Toothbrushing for preventing ventilator-associated pneumonia: a live issue worth further investigation
Wan-Jie Gu, Graduate School of Guangxi Medical University, Nanning 530021, Guangxi,China
7 March 2013
Reply: We would like to thank Labeau and Blot for their letter and insightful comments.[1] For Critical ill patients with intubation, dental plaque and the oral mucosa can be colonized with potential pathogens associated with ventilator-associated pneumonia (VAP).[2] Observational studies demonstrated that oral care with toothbrushing improved oral hygiene and reduced plaque load.[3,4] Theoretically, toothbrushing may have favorable effect on the development of VAP. However, evidence on this topic still remains limited, which precludes final verdicts and strong clinical recommendations. Moreover, diagnosis is crucial for the prevention of VAP, but debate remains as to the optimal means of diagnosing VAP. In this case, further research on toothbrushing for VAP prevention is warranted. We believe that research on the field is worthwhile. Large rigorous multicenter trials will help clarify such a live issue, confirming or refuting our prelimary findings.
References
1. Labeau SO, Blot SI: Toothbrushing for preventing ventilator-associated pneumonia. Crit Care 2013, 17:417.
2. Scannapieco FA, Stewart EM, Mylotte JM: Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit Care Med 1992, 20:740-745.
3. Ames NJ: Evidence to support tooth brushing in critically ill patients. Am J Crit Care 2011, 20:242¿250.
4. Fitch JA, Munro CL, Glass CA, Pellegrini JM: Oral care in the adult intensive care unit. Am J Crit Care 1999, 8:314¿318.
Critical Care
Toothbrushing for preventing ventilator-associated pneumonia: a live issue worth further investigation
7 March 2013
Reply: We would like to thank Labeau and Blot for their letter and insightful comments.[1] For Critical ill patients with intubation, dental plaque and the oral mucosa can be colonized with potential pathogens associated with ventilator-associated pneumonia (VAP).[2] Observational studies demonstrated that oral care with toothbrushing improved oral hygiene and reduced plaque load.[3,4] Theoretically, toothbrushing may have favorable effect on the development of VAP. However, evidence on this topic still remains limited, which precludes final verdicts and strong clinical recommendations. Moreover, diagnosis is crucial for the prevention of VAP, but debate remains as to the optimal means of diagnosing VAP. In this case, further research on toothbrushing for VAP prevention is warranted. We believe that research on the field is worthwhile. Large rigorous multicenter trials will help clarify such a live issue, confirming or refuting our prelimary findings.
References
1. Labeau SO, Blot SI: Toothbrushing for preventing ventilator-associated pneumonia. Crit Care 2013, 17:417.
2. Scannapieco FA, Stewart EM, Mylotte JM: Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit Care Med 1992, 20:740-745.
3. Ames NJ: Evidence to support tooth brushing in critically ill patients. Am J Crit Care 2011, 20:242¿250.
4. Fitch JA, Munro CL, Glass CA, Pellegrini JM: Oral care in the adult intensive care unit. Am J Crit Care 1999, 8:314¿318.
Competing interests
I have no conflicts of interest to disclose.