Familiar Tool Can Put Some Teeth into the Fight to Prevent Hospital-acquired Pneumonia

December 15, 2008
Todd Kunkler

Tel Aviv University researchers recently announced that brushing the teeth of ventilated patients three times a day, even if the patients are unconscious, can significantly reduce the onset of pneumonia.

Tel Aviv University researchers recently announced that brushing the teeth of ventilated patients three times a day, even if the patients are unconscious, can significantly reduce the onset of pneumonia.

A news release from Tel Aviv University noted that “hospital-borne infections are a serious risk of a long-term hospital stay, and ventilator-associated pneumonia (VAP), a lung infection that develops in about 15% of all people who are ventilated, is among the most dangerous.” In fact, more than 26,000 US patients each year who require mechanical ventilation during their hospital stay develop a serious infection. Nurse Ofra Raanan, the chief researcher in the new study and a lecturer at Tel Aviv University’s Department of Nursing, said that "Patients who are intubated can be contaminated with pneumonia only 2 or 3 days after the tube is put in place. But pneumonia can be effectively prevented if the right measures are taken.”

One surprisingly effective measure for preventing pneumonia, according to Ranaan, other nurses from Sheba Academic School of Nursing at The Chaim Sheba Medical Center, and additional teams of nurses at major Israeli medical centers, is the simple toothbrush.

Although the nurse researchers said that it is difficult to quantify the effects (though their published research showed a direct correlation for intubated patients), they found that thrice-daily brushing reduce pneumonia incidence by up to 50%. “While the research shows a definite improvement in reducing the incidence of hospital-borne pneumonia, it’s hard to say by exactly how much toothbrushing prevents VAP,” said Raanan.

Other researchers have produced similar results. A study conducted by researchers from the Barnes-Jewish Hospital surgical and trauma intensive care unit in St. Louis, MO, found that “a strict regimen of brushing the teeth of ICU patients on breathing machines twice daily dramatically reduced the bacteria that can cause up to 300,000 cases of deadly pneumonia yearly.” In the study, nurses in the 24-bed unit found that they could cut the incidence of VAP almost in half by simply brushing patients’ teeth twice a day and applying mouthwash to the inside of the mouth. “The study clearly demonstrates the importance of regimented dental hygiene in reducing VAP in the ICU,” said Timothy Buchman, MD, chief of acute and critical care surgery at Washington University School of Medicine and Barnes-Jewish Hospital and co-author of the study.