Literature DB >> 29777534

Is it necessary to have a dentist within an intensive care unit team? Report of a randomised clinical trial.

Wanessa Teixeira Bellissimo-Rodrigues1, Mayra Gonçalves Menegueti2, Gilberto Gambero Gaspar2, Hayala Cristina Cavenague de Souza3, Maria Auxiliadora-Martins4, Anibal Basile-Filho4, Roberto Martinez1, Fernando Bellissimo-Rodrigues2,3.   

Abstract

OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients.
METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff. The baseline oral health status of the enrolled patients was poor and included edentulism, caries, gingivitis, periodontitis and residual roots. Dental treatment consisted of toothbrushing, tongue scraping, removal of calculus, scaling and root planing, caries restoration and tooth extraction.
RESULTS: The Oral Hygiene Index Simplified (OHI-S) and Gingival Index (GI) scores decreased in the experimental group but did not change significantly in the control group during the ICU stay. Dental treatment prevented most of the episodes of respiratory tract infections, as previously reported. No severe adverse events from the dental treatment were observed.
CONCLUSION: From an interprofessional perspective, our results support the idea of including dentists in the ICU team to improve oral health in critical patients and effectively prevent respiratory tract infections, in addition to the improvement achievable by applying chlorhexidine alone.
© 2018 FDI World Dental Federation.

Entities:  

Keywords:  Infection control; clinical trials; interprofessional practice; oral hygiene; prevention

Mesh:

Year:  2018        PMID: 29777534      PMCID: PMC9379064          DOI: 10.1111/idj.12397

Source DB:  PubMed          Journal:  Int Dent J        ISSN: 0020-6539            Impact factor:   2.607


  47 in total

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Authors:  Teresa Márcia Nascimento de Morais; Antonio da Silva; Ana Luiza Ribeiro de Oliveira Avi; Patrícia Helena Rodrigues de Souza; Elias Knobel; Luiz Fernando Aranha Camargo
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Review 2.  Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis.

Authors:  Ee Yuee Chan; Annie Ruest; Maureen O Meade; Deborah J Cook
Journal:  BMJ       Date:  2007-03-26

3.  Oral decontamination techniques and ventilator-associated pneumonia.

Authors:  Ranjitha Chacko; Amala Rajan; Prabha Lionel; M Thilagavathi; Bijesh Yadav; Jeyarani Premkumar
Journal:  Br J Nurs       Date:  2017-06-08

Review 4.  Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia.

Authors:  Fang Hua; Huixu Xie; Helen V Worthington; Susan Furness; Qi Zhang; Chunjie Li
Journal:  Cochrane Database Syst Rev       Date:  2016-10-25

Review 5.  Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis.

Authors:  Benedetta Allegranzi; Sepideh Bagheri Nejad; Christophe Combescure; Wilco Graafmans; Homa Attar; Liam Donaldson; Didier Pittet
Journal:  Lancet       Date:  2010-12-09       Impact factor: 79.321

6.  The impact of oral care on oral health status and prevention of ventilator-associated pneumonia in critically ill patients.

Authors:  Abdullah Haghighi; Vida Shafipour; Masoumeh Bagheri-Nesami; Afshin Gholipour Baradari; Jamshid Yazdani Charati
Journal:  Aust Crit Care       Date:  2016-08-04       Impact factor: 2.737

Review 7.  Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia.

Authors:  Zongdao Shi; Huixu Xie; Ping Wang; Qi Zhang; Yan Wu; E Chen; Linda Ng; Helen V Worthington; Ian Needleman; Susan Furness
Journal:  Cochrane Database Syst Rev       Date:  2013-08-13

Review 8.  Oral topical decontamination for preventing ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials.

Authors:  J Li; D Xie; A Li; J Yue
Journal:  J Hosp Infect       Date:  2013-07-08       Impact factor: 3.926

Review 9.  Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis.

Authors:  Michael Klompas; Kathleen Speck; Michael D Howell; Linda R Greene; Sean M Berenholtz
Journal:  JAMA Intern Med       Date:  2014-05       Impact factor: 21.873

10.  Consort 2010 statement: extension to cluster randomised trials.

Authors:  Marion K Campbell; Gilda Piaggio; Diana R Elbourne; Douglas G Altman
Journal:  BMJ       Date:  2012-09-04
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Journal:  Int J Environ Res Public Health       Date:  2022-05-19       Impact factor: 4.614

2.  Comparison of perceptions, attitudes and performance regarding collaborative oral health care among health-care workers.

Authors:  Satoru Haresaku; Hisae Aoki; Keiko Kubota; Mayumi Monji; Maki Miyoshi; Kimie Machishima; Fuyuko Nakashima; Toru Naito
Journal:  Int Dent J       Date:  2020-06-12       Impact factor: 2.607

3.  Oral mucositis as a pathway for fatal outcome among critically ill patients exposed to chlorhexidine: post hoc analysis of a randomized clinical trial.

Authors:  Wanessa Teixeira Bellissimo-Rodrigues; Mayra Gonçalves Menegueti; Leandro Dorigan de Macedo; Anibal Basile-Filho; Roberto Martinez; Fernando Bellissimo-Rodrigues
Journal:  Crit Care       Date:  2019-11-27       Impact factor: 9.097

  3 in total

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