Pneumonia rates in ICU can be halved by cleaning teeth

Two sets of researchers found cleaning the teeth of intubated ICU patients at least twice a day could slash their risk of developing ventilator-related pneumonia (VAP) by half.

In one study, due to be published in the Journal of Intensive Care Medicine, US nurse specialists assessed the impact of a regimen of twice-daily brushing for one minute followed by the application of mouthwash at a 24-bed ICU unit.

At the end of a year, the researchers found that incidence of ventilator-related pneumonia had dropped from 5.2% (24 cases) to 2.4% (10 cases) – a drop of 46%.

Since the study, the nurses have continued the regimen in the ICU and the VAP rate has remained at 2.4% or lower, the researchers said.

‘The study clearly demonstrates the importance of regimented dental hygiene in reducing VAP in the ICU,’ they said.

A second as-yet unpublished study, involving ICUs in Israel, found that brushing teeth three times a day could reduce the onset of VAP by up to 50%, without the use of mouthwash.

‘Sometimes, however, doctors and nurses do everything right and the patient still gets pneumonia,’ the Israeli authors acknowledged.

‘But this approach will certainly improve the odds for survival,’ they added.

A small study, published in 2004 by the GKT Dental Institute at King’s College, London, in the journal Intensive and Critical Care Nursing, suggested that the majority of UK nurses saw oral hygiene in ICU as a priority.

Toothbrushes were used at least once a day by 85.5% of critical care nurses and chlorhexidine mouthwash products were used routinely by 50.5% of the 103 survey respondents.

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