Survey on the Issues and the Changes of Oral Health Condition of Inpatients in the Intensive Care Unit

Abstract

Abstract:The aim of this study was to consolidate oral health management systems in the acute stages. The practical status of oral health in perioperative patients and improvements achieved through coordinated oral health care were investigated. Subjects of the present study were 87 patients who underwent oral intubation in the intensive care unit (ICU). These patients attended an oral health care center from October 2010 to March 2011. Dentists rated the oral status of subjects within 24 h of admission to the ICU on a three-point scale by assessing the lips, teeth, mucous membrane, gingiva, tongue, and saliva. In addition, the number of Candida colonies detected on the tongue was noted at initial assessment. At initial assessment, 70% of participants with respiratory diseases were classifi ed as having oral problems. However, few subjects showed presence of dental plaque or reported problems involving the mucous membrane. The proportion of Candida-positive participants was higher in those with respiratory diseases than those with cardiovascular diseases. When comparing the Candida-positive and -negative subjects, a greater proportion of the former had problems with the lips, saliva, mucous membrane, and tongue. With regard to the time-dependent changes recorded on these problems, improvement in the condition of the lips tended to occur earlier than the conditions of the tongue. As it has been suggested that maintaining a clean tongue can be critical in patients undergoing oral intubation, it is important to continue appropriate oral health care in the acute stages.

Factor Analysis on Onset of Ventilator-Associated Pneumonia for Inpatients in the Intensive Care Unit

“…When xerostomia was present, it has been said that the risk of pneumonia increased, normal bacterial flora of the oral cavity, such as candida, also increased, as well as the changes in oral bacterial flora (Fields, 2008). It has also been reported that because orally intubated patients continue to have their mouths open, xerostomia often occurs (Ooka et al, 2013;2012). For this reason, pathogenic bacteria, including bacteria that causes pneumonia increase because of xerostomia and are thought to be related to occurence of VAP through the intubation tube.…”

“…The disease names of the control subjects were extracted from the hospital medical records. Based on the criteria of preceding studies, we classified the principal diseases into four groups: Cerebrovascular diseases; pulmonary diseases; gastrointestinal diseases; and circulatory diseases (Ooka et al, 2013;2012). Subject attributes and representative principal diseases are shown in Table 1.…”