title: Oral health promotion interventions on oral yeast in hospitalised and medically compromised patients: a systematic review.
abstract: Yeast are major aetiological agents of localised oral mucosal lesions, and are also leading causes of nosocomial bloodstream infections. The purpose of this systematic review was to examine the effectiveness of oral health promotion interventions on the prevalence and incidence of these opportunistic oral pathogens in hospitalised and medically compromised patients. The PubMed, ISI Web of Science and Cochrane Library databases were searched for clinical trials assessing the effect of oral health promotion interventions on oral yeast. Chlorhexidine delivered in a variety of oral hygiene products appeared to have some effect on oral yeast, although some studies found equivocal effects. Although a wide array of other compounds have also been investigated, their clinical effectiveness remains to be substantiated. Likewise, the utility of mechanical oral hygiene interventions and other oral health promotion measures such as topical application of salivary substitute, remains unsettled. Although many chemical agents contained in oral hygiene products have proven in vitro activity against oral yeast, their clinical effectiveness and potential role as adjuncts or alternative therapies to conventional treatment remains to be confirmed by further high-quality randomised controlled trials. This is pertinent, given the recent emergence of yeast resistance to conventional antifungal agents.
authors.affiliation: Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
authors.forename: Otto L T
authors.initials: OL
authors.lastname: Lam
authors.forename: H M H N
authors.initials: HM
authors.lastname: Bandara
authors.forename: Lakshman P
authors.initials: LP
authors.lastname: Samaranayake
authors.forename: Colman
authors.initials: C
authors.lastname: McGrath
authors.forename: Leonard S W
authors.initials: LS
authors.lastname: Li
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects* / Q000502:physiology; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D004202:Disinfectants / Q000008:administration & dosage / Q000627:therapeutic use; D025141:Drug Resistance, Fungal; D006293:Health Promotion; D006801:Humans; D007297:Inpatients; D009055:Mouth / Q000187:drug effects / Q000382:microbiology*; D009067:Mouthwashes / Q000008:administration & dosage / Q000627:therapeutic use; D009909:Oral Health; D009910:Oral Hygiene; D012464:Saliva, Artificial / Q000008:administration & dosage
chemical_list: D000935:Antifungal Agents; D004202:Disinfectants; D009067:Mouthwashes; D012464:Saliva, Artificial