Vulnerable patients in hospital intensive care units (ICUs) who received enhanced oral care from a dentist were at significantly less risk for developing a lower respiratory tract infection, such as ventilator-associated pneumonia, during their stay, according to a new study in Infection Control and Hospital Epidemiology (October 2, 2014).
"Bacteria causing healthcare-associated infections often start in the oral cavity," lead study author Fernando Bellissimo-Rodrigues, MD, said in a statement. "This study suggests that having a dentist provide weekly care as part the ICU team may improve outcomes for vulnerable patients in this setting."
Brazilian researchers used an observer-blind randomized clinical trial design to analyze data from 254 adult patients who stayed in a general ICU for at least 48 hours. Patients were randomized to receive enhanced dental care provided by a dentist or receive routine oral hygiene performed by the ICU nurse staff.
Enhanced dental care included toothbrushing, tongue scraping, removal of calculus, atraumatic restorative treatment of caries, tooth extraction, and topical application of chlorhexidine corresponding to each patients' needs four to five times a week. Comparatively, regular treatment consisted of mechanical cleansing using gauze followed by topical application of chlorhexidine three times a day.
Patients provided enhanced dental care were 56% less likely to develop a respiratory tract infection during their ICU stay compared with the control patient group, the study authors concluded. The researchers noted that enhanced dental treatment, including oral antisepsis, routinely performed in ICUs could be more effective in reducing the oral bacteria and help prevent migration of these bacteria into the lungs.
