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Oral health status of children in a Paediatric Intensive Care Unit
D Franklin1, N Senior, I James
1Great Ormond Street Hospital for Children NHS Trust, London, UK.
Insights
The current mouth care for critically ill children in the Paediatric Intensive Care Unit (PICU) is ineffective. This leads to increased plaque and gingival inflammation, posing risks for oral and systemic health.
Area of Science:
- Pediatric Intensive Care
- Dental Health
- Critical Care Medicine
Background:
- Critically ill children in Paediatric Intensive Care Units (PICUs) require specialized care, including oral hygiene.
- The effectiveness of standard mouth care protocols in this vulnerable population is not well-established.
- Poor oral health in critically ill patients can lead to local and systemic complications.
Purpose of the Study:
- To assess the dental status of children admitted to a Paediatric Intensive Care Unit (PICU).
- To evaluate the efficacy of the existing mouth care regimen in preventing dental issues.
- To identify potential risks associated with inadequate oral hygiene in critically ill children.
Main Methods:
- A prospective, nonrandomized study was conducted.
- 54 children admitted to the PICU were assessed for dental caries, plaque, gingival inflammation, and bleeding on admission and discharge.
- Statistical analysis included one-sample t-tests for caries and paired sample t-tests for plaque and gingival parameters.
Main Results:
- A highly significant increase in plaque accumulation (p = 0.001) was observed between admission and discharge.
- A significant increase in gingival inflammation (p = 0.006) was also noted during the PICU stay.
- No significant changes in dental caries were reported compared to national surveys.
Conclusions:
- The current mouth care regimen in the studied PICU is insufficient to prevent plaque buildup.
- The existing protocol fails to maintain adequate gingival health in critically ill children.
- These findings suggest that critically ill children in PICUs are at increased risk of complications due to poor oral hygiene.
Objective:
The aim of the present study was to examine the dental status of critically ill children in a Paediatric Intensive Care Unit (PICU) and determine the efficacy of the mouth care received.
Design:
Prospective nonrandomized study.
Setting:
The study was carried out in the PICU at Great Ormond Street Hospital for Children.
Patients And Participants:
All children admitted to the PICU during the period of the study were eligible for inclusion. A total of 54 children completed the study.
Measurements And Results:
Children were examined for dental caries, plaque accumulation, gingival inflammation and gingival bleeding on admission to the PICU. The examination was repeated on discharge from the Unit. The levels of dental caries found on examination were compared with results from the most recent national surveys carried out in the United Kingdom, and analysed using the one sample t-test. The levels of plaque accumulation, gingival inflammation and gingival bleeding on admission were compared to those on discharge and analysed using the paired sample t-test. Results revealed a very highly significant increase in plaque accumulation (p = 0.001), and a highly significant increase in gingival inflammation (p = 0.006) between admission to the PICU and discharge.
Conclusions:
Results indicate that the present mouth care regimen is not effective in preventing the build up of plaque or maintaining gingival health. These children may therefore be at unnecessary risk from local or systemic spread of oral microorganisms.