title: Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients.
abstract: BACKGROUND
  The presence of pathogens in dental plaque is a risk factor associated with postoperative pneumonia in esophageal cancer patients. The effectiveness of pre-operative dental brushing to decrease the risk of postoperative pneumonia in esophageal cancer patients was evaluated prospectively.
  
  
  METHODS
  A total of 86 thoracic esophageal cancer patients who underwent an esophagectomy were investigated. Patients were divided into 2 groups: the control group (41 patients) and the pre-operative dental brushing group (45 patients). The patients in the brushing group were assigned to brush their teeth 5 times a day. After the operation, the frequency of postoperative pneumonia and need for tracheostomy for pulmonary treatment was calculated.
  
  
  RESULTS
  Postoperative pneumonia was decreased markedly from 32% to 9% (P = .013), and the frequency of postoperative pneumonia requiring tracheostomy decreased from 12% to 0% in the dental brushing group, respectively. Limiting the patients who had positive pathogenic bacteria in their dental plaque on their admission, the frequency of postoperative pneumonia was decreased from 71% (5 of 7 patients) in the control group to 17% (2 of 12 patients) in the dental brushing group (P = .045).
  
  
  CONCLUSIONS
  Frequent pre-operative dental brushing is performed easily and seems to prevent postoperative pneumonia in esophageal cancer patients.
authors.affiliation: Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. yakutsu@faculty.chiba-u.jp
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Akutsu
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Toru
authors.initials: T
authors.lastname: Shiratori
authors.forename: Masaya
authors.initials: M
authors.lastname: Uesato
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Miyazawa
authors.forename: Isamu
authors.initials: I
authors.lastname: Hoshino
authors.forename: Kentaro
authors.initials: K
authors.lastname: Murakami
authors.forename: Akihiro
authors.initials: A
authors.lastname: Usui
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyauchi
mesh_terms: D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D001424:Bacterial Infections / Q000517:prevention & control; D003773:Dental Plaque / Q000150:complications / Q000382:microbiology / Q000517:prevention & control*; D004938:Esophageal Neoplasms / Q000601:surgery*; D006801:Humans; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D012307:Risk Factors; D013899:Thoracic Neoplasms / Q000601:surgery*; D014099:Toothbrushing / Q000379:methods*