Effect of Oral Care Protocol on Dental and Gingival Plaque Index in Patients With Endotracheal Tube Admitted to the Intensive Care Unit
Oral Care Protocol in Patients with Endotracheal Tube
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Abstract
Oral health is one of the most critical aspects of nursing care in critically ill patients. The study aimed to investigate the effect of oral health protocol on dental and gingival plaque index in patients with endotracheal tubes admitted into the ICU. This double-blind clinical trial was conducted on 70 patients admitted into ICU randomly by tossing a coin, and 35 patients were assigned to each of the experimental and control groups. Oral care was performed in the experimental group using the chlorhexidine (CHX) solution, toothpaste, and oral moisturizer protocol; in the control group, according to the routine method, 0.2% CHX was used twice a day. The data were collected at the time of inclusion and four days later, using the MGI and the O'Leary dental plaque index. The mean ages in the experimental and control groups were 38.4±14.4 and 41±14.5 years, respectively. In the experimental and control groups, 77% and 83% of the subjects were male, respectively. After the intervention, the mean gingival index in the experimental and control groups was 0.59±0.31 and 0.90±0.41, and the plaque index was 42.53±15.97 and 53.52±11.9, respectively. The differences before and after the intervention in each group and the difference between the two groups in both gingival and dental plaque indices were statistically significant (P=0.0001). The results showed that the oral health protocol was more effective in improving gingival and dental plaque indices than the routine (CHX) method.
2. Robinson E. A comparative evaluation of the Scrub and Bass Methods of toothbrushing with flossing as an adjunct (in fifth and sixth graders). Am J Public Health 1976;66:1078-81.
3. Scannapieco FA, Ho AW. Potential associations between chronic respiratory disease and periodontal disease: analysis of National Health and Nutrition Examination Survey III. J Periodontol 2001;72:50-6.
4. Munro CL, Grap MJ. Oral health and care in the intensive care unit: state of the science. Am J Crit Care 2004;13:25-33.
5. Hutchins K, Karras G, Erwin J, Sullivan KL. Ventilator-associated pneumonia and oral care: a successful quality improvement project. Am J Infect Control 2009;37:590-7.
6. Clerehugh V, Tugnait A. Periodontal diseases in children and adolescents: I. Aetiology and diagnosis. Dent Update 2001;28:222-30, 232.
7. Oh TJ, Eber R, Wang HL. Periodontal diseases in the child and adolescent. J Clin Periodontol 2002;29:400-10.
8. Carranca F, Newman M. Clinical periodontology. 8 ed. Philadelphia: WB Saunders Co, 1996.
9. Suresh L, Neiders ME. Definitive and differential diagnosis of desquamative gingivitis through direct immunofluorescence studies. J Periodontol 2012;83:1270-8.
10. Labeau S, Blot S. Research priorities in oral care for endotracheally-intubated patients. Annual update in intensive care and emergency medicine 2011: Springer; Springers2011:144-55.
11. Marron A, Carratala J, Gonzalez-Barca E, Fernandez-Sevilla A, Alcaide F, Gudiol F. Serious complications of bacteremia caused by Viridans streptococci in neutropenic patients with cancer. Clin Infect Dis 2000;31:1126-30.
12. Johnstone L, Spence D, Koziol-McClain J. Oral hygiene care in the pediatric intensive care unit: practice recommendations. Pediatr Nurs 2010;36:85-96.
13. Ganz FD, Fink NF, Raanan O, Asher M, Bruttin M, Nun MB, et al. ICU Nurses’ Oral‐Care Practices and the Current Best Evidence. J Nurs Scholarsh 2009;41:132-8.
14. Feider LL, Mitchell P, Bridges E. Oral care practices for orally intubated critically ill adults. Am J Crit Care 2010;19:175-83.
15. Adib-Hajbaghery M, Ansari A, Azizi-Fini E. Oral care in ICU patients: a review of research evidence. Journal of Kashan Univ Med Sci (FEYZ) 2011;15:280-93.
16. Rezaei S, Rezaei K. Comparison the effect of Miswak/Aloe Vera & chlorhexidine mouthwashes on gingival index in intubated patients. CMJA 2015;5:1155-66.
17. Lobene R, Weatherford T, Ross N, Lamm R, Menaker L. A modified gingival index for use in clinical trials. Clin Prev Dent 1986;8:3-6.
18. Ames NJ, Sulima P, Yates JM, McCullagh L, Gollins SL, Soeken K, et al. Effects of systematic oral care in critically ill patients: a multicenter study. Am J Crit Care 2011;20:e103-14.
19. Abidia RF. Oral care in the intensive care unit: a review. J Contemp Dent Pract 2007;8:76-82.
20. Jafari S, Ranjbar H, Kamrani F, Alavi-Majd H, Yaghmaei F. Effects of chlorhexidine and normal saline on dental plaque formation in ICU patients: a comparative study. J Shahid Beheshti Sch Nurs Midwifery 2007;17:40-9.
21. Halm MA, Armola R. Effect of oral care on bacterial colonization and ventilator-associated pneumonia. Am J Crit Care 2009;18:275-8.
22. Bayat M, Nikoo K, Mohsen S, Afshar Hezarkhani F. Prevalence of systemic diseasesin patients with dental infections. J Dent Med 2012;25:283-9.
23. Corbet E, Holmgren C, Lim L, Davies W. Sex differences in the periodontal status of Hong Kong adults aged 35-44 years. Community Dent Health 1989;6:23-30.
24. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet 2005;366:1809-20.
25. Lo Russo L, Fierro G, Guiglia R, Compilato D, Testa NF, Lo Muzio L, et al. Epidemiology of desquamative gingivitis: evaluation of 125 patients and review of the literature. Int J Dermatol 2009;48:1049-52.
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| Issue | Vol 59, No 6 (2021) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v59i6.6893 | |
| Keywords | ||
| Dental plaque Gingivitis Oral health Protocol | ||
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