Dental Care Reduces Respiratory Infections in ICU

By Jane Farrell

Research done in Brazil and published in the November 2014 issue of Infection Control and Hospital Epidemiology, found that vulnerable patients in the Intensive Care Unit (ICU) who received enhanced oral care from a dentist were at significantly less risk for developing a lower respiratory tract infection (LRTI) such as ventilator-associated pneumonia, during their stay.

A release from the Society for Healthcare Epidemiology of America (SHEA) quotes lead author Fernando Bellissimo-Rodrigues, MD as saying, “Bacteria causing healthcare-associated infections often start in the oral cavity. 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 release explain that the Brazilian researchers utilized 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 to receive routine oral hygiene performed by the ICU nurse staff.

Enhanced dental care included teeth brushing, 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 percent less likely to develop a respiratory tract infection during their ICU stay compared to the control patient group. Researchers note 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.