Enhanced dental care lowers risk of respiratory infections in ICU patients

by Bruce Sylvester: Intensive Care Unit (ICU) patients receiving enhanced oral care from a dentist have a significantly lower risk of developing a lower respiratory tract infection (LRTI), like ventilator-associated pneumonia, during their hospitalization, researchers reported in the November issue of Infection Control and Hospital Epidemiology.

“Bacteria causing healthcare-associated infections often start in the oral cavity,” said lead author Fernando Bellissimo-Rodrigues, MD, PhD, Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo in Brazil. “This study suggests that having a dentist provide weekly care as part the ICU team may improve outcomes for vulnerable patients in this setting.”

The investigators enrolled 254 adult patients who stayed in a general ICU for at least 48 hours. They randomized the subjects to enhanced dental care provided by a dentist or to routine oral hygiene performed by the ICU nurses.

Enhanced dental care took place 4 to5 times a week, according to individual needs. It included teeth brushing, tongue scraping, removal of calculus, atraumatic restorative treatment of caries, tooth extraction and topical application of chlorhexidine.

Regular treatment took place 3 times a day and included mechanical cleansing using gauze and topical application of chlorhexidine.

The investigators reported that subjects who had received dental care were 56 percent less likely to develop a respiratory tract infection during their ICU stay compared to those who received regular dental care.

The researchers concluded that enhanced dental treatment routinely performed in ICUs reduce oral bacteria and help prevent migration of such bacteria to the lungs.