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Cited by 276Nosocomial Infections in ICUOral microbiology and periodontitis researchDental Health and Care Utilization

Oral health and care in the intensive care unit: state of the science

Munro, Cindy L., Grap, Mary Jo·2004·American Journal of Critical Care
DOI 10.4037/ajcc2004.13.1.25
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Abstract

Oral health is influenced by oral microbial flora, which are concentrated in dental plaque. Dental plaque provides a microhabitat for organisms and an opportunity for adherence of the organisms to either the tooth surface or other microorganisms. In critically ill patients, potential pathogens can be cultured from the oral cavity. These microorganisms in the mouth can translocate and colonize the lung, resulting in ventilator-associated pneumonia. The importance of oral care in the intensive care unit has been noted in the literature, but little research is available on mechanical or pharmacological approaches to reducing oral microbial flora via oral care in critically ill adults. Most research in oral care has been directed toward patients' comfort; the microbiological and physiological effects of tooth brushing in the intensive care unit have not been reported. Although 2 studies indicated reductions in rates of ventilator-associated pneumonia in cardiac surgery patients who received chlorhexidine before intubation and postoperatively, the effects of chlorhexidine in reducing ventilator-associated pneumonia in other populations of critically ill patients or its effect when treatment with the agent initiated after intubation have not been reported. In addition, no evaluation of the effectiveness of pharmacological and mechanical interventions relative to each other or in combination has been published. Additional studies are needed to develop and test best practices for oral care in critically ill patients.

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Crossref · 10.4037/ajcc2004.13.1.25

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  • The oropharynx in critical illness becomes overrun by potentially pathogenic bacteria, including prominent Proteobacteria such as P aeruginosa and K pneumoniae.

    “becomes overrun by potentially pathogenic bacteria, including prominent Proteobacteria, such as P aeruginosa and K pneumoniae.”

    From The microbiome and critical illness (2016) · cites this paper as [81]

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Authors
Munro, C. L., & Grap, M. J.
Affiliations
Virginia Commonwealth University (US)
ORCID
Venue
American Journal of Critical Care
Publisher
AACN Publishing
Published
2004-01-01
Volume
13
Issue
1
Pages
25-34
ISSN
  • 1062-3264 (ISSN-L)
  • 1937-710X
DOI
10.4037/ajcc2004.13.1.25
OpenAlex
W2141434923
Cited by
276
References
85
Citations by year
2026: 3 · 2025: 3 · 2024: 7 · 2023: 9 · 2022: 11 · 2021: 13 · 2020: 16 · 2019: 8 · 2018: 15 · 2017: 16 · 2016: 18 · 2015: 17 · 2014: 20 · 2013: 14 · 2012: 12
FWCI
10.86
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Nursing Research (R01NR07652, R01NR007652)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Keywords
oral care, intensive care unit, critically ill patients, oral microbiota, dental plaque, ventilator-associated pneumonia, chlorhexidine, toothbrushing, oral colonization, cardiac surgery patients
MeSH terms
Chlorhexidine, Critical Care, Dental Plaque, Disinfectants, Humans, Intensive Care Units, Mouth, Oral Health, Pneumonia, Respiration, Artificial, Toothbrushing

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