# Oral hygiene management in critically ill patients: prevention of ventilator-associated pneumonia

**Authors:** M. Martelli, A. Rosa, M. Miranda, R. Simone, M. Scarpati Cioffari di Castiglione, F. De Falco, M. Gargari, P. Bollero, F. Gianfreda

PMC · DOI: 10.3389/fdmed.2026.1748329 · Frontiers in Dental Medicine · 2026-02-19

## TL;DR

This paper reviews how managing oral hygiene in critically ill patients can help prevent ventilator-associated pneumonia and improve patient outcomes.

## Contribution

The study provides evidence that combining mechanical plaque removal with chlorhexidine is effective in reducing VAP.

## Key findings

- Combined mechanical plaque removal and chlorhexidine reduce VAP incidence.
- Standardized protocols and multidisciplinary approaches improve oral hygiene outcomes.
- Personalized interventions based on patient conditions are recommended to minimize risks.

## Abstract

Oral hygiene in critically ill patients in intensive care is essential for preventing infectious complications, particularly ventilator-associated pneumonia (VAP), which is one of the most severe and frequent complications in these units. The management of oral health can reduce bacterial load and the risk of respiratory infections.

This study analyzes oral hygiene management strategies in critically ill patients undergoing mechanical ventilation through a systematic literature review following the PRISMA-ScR method. Studies published from 2000 to 2023 were examined, focusing on the comparison between mechanical plaque removal interventions and the use of chlorhexidine against other measures.

The results highlight that the combined use of mechanical plaque removal and chlorhexidine significantly reduces the incidence of VAP and improves oral hygiene. The analysis of the evidence suggests that standardized protocols and a multidisciplinary approach, including collaboration with dental specialists, can optimize oral health in these critically ill patients.

The collected evidence underscores the importance of oral hygiene management not only to reduce the risk of VAP but also to improve the overall well-being of patients in intensive care. It is crucial to consider each patient's specific conditions, including comorbidities, to implement personalized interventions that minimize associated risks. Despite promising results, further investigation is needed regarding the optimization of oral hygiene techniques and the standardization of protocols to ensure uniformity in clinical practices.

The findings support the importance of adequate oral hygiene management in intensive care to reduce the risk of respiratory infections, emphasizing the need for continued research and the development of evidence-based practices that enhance clinical outcomes.

## Linked entities

- **Chemicals:** chlorhexidine (PubChem CID 9552079)

## Full-text entities

- **Diseases:** infectious (MESH:D003141), periodontal disease (MESH:D010510), peri-implantitis (MESH:D057873), bacterial (MESH:D001424), xerostomia (MESH:D014987), cough (MESH:D003371), Healthcare Associated Pneumoniae (MESH:D000077299), cardiovascular disease (MESH:D002318), infection (MESH:D007239), malnutrition (MESH:D044342), Deaths (MESH:D003643), caries (MESH:D003731), nosocomial infections (MESH:D003428), VAP (MESH:D053717), chronic obstructive pulmonary disease (MESH:D029424), pneumonia (MESH:D011014), oral lesions (MESH:D009059), renal failure (MESH:D051437), diabetes mellitus (MESH:D003920), respiratory complications (MESH:D012140), Pulmonary Infection (MESH:D012141), oral abscesses (MESH:D000038), inflammatory (MESH:D007249), Periodontitis (MESH:D010518), Critically ill (MESH:D016638)
- **Chemicals:** Povidone-Iodine (MESH:D011206), sodium bicarbonate (MESH:D017693), BOAG (-), Chlorhexidine (MESH:D002710), vitamin A + (MESH:D014801), NaCl (MESH:D012965)
- **Species:** Acinetobacter baumannii (species) [taxon 470], Homo sapiens (human, species) [taxon 9606], Candida [taxon 1535326], Staphylococcus aureus (species) [taxon 1280], Streptococcus pneumoniae (species) [taxon 1313], Klebsiella pneumoniae (species) [taxon 573], Pseudomonas aeruginosa (species) [taxon 287]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12960487/full.md

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12960487/full.md

## References

34 references — full list in the complete paper: https://tomesphere.com/paper/PMC12960487/full.md

---
Source: https://tomesphere.com/paper/PMC12960487