Oral evaluation of children and adolescents in intensive care unit

Abstract

Introduction: Hospitalized children can present some complications if they do not present a correct oral care during hospitalization. Objective: This study aimed to perform an oral evaluation of children and adolescents hospitalized in an intensive care unit of a children's hospital at southern Brazil. Material and methods: 49 subjects were examined, aged from 0 to 17 years old, using the modified Oral Assessment Guide (OAGm). The lips, corner of the mouth, gums, oral mucosa, saliva, tongue, and teeth were examined. Each category was classified in a numeric scale from 1 to 3, where 1 means the better condition and 3 the worse. Results: The results showed alterations in the lips, tongue, oral biofilm, and saliva in most of the subjects. The OAGm value indicated a worse oral condition in older children. The OAGm values for children with teeth were higher than that for edentulous children, this difference was statistically significant (p<0.05). Conclusion: It could be concluded that children hospitalized in an intensive care unit show deficiency in oral health when assessed through OAGm.

Assessment of the Oral Health Status of Patients Admitted to Pediatric Intensive Care Units

“…The literature also suggests that, as age increases, oral health changes become more likely to occur in hospitalized patients. 7 This study found that the mean OAG scores of the patients ≥61 months or older were higher than those of the patients 60 months or younger, and their oral health status worsened accordingly. This finding is similar to that reported by Schunemann et al 7 The teeth are known as a host for dental plaques, which are also a favorable site for harmful pathogens.…”

“…A patient information form was prepared in line with the literature to assess the patients' descriptive characteristics. [2][3][4]7,19,20 The Oral Assessment Guide (OAG) was developed by Gibson et al 21 in 2006. Çiftcioğlu and Efe 22 evaluated and confirmed the validity and reliability of the Turkish version of the OAG.…”

“…In children admitted to pediatric intensive care units (PICUs), salivary production must be evaluated. 4,6,7 Dry mouth due to salivary deficiency is often recognized as an irritating symptom among intensive care unit (ICU) patients, alongside shortness of breath, fatigue, or pain. Ensuring proper oral hygiene helps increase the comfort level of patients admitted to PICUs.…”

“…8 In ICUs, inadequate oral hygiene leads to increased formation of dental plaques and accumulation of pathogenic microorganisms in the oropharynx, resulting in nosocomial infection. 7,[9][10][11] Ventilator-associated pneumonia is the second most common nosocomial infection and complication in children and adults. 9 Among ICU patients, 70% of the microorganisms present are located in dental biofilms, and 63.33% are located on the tongue.…”

“…The rate of dental plaque formation in hospitalized children is 67.7% from the third day and reaches 100% from the fifth day. 7 Oral care is among the nursing interventions frequently performed in PICUs, 10 but it receives lower priority. 12 Oral care is one of the basic nursing practices for maintaining patients' nutrition, preventing oral infections, and increasing comfort.…”