Related Experiment Video
Updated: Jun 2, 2026
08:47
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Evidence to support tooth brushing in critically ill patients
1Clinical Center, National Institutes of Health in Bethesda, Maryland 20892, USA. names@nih.gov
Summary
Tooth brushing for critically ill patients on mechanical ventilation shows limited evidence of preventing pneumonia. Further research is needed to evaluate the true effectiveness of this oral care intervention.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Oral Health
Background:
- Oral care is increasingly emphasized in critical care settings.
- An association exists between oral bacteria and respiratory pathogens causing pneumonia.
- Aspiration of oral pathogens is a plausible mechanism for ventilator-associated pneumonia (VAP).
Purpose of the Study:
- To review the evidence supporting tooth brushing effectiveness in critically ill adults and children on mechanical ventilation.
- To discuss potential reasons for the lack of demonstrated benefit in clinical trials.
- To suggest recommendations for future research in this patient population.
Main Methods:
- Systematic review of existing literature on tooth brushing in mechanically ventilated patients.
- Analysis of studies investigating the impact of oral care interventions on VAP incidence.
- Discussion of clinical trial outcomes, including early termination due to lack of efficacy.
Main Results:
- Limited clinical evidence currently supports the effectiveness of tooth brushing in reducing VAP.
- A recent trial using a powered toothbrush was stopped early due to a lack of effect.
- The review highlights the need for careful evaluation of the evidence base.
Conclusions:
- The current evidence base for tooth brushing as a standard of care in critically ill patients is weak.
- Further high-quality trials are necessary to definitively establish the efficacy of tooth brushing in preventing VAP.
- Emphasis on oral care must be supported by robust scientific evidence.
Related Concept Videos
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
01:19Handwashing II: Pre-procedure and Initial Procedure Steps
The pre-procedure steps of handwashing include removing jewelry and rolling up sleeves. However, many organizations allow staff to wear wedding rings.
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail paint...
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail paint...
01:15Handwashing III: During the Procedure and Post-Procedure Steps
To wash hands properly, follow these steps:
01:27The Oral Microbiota
The oral microbiome includes a complex ecosystem comprising over 700 microbial species, identified through genomic sequencing and culture-based analyses to date. This community includes a core microbiome, found universally among individuals, and a variable component influenced by environmental factors such as diet, lifestyle, and host genetics. Site-specific conditions, including oxygen gradients, pH levels, and nutrient availability, determine the spatial distribution of these microorganisms...
01:23Tracheostomy Suctioning II: Procedure
Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
01:21Tooth Anatomy
The human tooth enables us to eat a variety of foods, speak clearly, and even aid in shaping our faces. Teeth are composed of various elements that work together. Here's a detailed look at the anatomy of a human tooth.
The Crown, Neck, and Root
The visible part of the tooth is referred to as the crown. It's covered by enamel, the hardest substance in the human body. The crown is uniquely shaped for each type of tooth, allowing for different functions such as cutting, tearing, or grinding food.
The Crown, Neck, and Root
The visible part of the tooth is referred to as the crown. It's covered by enamel, the hardest substance in the human body. The crown is uniquely shaped for each type of tooth, allowing for different functions such as cutting, tearing, or grinding food.