The Comparison of Chlorhexidine Solution and Swab With Toothbrush and Toothpaste Effect on Preventing Oral Lesions in Hospitalized Patients in Intensive Care Unit

Abstract

Background:Maintaining of oral hygiene has been known as one of the basic tasks of nurses working at intensive care unit. This study aimed to compare the effectiveness of chlorhexidine solution with toothbrush in prevention of oral lesions or ulcers in the different parts of the mouth.Methods:In this clinical trial study, research Society included patients hospitalized with endotracheal tube since the arrival time in intensive care unit. In this study, 30 patients were selected with target-based approach and equally divided into two groups through the permutation blocking method for oral care toothbrush and toothpaste and using chlorhexidine and swab. The modified form of Beck Oral Assessment Scale (BOAS) and MPS were used to obtain needed information. Data were analyzed by means of R software (version 3.0.2) and also multiple logistic regressions in the confidence level of 95%.Results:This study indicated an association between using toothbrush and the oral health level (OR: 1.52). In different parts of the mouth, there was no difference between two groups in prevention of lesions in gums, lips and tongue while, this was significant in relation to plaque, mucus and teeth with an odd ratio of 3.94 for teeth and 2.75 for mucus. In comparison, there was an association between implying chlorhexidine and saliva health level. (OR: 2.046).Conclusion:This survey showed that using toothbrush has a noticeable impact on declining oral lesions in varied parts of the mouth.

Effects of a Comprehensive Oral Care Program and a Combined Toothbrush and Mouthwash Program with 0.2% Chlorhexidine on Oral Health in Mechanically Ventilated Intubated Patients: A Clinical Trial

“…The use of a baby toothbrush, which was also used in the present study, has benefits, such as easy and good access to intubated patients' oral cavity, which is almost closed, and also causes less damage and discomfort to be fragile and vulnerable tissues (25). Griffith et al recommended the use of a small soft toothbrush to remove plaque in patients admitted to ICUs because of the possibility of brushing the back of the mouth, as well as cleaning the tongue, gums, and teeth, as quoted by Estaji et al (7).…”

“…Alone compared to pharmacological methods. For example, Estaji et al (7) showed that using toothbrushes and chlorhexidine was effective in preventing oral lesions. However, they reported that using toothbrushes compared to chlorhexidine led to better improve-ment of the patient's oral health and had a significant effect on reducing oral lesions (7).…”

“…These changes cause bacteria to accumulate and proliferate opportunistic pathogens in the oral cavity, causing local and general complications such as stomatitis, tooth decay, peripheral tissue infection, and the subsequent systemic spread of infection, bacteremia, respiratory infections, such as pneumonia, and even infection of the joints and heart (6). Patients in ICUs are more prone to dental plaque and oral lesions due to immunosuppression, underlying diseases, endotracheal and gastric tubes, medication side effects, decreased fluid intake, lack of spontaneous tongue movements, and lack of swallowing (7).…”

Quantitative oral health assessments in mechanically ventilated patients: A scoping review

“…509 and 2673 further articles were removed based on the screening of titles and abstracts (Figure S1). 14 Fifty‐three full texts were screened, 41 were excluded (Table S3) 15‐55 and 12 studies were included in the final review. Study characteristics are noted in Table S4.…”

Prosedur Pencegahan Terjadinya entilator Associated neumonia (VAP) di Ruang Intensive Care Unit (ICU) : A Literature Review

“…Sejalan dengan penelitian De Lacerda Vidal et al (2017), mengatakan menggunakan toothbrushing dengan 0,12% gel Chlorhexidine gluconate memiliki insiden VAP yang lebih rendah dibanding kelompok control tetapi tidak signifikan. Estaji, et al (2016) mengatakan bahwa toothbrushing menjadi tindakan esensial dalam pelaksanaan oral care pada pasien intubasi. Menyikat gigi dilakukan pada gigi, gusi, palatum, serta lidah.…”