Prevention of Healthcare-Associated Pneumonia with Oral Care in Individuals Without Mechanical Ventilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

This analysis suggests a preventive effect of oral care on pneumonia in nonventilated individuals. This effect, however, should be interpreted with caution due to risk of bias in the included trials.

The Effect of Ozonated Water and Chlorhexidine Gluconate on Prevention of Ventilator-Associated Pneumonia: A Double-Blind, Randomized, Clinical Trial

“…As the oral cavity is in contact with the lower airways of the trachea, the oral secretion causes the transfer of colonized bacteria in the mouth to the lower airways, which results in infection and pneumonia (8,9). The results of the current study showed that lack of adequate care of the mouth leads to dry mucosa of the mouth, reduced salivary flow, inflammation of the oral mucosa, and colonization of pathogenic bacteria in the mouth and oropharynx (10,11).…”

The impact of hospitalization on periodontal health status: an observational study

“…In addition to the aggravation of periodontal disease, there is a bidirectional causality between some diseases of the oral cavity and systemic morbidities, such as cardiovascular and respiratory diseases 11,13,[25][26] . The presence of oral biofilm in these patients could trigger an inflammatory response, causing a significant increase in the quantity of immunoglobulin and circulating chemical mediators of inflammation.…”

“…This scenario is true for many hospitals 27-29 , both public 2-4 and private 3,8 , due to the scarcity of trained professionals able to get involved in promoting oral healthcare. The training of professionals is a successful practice for reducing infections acquired in hospitals, because they prevent the accumulation of bacterial biofilm and the development of periodontal diseases [26][27][28] .…”

“…The academic training of professionals for insertion into the team of hospital professionals would be beneficial for patients and professionals 29 . Moreover, investment in the implementation of oral healthcare protocols is a measure that should be put in place in hospitals 4,8,[25][26][27][28][29] .…”

“…This could have a positive impact on morbidity, mortality, time and cost of hospitalization 27, [29][30] . The use of mechanical tooth brushing, oral antiseptics and antimicrobials has been shown to modulate the oral microenvironment and reduce the impact of hospitalization on the oral health of patients [25][26]28 .…”