Toothbrushing to reduce ventilator-associated pneumonia pathogens and dental plaque in a critical care unit

shutterstock_77733628-powered toothbrush

Ventilator-associated pneumonia (VAP) is a life-threatening condition in critically ill patients receiving mechanical ventilation. The incidence of VAP in varies between 9% and 45%  with mortality rates of up to 50% . It is accompanied by an increase both in length of stay in intensive care units ICU and healthcare.

The aim of this trial was to investigate the effect of a powered toothbrush on colonization of dental plaque by ventilator-associated pneumonia (VAP)-associated organisms and dental plaque removal.

The study  was a  parallel-arm, single-centre, examiner- and analyst-masked randomized controlled trial. Patients were recruited within 48-hrs of admission. The test group had oral hygiene performed by a nurse with a powered toothbrush with the  control group using a sponge toothette. This was conducted 4-times per day for 2-minutes  with groups receiving 20 ml, 0.2% chlorhexidine mouthwash at each time point.

They found:-

  • A low prevalence of respiratory pathogens throughout with no statistically significant differences between groups
  • A highly statistically significantly  reduction in dental plaque was produced by the powered toothbrush compared with the control treatment

[table id=5 /]


They concluded:-

Powered toothbrushes are highly effective for plaque removal in intubated patients in a critical unit and should be tested for their potential to reduce VAP incidence and health complications.

Needleman IG, Hirsch NP, Leemans M, Moles DR, Wilson M, Ready DR, Ismail S,Ciric L, Shaw MJ, Smith M, Garner A, Wilson S. Randomized controlled trial of toothbrushing to reduce ventilator-associated pneumonia pathogens and dental plaque in a critical care unit. J Clin Periodontol. 2011 Mar;38(3):246-52. doi:10.1111/j.1600-051X.2010.01688.x. Epub 2011 Jan 11. PubMed PMID: 21223352.

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –