Effects of combination oral care on oral health, dry mouth and salivary pH of intubated patients: A randomized controlled trial

Abstract

Intubated patients are at risk of oral health problems. Although a variety of oral care regimens for intubated patients have been studied, there is a lack of research on the effects of combination oral care that includes tooth brushing, chlorhexidine and cold water. This open-labelled, randomized, controlled trial aimed to evaluate the effects of combination oral care on oral health status. Participants aged 20 years and older were recruited on the first day after intubation through convenience sampling in a medical intensive care unit. Random assignment was performed using an internet randomization service. The primary outcome was oral health status. Data were collected during May and June 2013. Participants were randomized to one of two groups (23 intervention and 21 control). The final analysis included 18 patients with combination oral care and 17 in the control group. The intervention group had better oral health (effect size = 1.56), less dry mouth and higher salivary pH than the control group. Any additional burden of providing combination oral care to patients who are mechanically ventilated is worthwhile in terms of clinical outcomes.

Examination of intensive care unit patients' oral health

“…Although there are many oral care techniques and materials that have been developed for use with ICU patients in critical condition, the effectiveness of these is as yet unclear (Jang & Shin, ). A toothbrush was used in 5.9% of our patients and a gauze‐wrapped tongue depressor in 19.4%.…”

Effect of oral care program on prevention of ventilator-associated pneumonia in intensive care unit patients: A randomized controlled trial

“…It should be noted that intervention was planned based on previous studies and arranged as follows: adjusting the pressure of the cuff of the endotracheal tube between 20 and 25 mmHg using a special manometer; Elevating the head of the bed from 30° to 45°; deep mouth and throat suctioning; brushing all internal and external surfaces of the teeth, gums, and tongue for 2 min using a baby toothbrush and antimicrobial chlorhexidine 0.2%; moisturizing all surfaces of the oral mucosa, gums, and tongue of the patient using swabs and moisturizing gel containing aloe vera and peppermint essential oil; applying a thin layer of petroleum jelly to the lip; removing and cleaning any airway obstruction; and reinserting the tube in the patient's mouth. [ 2 3 21 22 23 ]…”

“…[ 16 ] Therefore, studies have recommended that further researches be conducted on oral care in patients in ICUs. [ 21 ] Therefore, the aim of this study was to evaluate the effect of an oral care program on the incidence of VAP in patients in ICUs.…”

The effects of Aloe vera-Peppermint (Veramin) moisturizing gel on mouth dryness and oral health among patients hospitalized in intensive care units: A triple-blind randomized placebo-controlled trial

“…Using the results of an earlier study[ 2 ] and with a Type II error of 0.05 and a power of 0.80, necessary number of patients for each study group was calculated to be 35. Given an attrition rate of 10%, 40 patients were recruited to each group.…”

“…P atients hospitalized in Intensive Care Units (ICUs) may develop mouth dryness[ 1 2 ] due to a wide range of factors. For example, transoral endotracheal or orogastric tubes not only cause the mouth to remain open and go dry but also make oral care difficult.…”