A review of 15 RCTs (n=10,742) found toothbrushing was associated with a significantly lower risk of hospital acquired pneumonia (HR 0.67, 95%CI 0.56-0.81), ICU (intensive care unit) mortality (0.81, 0.69-0.95), & reduction in mechanical ventilation (-1.24 days, -2.42 to -0.06 days) vs no toothbrushing (1):
- findings suggest that daily toothbrushing may be associated with lower rates of pneumonia and ICU mortality, particularly among patients undergoing invasive mechanical ventilation; programs and policies to encourage daily toothbrushing are warranted
A related commentary notes extensive data from epidemiological, microbiological, and molecular studies have established a link between the oral microbiome, oral health, dental plaques, and periodontal disease and the development of pneumonia (2)
- therefore, rigorous oral care is recommended to prevent hospital acquired pneumonia
- suggests this study provides an important contribution to infection prevention and reinforces the notion that routine toothbrushing is an essential component of standard of care in ventilated patients
- notes that there is still uncertainty regarding non-ventilated patients, as the results were not statistically significant in that subgroup
Reference:
- Ehrenzeller S, Klompas M. Association Between Daily Toothbrushing and Hospital-Acquired Pneumonia: A Systematic Review and Meta-Analysis. JAMA Intern Med. Published online December 18, 2023. doi:10.1001/jamainternmed.2023.6638
- Datta R. Daily Toothbrushing to Prevent Hospital-Acquired Pneumonia - Brushing Away the Risk. JAMA Intern Med. Published online December 18, 2023. doi:10.1001/jamainternmed.2023.6807