of oropharyngeal bacteria [17], and complications such as pneumonia [18]. On the other hand, self-care as well as professional care are needed to improve postoperative oral hygiene status, which contributes to complications.…”

Prevalence of Tongue Cleaning Using a Toothbrush: A Questionnaire Survey in Fukui Prefecture, Japan

“…In hospitalized patients, infectious complications, such as ventilator-associated pneumonia (VAP) and surgical site infection, sometimes lead to critical conditions [4][5][6]. Some studies have suggested that oral care, including tongue cleaning, could reduce those complications, and that oral care improving the quality of patient care was economically viable [4][5][6]. Also, Tajima et al reported that tongue cleaning was also useful for elders fed with a feeding tube because it could decrease the number of microbes on the tongue surface [7].…”