Oral health treatment in patients due for surgery= much lower rates of postoperative pneumonia and shorter hospital stays

Article URL: http://plos.io/3JzmJ5G 

Oral care protocol

The institutional oral care protocol was implemented at least 2 weeks before surgery in patients with sufficient preoperative time, typically during outpatient visits prior to hospitalization. This protocol initially comprised a comprehensive oral evaluation, including dental radiography, periodontal tissue examination, oral hygiene assessment, and identification of potential sources of infection such as dental caries and periodontal disease. To achieve oral bacterial control, dental practitioners treat infected teeth; dental hygienists remove plaque and calculus using ultrasonic scalers and manual instruments; mechanical tooth surface cleaning with fluoride-containing paste; tongue coating removal; and ultrasonic denture cleaning.

Patients received detailed instructions on self-care practices. This instruction encompasses dental plaque and food debris removal from tooth surfaces and interdental areas through appropriate brushing techniques supplemented by auxiliary cleaning devices such as interdental brushes and dental floss. The patients were advised to clean their oral mucosa using tongue and sponge brushes, maintain dentures with specialized cleansing agents, and use chlorhexidine-containing mouthwash rinses.

In patients with insufficient preoperative time, a single session of mechanical tooth surface cleaning was performed. When required, custom mouthpieces were fabricated to prevent tooth displacement during endotracheal intubation. Patients who declined the oral care protocol underwent surgery without implementing these preventive measures.