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

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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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Authors: Munro, C. L., & Grap, M. J.
Affiliations: Virginia Commonwealth University (US)
ORCID: Munro, Cindy L.
Grap, Mary Jo
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 › General Dentistry › 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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Oral Health and Care in the Intensive Care Unit: State of the Science

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