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• W2511821027 abstract "<h3>Introduction</h3> During critical illness, dental plaque may serve as a reservoir of respiratory pathogens. This study compared the effectiveness of toothbrushing with a small-headed toothbrush or a foam-headed swab in mechanically ventilated patients. <h3>Methods</h3> This was a randomised, assessor-blinded, split-mouth trial, performed at a single critical care unit. Adult, orally intubated patients with >20 teeth, where >24 hours of mechanical ventilation was expected were included. Teeth were cleaned 12-hourly using a foam swab or toothbrush (each randomly assigned to one side of the mouth). Cleaning efficacy was based on plaque scores, gingival index and microbial plaque counts. <h3>Results</h3> High initial plaque (mean=2.1 (SD 0.45)) and gingival (mean=2.0 (SD 0.54)) scores were recorded for 21 patients. A significant reduction compared with initial plaque index occurred using both toothbrushes (mean change=−1.26, 95% CI −1.57 to −0.95; p<0.001) and foam swabs (mean change=−1.28, 95% CI −1.54 to −1.01; p<0.001). There was significant reduction in gingival index over time using toothbrushes (mean change=−0.92; 95% CI −1.19 to −0.64; p<0.001) and foam swabs (mean change=−0.85; 95% CI −1.10 to −0.61; p<0.001). Differences between cleaning methods were not statistically significant (p=0.12 for change in gingival index; p=0.24 for change in plaque index). There was no significant change in bacterial dental plaque counts between toothbrushing (mean change 3.7×10⁴ colony-forming units (CFUs); minimum to maximum (−2.5×10¹⁰ CFUs, 8.7×10⁷ CFUs)) and foam swabs (mean change 9×10⁴ CFUs; minimum to maximum (−3.1×10¹⁰ CFUs, 3.0×10⁷ CFUs)). <h3>Conclusions</h3> Patients admitted to adult intensive care had poor oral health, which improved after brushing with a toothbrush or foam swab. Both interventions were equally effective at removing plaque and reducing gingival inflammation. <h3>Trial registration number</h3> NCT01154257; Pre-results." @default.
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• W2511821027 date "2016-10-01" @default.
• W2511821027 modified "2023-09-26" @default.
• W2511821027 title "Comparison of foam swabs and toothbrushes as oral hygiene interventions in mechanically ventilated patients: a randomised split mouth study" @default.
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• W2511821027 doi "https://doi.org/10.1136/bmjresp-2016-000150" @default.
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