Oral Care

The Facts about Oral Care

Reduce VAP with Oral Care
Ventilator associated pneumonia (VAP) causes prolonged intubation and a prolonged stay in ICU with the associated costs. It is also a serious cause of mortality in compromised patients.

A combination of oral care treatments (brushing and suctioning) in a proper oral care protocol means care providers can efficiently prevent oropharyngeal bacterial biofilm build-up. This in turn leads to a reduction of VAP and aspiration pneumonias and greatly reduces associated treatment costs ^{(1, 2, 3).}

VAP Fact 1: VAP occurs in 9-25% of all patients in ICU	VAP Fact 2: Each case of VAP costs the hospital $30,000-$40,000	VAP Fact 3: VAP mortality rate is approximately 10-40%


Dental plaque is a biofilm made up from bacteria and their excretions, sitting mainly at the gum line and between teeth.	The biofilm will develop freshly after each intervention and will cover the complete tooth surface in only two hours. The biofilm protects pathogenic bacteria such as MRSA and Klebsiella, which are common problems in many intensive care units. Biofilm must be broken up prior to the application of antibacterial agents.	From the oral cavity saliva, mucous and biofilm build-up move to the ET tube cuff and may be aspirated into the lungs, as the cuff seal will never be 100%. When aspirated into the lungs, these bacteria may cause VAP and require treatment with antibiotics.

References:
1. R. GARCIA, L. JENDRESKY, L. COLBERT, A. BAILEY, M. ZAMAN et M. MAJUMDER, Reducing Ventilator-Associated Pneumonia Through Advanced Oral-Dental Care: A 48-Month Study, AJCC, July 2009.
2. J. Rello, D. Ollendorf, G. Oster, M. Vera-Llonch, L. Bellm, R. Redman, M. Kollef: Epidemiology and outcomes of ventilator-associated-pneumonia in a large US database, Chest, December 2002.
3. L. Frampton: Preventig HCAI on the intensive care unit, The Clinal Services Journal, March 2014.

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